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From flab to fab: A cross-sectional study for cultural adaptation and validation of the Fat Phobia Scale-Short Form
Kumari Rina1, Rosali Bhoi1, Anubhav Vindal2
1Department of Psychiatry, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, Maulana Azad Medical College (University of Delhi) and Associated Lok Nayak Hospital, New Delhi, India.
Background:
Due to the lack of a validated instrument to measure fatphobia, its epidemiology in India remains unknown. This study aimed to culturally adapt and validate the Fat Phobia Scale-Short Form (FPS-SF) in Hindi.
Patients And Methods:
A cross-sectional study using a purposive sampling technique was conducted in the metabolic surgery clinic of a tertiary care teaching institution. We followed the World Health Organization's procedure for cultural adaptation and validation of an instrument. The study was biphasic. The phase-1 entailed forward translation, formation of an expert panel, backward translation and cognitive interviewing with the two groups of seven individuals, each with severe obesity. During phase-2, 175 participants (students [n = 120], patients [n = 55]) were recruited after written informed consent. Hindi-FPS-SF was administered to students twice, 1 week apart. All participants completed Hindi-FPS-SF, Modified Weight Bias Internalization Scale (Hindi-WBIS-M), Patient Health Questionnaire (Hindi-PHQ-9) and Generalised Anxiety Disorder Questionnaire (Hindi-GAD-7). Statistical analysis was done.
Results:
Several items of forward-translated Hindi-FPS-SF underwent culture-specific modifications in Phase-1. Content or curricular validity and face validity were assessed. In Phase-2, the reliability and validity of Hindi-FPS-SF were evaluated. The internal consistency (Cronbach's alpha), intra-class correlation type-A coefficient (ICC) and cross-cultural reliability were α =0.902 (P < 0.001), 0.799 (95% CI = 0.753-0.840) (P < 0.001) and (ICC: 0.865-0.992) (P < 0.001), respectively. The convergent-construct validity assessed by correlations between total scores of Hindi-WBIS-M and Hindi-FPS-SF was significant. Criterion validity measured through correlations with original FPS-SF, Hindi-WBIS-M, PHQ-9 and GAD-7 was significant.
Conclusions:
The Hindi-FPS-SF demonstrated good psychometric properties and may be used to measure fat phobia and its correlates in India for epidemiological purposes.
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