Escala de Estigma de Cortesia entre Familiares de Usuários de Drogas (ECOFAD)

Abstract

The Escala de Estigma de Cortesia entre Familiares de Usuários de Drogas (ECOFAD), also known as the Courtesy Stigma among Family Members of Drug Users Scale, was developed to comprehend and evaluate the psychological and social repercussions associated with courtesy stigma experienced by the family members of individuals who use drugs. This instrument specifically assesses the detrimental effects that this form of stigma inflicts upon these individuals. The development process began with the creation of an initial pool of items derived from a comprehensive literature review. These items, originally available only in English, were translated into Portuguese and subsequently adapted to reflect the specific context of family members of individuals who use alcohol and other drugs. The research team also contributed additional items to ensure the construct was covered as comprehensively as possible. This resulted in a total of 38 items, which were categorized into one of three dimensions: cognitive, affective, and behavioral. To ensure content validity, the scale was reviewed by a panel of experts, including psychologists and specialists in the fields of stigma, alcohol and other drugs, family psychotherapy, and psychometry. The measure was then validated using a sample of family members of drug users who were participants in mutual help groups. The validation process yielded results concerning the scale’s reliability, validity, and factor structure.

Keywords

Affective; Behavioral; Cognitive; Courtesy Stigma; Drug Users; Family Members; Family Relations; Stigma; Substance Use and Addiction Measures; Substance Use Disorder; Family and Parenting Measures; Addiction (Attitudes Toward)

Authors

Maldonado, Daniel Augusto Costa; Martins, Leonardo Fernandes; da Silveira, Pollyanna Santos; Ronzani, Telmo Mota

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Purpose

This scale is designed to evaluate the presence and extent of courtesy stigma among family members of individuals who use drugs within the Brazilian cultural context.

Construct

Courtesy Stigma; Drug Use

Validity

The scale’s content validity was rigorously assessed. The Content Validity Coefficients (CVC) for the items across the dimensions were 0.78 for writing, 0.82 for clarity, and 0.87 for relevance. The writing category’s coefficient was slightly below the expected threshold, a result attributed to the numerous rewriting suggestions provided by the expert judges. Despite some items being altered, approximately 82% of them achieved a CVC above 0.7 for writing quality. For clarity, 89.5% of items met this standard, and regarding pertinence to their respective dimensions, nearly all items (97.4%) had a coefficient exceeding 0.7. Based on these strong results, the decision was made to retain all 38 items of the ECOFAD for the pilot study involving family members of drug users.

Reliability

The scale demonstrates strong reliability. For internal consistency, the three dimensions all produced Cronbach’s alpha coefficients above 0.8, with the Affective dimension at 0.89, the Cognitive dimension at 0.88, and the Behavioral dimension at 0.82. The overall Cronbach’s alpha for the entire scale was 0.94. In terms of split-half reliability, the Spearman-Brown correlation coefficient was 0.95. The corrected total item correlation coefficients were all above the criterion value of 0.30, with the only exceptions being items 15 and 25.

Factor Analysis

An Exploratory Factor Analysis was conducted, with a parallel analysis indicating that a three-factor structure was the most representative for the data, accounting for 48.7% of the total explained variance. All items within the affective dimension and the majority from the behavioral dimension exhibited high factorial loads and commonalities. Within the cognitive dimension, only items 15, 18, 19, 24, and 25 displayed low values in comparison to the other items on the scale. The instrument’s adjustment indices were found to be adequate (x2 =651.457, gl =592, p =0.04528, RMSEA=0.034, CFI=0.993 and TLI=0.992). The measure of replicability for the factorial structure, the H-index, yielded values of 1.017 for the Affective factor, 1.000 for the Cognitive factor, and 0.941 for the Behavioral factor.

Instrument

Test Type: This is an Original inventory/questionnaire.
Format: The test is administered in an Electronic format.
Language Available: The test is available in Portuguese.
Population Group: The intended population includes human subjects, both male and female, who are family members of drug users.
Age Group: The scale is designed for adults aged 18 and older, with the validation sample including individuals in Adulthood (18 yrs & older), Thirties (30-39 yrs), Middle Age (40-64 yrs), and Aged (65 yrs & older). The specific age range of the validation sample was 32-78 years.
Population Details: The study was conducted in Brazil with respondents who were family members of individuals who use drugs.
Test Methodology: The development and validation involved assessments of Test Validity, Content Validity, Test Reliability, Internal Consistency, Split-Half Reliability, Factor Analysis, and Exploratory Factor Analysis.

Keywords

Affective; Behavioral; Cognitive; Courtesy Stigma; Drug Users; Family Members

Authors

Maldonado, Daniel Augusto Costa

• Author ORCID Identifier: No data is Available

• Affiliation: Universidade Federal de Juiz de Fora (UFJF)

• Email addresses: No data is Available

Martins, Leonardo Fernandes

• Author ORCID Identifier: No data is Available

• Affiliation: Pontifícia Universidade Católica do Rio de Janeiro

• Email addresses: No data is Available

da Silveira, Pollyanna Santos

• Author ORCID Identifier: No data is Available

• Affiliation: Universidade Católica de Petrópolis

• Email addresses: No data is Available

Ronzani, Telmo Mota

• Author ORCID Identifier: No data is Available

• Affiliation: Universidade Federal de Juiz de Fora

• Email addresses: [email protected]

• Correspondence Address: Universidade Federal de Juiz de Fora, Instituto de Ciências Humanas, Departamento de Psicologia, Campus Universitário, Bairro Martelos, Juiz de Fora, Minas Gerais, Brazil, 36036-900

Permissions & Fee and Test Year

To use this scale, please contact the corresponding author, Telmo Mota Ronzani. The instrument is not commercial and there is no fee for its use. The test was developed in the year 2023.

Reference’s

Maldonado, D. A. C., Martins, L. F., da Silveira, P. S., & Ronzani, T. M. (2023). Escala de Estigma de Cortesia entre Familiares de Usuários de Drogas (ECOFAD) [Construction of the Courtesy Stigma among Family Members of Drug Users Scale (ECOFAD)]. Avaliação Psicológica, 22(1), 92–102. https://doi.org/10.15689/ap.2023.2201.25055.10

Items of the Courtesy Stigma among Family Members of Drug Users Scale

This measure is composed of 38 items. The items themselves are not available in this record but can be found in the source publication cited above, specifically in Table 3 on pages 97-98. The scale is structured into three distinct dimensions: Affective, Cognitive, and Behavioral.