Exploring the psychometric validity and reliability of the Stillbirth Stigma Scale

Background: In 2011 and 2016, the Lancet Stillbirth Series released a call for action to identify mechanisms which could lead to a reduction in stillbirth stigma. Despite this repeated call, stillbirth stigma remains a relatively unexplored area. This research is answering that call by providing further psychometric assessment on the recently developed 20-item Stillbirth Stigma Scale. Methods: Bereaved parents (n=1015) from high-income countries (Australia, United States of America (USA), United Kingdom (UK), New Zealand and Canada) who have endured a stillbirth were surveyed. A confirmatory factor analysis was undertaken, to confirm the factor structure. Reliability analysis and convergent validity were conducted to further determine the reliability and validity of the scale. Ethics: This study was approved on 5 December 2016 by the University of South Australia Human Research Ethics Committee, protocol number 0000036017. Results: Based on the initial findings of the exploratory factor analysis, 20 items contained within four factors (Perceived Devaluation, Discrimination, Self-stigma and Disclosure) were entered into the confirmatory factor analysis. Results supported a four-factor structure of the Stillbirth Stigma Scale and goodness of fit measurements were satisfactory. Internal consistencies of each sub-scale, and the total scale were good (α =.89). Convergent validity was also established with other related measures (Rosenberg Self-esteem Scale). Conclusion: Analysis suggests the Stillbirth Stigma Scale is a theoretical and statistically sound scale, which can be used within health promotion and clinical settings to identify bereaved parents at risk of experiencing higher levels of stillbirth stigma.