BACKGROUND Stigma related to abortion and contraceptive use is a serious public health threat for young people, and validated scales to measure this stigma are scarce. The purposes of the study were to validate a newly constructed scale to measure the stigma of contraceptive use and to adapt a scale to measure the stigma of abortion. METHODS A study nested in a cluster-randomised trial. In 2017, data was collected from 633 secondary school youths, in a semi-urban setting in western Kenya. A qualitative pre-phase (face-validity) were initially utilised to draft and validate a seven-item scale to capture contraceptive use stigma (CUS) and to adapt the Stigmatizing Attitudes, Beliefs and Actions (SABA) scale (18 items), which captures aspects of abortion stigma. Statistical tests used included test-retest reliability analysis, Pearson's correlation coefficients, Wilcoxon signed-rank test, Factor Analysis, Principal Component Analysis, interclass correlation and Cronbach's alpha. RESULTS For the CUS scale, paired t-test and Wilcoxon signed-rank test showed no significant score changed between time points (p = 0.64; 0.67). CUS had similar patterns between time points, with two relevant components: promiscuity and lack of autonomy. Cronbach's alpha indicated acceptable internal consistency between time points (0.71;0.7). The confirmatory factor loadings for each item in the modified three subscales of SABA had a similar pattern to the original SABA scale, in particularly regarding negative stereotyping and, excluding and discriminating factors. The Cronbach's alpha was adequate, although lower for the modified SABA (0.74) as compared to the original SABA (0.9). The SABA scale was renamed into Adolescents Stigmatizing Attitudes, Beliefs and Action (ASABA) scale. CONCLUSIONS The CUS scale is considered valid and reliable for measuring contraceptive use stigma, and the ASABA scale was rated as reliable for capturing abortion stigma based on negative stereotyping and excluding and discriminating factors. The CUS, up to date the first ever proposed CUS scale, and the ASABA scale can be used to measure effects of stigma reduction interventions with the aim of preventing unintended pregnancies, motherhood and unsafe abortion among adolescents in Kenya and similar low-resource settings.

中文翻译：

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肯尼亚与避孕药具使用和堕胎有关的污名化：量表的制定和验证。

背景技术与堕胎和使用避孕药有关的污名是对年轻人的严重公共卫生威胁，并且用于测量该污名的有效量表是稀缺的。该研究的目的是验证一种新的量表，以衡量使用避孕药具的耻辱感，并调整一个量表，以衡量流产的耻辱感。方法一项研究嵌套在整群随机试验中。2017年，在肯尼亚西部半城市环境下，从633名中学青年中收集了数据。最初使用定性前期（面部验证）来起草并验证一个七个项目的量表，以捕获避孕药具使用的耻辱感（CUS）并适应“耻辱态度，信念和行动”（SABA）量表（18个项目），该量表记录堕胎污名的各个方面。使用的统计测试包括重测可靠性分析，Pearson' 相关系数，Wilcoxon符号秩检验，因子分析，主成分分析，类间相关和Cronbach's alpha。结果对于CUS量表，配对t检验和Wilcoxon符号秩检验未显示时间点之间的显着得分变化（p = 0.64; 0.67）。CUS在时间点之间具有相似的模式，具有两个相关的组成部分：滥交和缺乏自治。Cronbach的alpha表示时间点之间的可接受的内部一致性（0.71; 0.7）。修改后的SABA的三个子量表中每个项目的确认性因素负荷与原始SABA量表具有相似的模式，特别是在负面定型观念以及排除和区分因素方面。尽管修改后的SABA（0.74）比原始SABA（0.9）低，但Cronbach's alpha足够。SABA量表已重命名为“青少年歧视态度，信念和行动”量表（ASABA）。结论CUS量表被认为是有效的和可靠的，可用于衡量避孕药具的耻辱感，而ASABA量表被认为是可靠的，基于负面的刻板印象以及排除和歧视因素，可以捕获流产的耻辱感。CUS是迄今为止首次提出的CUS量表，而ASABA量表可用于衡量减少耻辱感干预措施的效果，目的是防止肯尼亚和类似的资源贫乏地区的青少年意外怀孕，母亲和不安全堕胎。根据不良定型观念以及排除和区分因素，ASAB量表被认为可可靠地捕获流产的耻辱感。CUS是迄今为止首次提出的CUS量表，而ASABA量表可用于衡量减少耻辱感干预措施的效果，目的是防止肯尼亚和类似的资源贫乏地区的青少年意外怀孕，母亲和不安全堕胎。根据不良定型观念以及排除和区分因素，ASAB量表被认为可可靠地捕获流产的耻辱感。CUS是迄今为止首次提出的CUS量表，而ASABA量表可用于衡量减少耻辱感干预措施的效果，目的是防止肯尼亚和类似的资源贫乏地区的青少年意外怀孕，母亲和不安全堕胎。