Skip to main content
Top
Published in: BMC Psychiatry 1/2014

Open Access 01-12-2014 | Research article

Opening Minds Stigma Scale for Health Care Providers (OMS-HC): Examination of psychometric properties and responsiveness

Authors: Geeta Modgill, Scott B Patten, Stephanie Knaak, Aliya Kassam, Andrew CH Szeto

Published in: BMC Psychiatry | Issue 1/2014

Login to get access

Abstract

Background

Diminishing stigmatization for those with mental illnesses by health care providers (HCPs) is becoming a priority for programming and policy, as well as research. In order to be successful, we must accurately measure stigmatizing attitudes and behaviours among HCPs. The Opening Minds Stigma Scale for Health Care Providers (OMS-HC) was developed to measure stigma in HCP populations. In this study we revisit the factor structure and the responsiveness of the OMS-HC in a larger, more representative sample of HCPs that are more likely to be targets for anti-stigma interventions.

Methods

Baseline data were collected from HCPs (n = 1,523) during 12 different anti-stigma interventions across Canada. The majority of HCPs were women (77.4%) and were either physicians (MDs) (41.5%), nurses (17.0%), medical students (13.4%), or students in allied health programs (14.0%). Exploratory factor analysis (EFA) was conducted using complete pre-test (n = 1,305) survey data and responsiveness to change analyses was examined with pre and post matched data (n = 803). The internal consistency of the OMS-HC scale and subscales was evaluated using the Cronbach’s alpha coefficient. The scale’s sensitivity to change was examined using paired t-tests, effect sizes (Cohen’s d), and standardized response means (SRM).

Results

The EFA favored a 3-factor structure which accounted for 45.3% of the variance using 15 of 20 items. The overall internal consistency for the 15-item scale (α = 0.79) and three subscales (α = 0.67 to 0.68) was acceptable. Subgroup analysis showed the internal consistency was satisfactory across HCP groups including physicians and nurses (α = 0.66 to 0.78). Evidence for the scale’s responsiveness to change occurred across multiple samples, including student-targeted interventions and workshops for practicing HCPs. The Social Distance subscale had the weakest level of responsiveness (SRM ≤ 0.50) whereas the more attitudinal-based items comprising the Attitude (SRM ≤ 0.91) and Disclosure and Help-seeking (SRM ≤ 0.68) subscales had stronger responsiveness.

Conclusions

The OMS-HC has shown to have acceptable internal consistency and has been successful in detecting positive changes in various anti-stigma interventions. Our results support the use of a 15-item scale, with the calculation of three sub scores for Attitude, Disclosure and Help-seeking, and Social Distance.
Appendix
Available only for authorised users
Literature
1.
go back to reference Link B, Phelan J: Conceptualizing stigma. Annu Rev Sociol. 2001, 27: 363-385. 10.1146/annurev.soc.27.1.363.CrossRef Link B, Phelan J: Conceptualizing stigma. Annu Rev Sociol. 2001, 27: 363-385. 10.1146/annurev.soc.27.1.363.CrossRef
2.
go back to reference Corrigan PW, Salzer M, Ralph RO, Sangster Y, Keck L: Examining the factor structure of the recovery assessment scale. Schizophr Bull. 2004, 30: 1035-1041. 10.1093/oxfordjournals.schbul.a007118.CrossRefPubMed Corrigan PW, Salzer M, Ralph RO, Sangster Y, Keck L: Examining the factor structure of the recovery assessment scale. Schizophr Bull. 2004, 30: 1035-1041. 10.1093/oxfordjournals.schbul.a007118.CrossRefPubMed
3.
go back to reference Link B, Cullen F, Frank J, Wozniak J: The social rejection of former mental patients: understanding why labels matter. Am J Sociol. 1987, 92: 1461-1500. 10.1086/228672.CrossRef Link B, Cullen F, Frank J, Wozniak J: The social rejection of former mental patients: understanding why labels matter. Am J Sociol. 1987, 92: 1461-1500. 10.1086/228672.CrossRef
4.
go back to reference Link BG, Cullen FT: Contact with the mentally ill and perceptions of how dangerous they are. J Health Soc Behav. 1986, 27: 289-302. 10.2307/2136945.CrossRefPubMed Link BG, Cullen FT: Contact with the mentally ill and perceptions of how dangerous they are. J Health Soc Behav. 1986, 27: 289-302. 10.2307/2136945.CrossRefPubMed
5.
go back to reference Corrigan P, Markowitz FE, Watson A, Rowan D, Kubiak MA: An attribution model of public discrimination towards persons with mental illness. J Health Soc Behav. 2003, 44: 162-179. 10.2307/1519806.CrossRefPubMed Corrigan P, Markowitz FE, Watson A, Rowan D, Kubiak MA: An attribution model of public discrimination towards persons with mental illness. J Health Soc Behav. 2003, 44: 162-179. 10.2307/1519806.CrossRefPubMed
6.
go back to reference Corrigan PW, Watson AC: The paradox of self-stigma and mental illness. Clin Psychol Sci Pract. 2002, 9: 35-53. 10.1093/clipsy.9.1.35.CrossRef Corrigan PW, Watson AC: The paradox of self-stigma and mental illness. Clin Psychol Sci Pract. 2002, 9: 35-53. 10.1093/clipsy.9.1.35.CrossRef
7.
go back to reference Bentz W, Hollister W, Kherlopian M: Attitudes of social distance and social responsibility for mental illness: a comparison of teachers and the general public. Psychol Sch. 1970, 7: 198-203. 10.1002/1520-6807(197004)7:2<198::AID-PITS2310070218>3.0.CO;2-D.CrossRef Bentz W, Hollister W, Kherlopian M: Attitudes of social distance and social responsibility for mental illness: a comparison of teachers and the general public. Psychol Sch. 1970, 7: 198-203. 10.1002/1520-6807(197004)7:2<198::AID-PITS2310070218>3.0.CO;2-D.CrossRef
8.
go back to reference Szeto AH, Luong D, Dobson K: Does labeling matter? An examination of attitudes and perceptions of labels for mental disorders. Soc Psychiatry Psychiatr Epidemiol. 2013, 48: 659-671. 10.1007/s00127-012-0532-7.CrossRefPubMed Szeto AH, Luong D, Dobson K: Does labeling matter? An examination of attitudes and perceptions of labels for mental disorders. Soc Psychiatry Psychiatr Epidemiol. 2013, 48: 659-671. 10.1007/s00127-012-0532-7.CrossRefPubMed
9.
go back to reference Mueser KT: Illness management and recovery: a review of the research. Psychiatr Serv. 2002, 53: 1272-1284. 10.1176/appi.ps.53.10.1272.CrossRefPubMed Mueser KT: Illness management and recovery: a review of the research. Psychiatr Serv. 2002, 53: 1272-1284. 10.1176/appi.ps.53.10.1272.CrossRefPubMed
10.
go back to reference Angermeyer M: Emotional reactions to people with mental illness. Epidemiol Psichiatr Soc. 2010, 19: 26-32.PubMed Angermeyer M: Emotional reactions to people with mental illness. Epidemiol Psichiatr Soc. 2010, 19: 26-32.PubMed
11.
12.
go back to reference Smith M: Stigma. Adv Psychiatr Treat. 2002, 8: 317-325. 10.1192/apt.8.5.317.CrossRef Smith M: Stigma. Adv Psychiatr Treat. 2002, 8: 317-325. 10.1192/apt.8.5.317.CrossRef
13.
go back to reference Corrigan P: The impact of stigma on severe mental illness. Cogn Behav Pract. 1999, 5: 201-222.CrossRef Corrigan P: The impact of stigma on severe mental illness. Cogn Behav Pract. 1999, 5: 201-222.CrossRef
14.
go back to reference Oliver M, Pearson N: Help-seeking behaviour in men and women with common mental health problems: cross-sectional study. Br J Psychiatry. 2005, 186: 297-301. 10.1192/bjp.186.4.297.CrossRefPubMed Oliver M, Pearson N: Help-seeking behaviour in men and women with common mental health problems: cross-sectional study. Br J Psychiatry. 2005, 186: 297-301. 10.1192/bjp.186.4.297.CrossRefPubMed
15.
go back to reference Thornicroft G: Stigma and discrimination limit access to mental health care. Epidemiol Psichiatr Soc. 2008, 17: 14-19. 10.1017/S1121189X00002621.CrossRefPubMed Thornicroft G: Stigma and discrimination limit access to mental health care. Epidemiol Psichiatr Soc. 2008, 17: 14-19. 10.1017/S1121189X00002621.CrossRefPubMed
16.
go back to reference Kassam A, Papish A, Modgill G, Patten S: The development and psychometric properties of a new scale to measure mental illness related stigma by health care providers: the Opening Minds Scale for Health Care Providers (OMS-HC). BMC Psychiatry. 2012, 12: 62-10.1186/1471-244X-12-62.CrossRefPubMedPubMedCentral Kassam A, Papish A, Modgill G, Patten S: The development and psychometric properties of a new scale to measure mental illness related stigma by health care providers: the Opening Minds Scale for Health Care Providers (OMS-HC). BMC Psychiatry. 2012, 12: 62-10.1186/1471-244X-12-62.CrossRefPubMedPubMedCentral
17.
go back to reference Corrigan PW, Edwards AB, Green A, Diwan SL, Penn DL: Prejudice, social distance, and familiarity with mental illness. Schizophr Bull. 2001, 27: 219-225. 10.1093/oxfordjournals.schbul.a006868.CrossRefPubMed Corrigan PW, Edwards AB, Green A, Diwan SL, Penn DL: Prejudice, social distance, and familiarity with mental illness. Schizophr Bull. 2001, 27: 219-225. 10.1093/oxfordjournals.schbul.a006868.CrossRefPubMed
20.
go back to reference Kline P: An Easy Guide to Factor Analysis. 1994, London; New York: Routledge Kline P: An Easy Guide to Factor Analysis. 1994, London; New York: Routledge
21.
go back to reference StataCorp: Stata Statistical Software. 2011 StataCorp: Stata Statistical Software. 2011
22.
go back to reference Cattell R: The scree test for the number of factors. Multivariate Behav Res. 1966, 1: 245-276. 10.1207/s15327906mbr0102_10.CrossRefPubMed Cattell R: The scree test for the number of factors. Multivariate Behav Res. 1966, 1: 245-276. 10.1207/s15327906mbr0102_10.CrossRefPubMed
23.
go back to reference Horn J: A rationale and test for the number of factors in factor analysis. Psychometrika. 1965, 30: 179-185. 10.1007/BF02289447.CrossRefPubMed Horn J: A rationale and test for the number of factors in factor analysis. Psychometrika. 1965, 30: 179-185. 10.1007/BF02289447.CrossRefPubMed
24.
go back to reference Longman RS, Cota AA, Holden RR, Fekken GC: A regression equation for the parallel analysis criterion in principal components analysis: mean and 95th percentile eigenvalues. Multivariate Behav Res. 1989, 24: 59-69. 10.1207/s15327906mbr2401_4.CrossRefPubMed Longman RS, Cota AA, Holden RR, Fekken GC: A regression equation for the parallel analysis criterion in principal components analysis: mean and 95th percentile eigenvalues. Multivariate Behav Res. 1989, 24: 59-69. 10.1207/s15327906mbr2401_4.CrossRefPubMed
25.
go back to reference Dinno A: Implementing Horn’s parallel analysis for principal component analysis and factor analysis. Stata J. 2009, 9: 291-298. Dinno A: Implementing Horn’s parallel analysis for principal component analysis and factor analysis. Stata J. 2009, 9: 291-298.
26.
go back to reference Kim J-O, Mueller CW: Factor analysis: statistical methods and practical issues. Sage Univ Pap Ser Quant Appl Soc Sci. 1978, Beverly Hills, CA: SAGE Publications, 14: 07-014. Kim J-O, Mueller CW: Factor analysis: statistical methods and practical issues. Sage Univ Pap Ser Quant Appl Soc Sci. 1978, Beverly Hills, CA: SAGE Publications, 14: 07-014.
27.
go back to reference Tabachnick BG, Fidell LS: Using Multivariate Statistics. 1989, Cambridge, England; Philadelphia: Harper & Row Tabachnick BG, Fidell LS: Using Multivariate Statistics. 1989, Cambridge, England; Philadelphia: Harper & Row
28.
go back to reference Guyatt G, Deyo R, Charlson M: Responsiveness and validity in health status measurement: a clarification. J Clin Epidemiol. 1989, 42: 403-408. 10.1016/0895-4356(89)90128-5.CrossRefPubMed Guyatt G, Deyo R, Charlson M: Responsiveness and validity in health status measurement: a clarification. J Clin Epidemiol. 1989, 42: 403-408. 10.1016/0895-4356(89)90128-5.CrossRefPubMed
29.
go back to reference Husted JA, Cook RJ, Farewell VT, Gladman DD: Methods for assessing responsiveness: a critical review and recommendations. J Clin Epidemiol. 2000, 53: 459-468. 10.1016/S0895-4356(99)00206-1.CrossRefPubMed Husted JA, Cook RJ, Farewell VT, Gladman DD: Methods for assessing responsiveness: a critical review and recommendations. J Clin Epidemiol. 2000, 53: 459-468. 10.1016/S0895-4356(99)00206-1.CrossRefPubMed
30.
go back to reference Kazis L, Anderson J, Meenan R: Effect sizes for interpreting changes in health status. Med Care. 1989, 27 (3 Suppl): S178-S189.CrossRefPubMed Kazis L, Anderson J, Meenan R: Effect sizes for interpreting changes in health status. Med Care. 1989, 27 (3 Suppl): S178-S189.CrossRefPubMed
31.
go back to reference Fitzpatrick R, Davey C, Buxton M, Jones D: Evaluating patient-based outcome measures for use in clinical trials. Health Technol Assess (Rockv). 1998, 2: 14- Fitzpatrick R, Davey C, Buxton M, Jones D: Evaluating patient-based outcome measures for use in clinical trials. Health Technol Assess (Rockv). 1998, 2: 14-
32.
go back to reference Cohen J: Statistical power analysis for the behavioral sciences (revised ed.). 1988, New York: Academic Press, 474- Cohen J: Statistical power analysis for the behavioral sciences (revised ed.). 1988, New York: Academic Press, 474-
33.
go back to reference Terwee CB, Bot SDM, de Boer MR, van der Windt DAWM, Knol DL, Dekker J, Bouter LM, de Vet HCW: Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol. 2007, 60: 34-42. 10.1016/j.jclinepi.2006.03.012.CrossRefPubMed Terwee CB, Bot SDM, de Boer MR, van der Windt DAWM, Knol DL, Dekker J, Bouter LM, de Vet HCW: Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol. 2007, 60: 34-42. 10.1016/j.jclinepi.2006.03.012.CrossRefPubMed
34.
go back to reference McHorney CA, Tarlov AR: Individual-patient monitoring in clinical practice: are available health status surveys adequate?. Qual Life Res. 1995, 4: 293-307. 10.1007/BF01593882.CrossRefPubMed McHorney CA, Tarlov AR: Individual-patient monitoring in clinical practice: are available health status surveys adequate?. Qual Life Res. 1995, 4: 293-307. 10.1007/BF01593882.CrossRefPubMed
35.
go back to reference Streiner D: Starting at the beginning: an introduction to coefficient alpha and internal consistency. J Pers Assess. 2003, 80: 99-103. 10.1207/S15327752JPA8001_18.CrossRefPubMed Streiner D: Starting at the beginning: an introduction to coefficient alpha and internal consistency. J Pers Assess. 2003, 80: 99-103. 10.1207/S15327752JPA8001_18.CrossRefPubMed
36.
go back to reference Patten SB, Remillard A, Phillips L, Modgill G, Szeto AC, Kassam A, Gardner DM: Effectiveness of contact-based education for reducing mental illness-related stigma in pharmacy students. BMC Med Educ. 2012, 12: 120-10.1186/1472-6920-12-120.CrossRefPubMedPubMedCentral Patten SB, Remillard A, Phillips L, Modgill G, Szeto AC, Kassam A, Gardner DM: Effectiveness of contact-based education for reducing mental illness-related stigma in pharmacy students. BMC Med Educ. 2012, 12: 120-10.1186/1472-6920-12-120.CrossRefPubMedPubMedCentral
37.
go back to reference Corrigan PW, Larson J, Sells M, Niessen N, Watson AC: Will filmed presentations of education and contact diminish mental illness stigma?. Community Ment Health J. 2007, 43: 171-181. 10.1007/s10597-006-9061-8.CrossRefPubMed Corrigan PW, Larson J, Sells M, Niessen N, Watson AC: Will filmed presentations of education and contact diminish mental illness stigma?. Community Ment Health J. 2007, 43: 171-181. 10.1007/s10597-006-9061-8.CrossRefPubMed
38.
go back to reference Couture S, Penn D: Interpersonal contact and the stigma of mental illness: a review of the literature. J Ment Heal. 2003, 12: 291-305. 10.1080/09638231000118276.CrossRef Couture S, Penn D: Interpersonal contact and the stigma of mental illness: a review of the literature. J Ment Heal. 2003, 12: 291-305. 10.1080/09638231000118276.CrossRef
39.
go back to reference Corrigan PW, Morris SB, Michaels PJ, Rafacz JD, Rüsch N: Challenging the public stigma of mental illness: a meta-analysis of outcome studies. Psychiatr Serv. 2012, 63: 96- Corrigan PW, Morris SB, Michaels PJ, Rafacz JD, Rüsch N: Challenging the public stigma of mental illness: a meta-analysis of outcome studies. Psychiatr Serv. 2012, 63: 96-
40.
go back to reference Pettigrew TF, Tropp LR: How does intergroup contact reduce prejudice? Meta-analytic tests of three mediators. Eur J Soc Pschology. 2008, 38: 922-934. 10.1002/ejsp.504.CrossRef Pettigrew TF, Tropp LR: How does intergroup contact reduce prejudice? Meta-analytic tests of three mediators. Eur J Soc Pschology. 2008, 38: 922-934. 10.1002/ejsp.504.CrossRef
41.
go back to reference Arboleda-Flórez J, Stuart H: From sin to science: fighting the stigmatization of mental illnesses. Can J Psychiatry. 2012, 57: 457-463.PubMed Arboleda-Flórez J, Stuart H: From sin to science: fighting the stigmatization of mental illnesses. Can J Psychiatry. 2012, 57: 457-463.PubMed
42.
go back to reference Patrick WBC, Eduardo V, Jon L, Patrick JM, Glen M, Richard K, Michael G, Buchholz : California schedule of key ingredients for contact-based antistigma programs.pdf. Psychiatr Rehabil J. 2013, 36: 173-179.CrossRef Patrick WBC, Eduardo V, Jon L, Patrick JM, Glen M, Richard K, Michael G, Buchholz : California schedule of key ingredients for contact-based antistigma programs.pdf. Psychiatr Rehabil J. 2013, 36: 173-179.CrossRef
43.
go back to reference Papish A, Kassam A, Modgill G, Vaz G, Zanussi L, Patten S: Reducing the stigma of mental illness in undergraduate medical education: a randomized controlled trial. BMC Med Educ. 2013, 13: 141-10.1186/1472-6920-13-141.CrossRefPubMedPubMedCentral Papish A, Kassam A, Modgill G, Vaz G, Zanussi L, Patten S: Reducing the stigma of mental illness in undergraduate medical education: a randomized controlled trial. BMC Med Educ. 2013, 13: 141-10.1186/1472-6920-13-141.CrossRefPubMedPubMedCentral
48.
go back to reference Barney L, Griffiths K: The Self Stigma of Depression Scale (SSDS): development and psychometric evaluation of a new instrument. Int J Methods Psychiatr Res. 2010, 19 (August): 243-254.CrossRefPubMed Barney L, Griffiths K: The Self Stigma of Depression Scale (SSDS): development and psychometric evaluation of a new instrument. Int J Methods Psychiatr Res. 2010, 19 (August): 243-254.CrossRefPubMed
49.
go back to reference Lauber C, Anthony M, Ajdacic-Gross V, Rössler W: What about psychiatrists’ attitude to mentally ill people?. Eur Psychiatry. 2004, 19: 423-427. 10.1016/j.eurpsy.2004.06.019.CrossRefPubMed Lauber C, Anthony M, Ajdacic-Gross V, Rössler W: What about psychiatrists’ attitude to mentally ill people?. Eur Psychiatry. 2004, 19: 423-427. 10.1016/j.eurpsy.2004.06.019.CrossRefPubMed
50.
go back to reference Link BG, Yang LH, Phelan JC, Collins PY: Measuring mental illness stigma. Schizophr Bull. 2004, 30: 511-541. 10.1093/oxfordjournals.schbul.a007098.CrossRefPubMed Link BG, Yang LH, Phelan JC, Collins PY: Measuring mental illness stigma. Schizophr Bull. 2004, 30: 511-541. 10.1093/oxfordjournals.schbul.a007098.CrossRefPubMed
51.
go back to reference Griffiths KM, Batterham PJ, Barney L, Parsons A: The Generalised Anxiety Stigma Scale (GASS): psychometric properties in a community sample. BMC Psychiatry. 2011, 11: 184-10.1186/1471-244X-11-184.CrossRefPubMedPubMedCentral Griffiths KM, Batterham PJ, Barney L, Parsons A: The Generalised Anxiety Stigma Scale (GASS): psychometric properties in a community sample. BMC Psychiatry. 2011, 11: 184-10.1186/1471-244X-11-184.CrossRefPubMedPubMedCentral
52.
go back to reference Morris E, Inglis A, Friedman J, Austin J: Discussing the psychiatric manifestations of 22q11.2 deletion syndrome: an exploration of clinical practice among medical geneticists. Genet Med. 2013, 15: 713-720. 10.1038/gim.2013.31.CrossRefPubMedPubMedCentral Morris E, Inglis A, Friedman J, Austin J: Discussing the psychiatric manifestations of 22q11.2 deletion syndrome: an exploration of clinical practice among medical geneticists. Genet Med. 2013, 15: 713-720. 10.1038/gim.2013.31.CrossRefPubMedPubMedCentral
53.
go back to reference Chan JYN, Mak WWS, Law LSC: Combining education and video-based contact to reduce stigma of mental illness: “The Same or Not the Same” anti-stigma program for secondary schools in Hong Kong. Soc Sci Med. 2009, 68: 1521-1526. 10.1016/j.socscimed.2009.02.016.CrossRefPubMed Chan JYN, Mak WWS, Law LSC: Combining education and video-based contact to reduce stigma of mental illness: “The Same or Not the Same” anti-stigma program for secondary schools in Hong Kong. Soc Sci Med. 2009, 68: 1521-1526. 10.1016/j.socscimed.2009.02.016.CrossRefPubMed
54.
go back to reference Anderson K, Austin JC: Effects of a documentary film on public stigma related to mental illness among genetic counselors. J Genet Couns. 2012, 21: 573-581. 10.1007/s10897-011-9414-5.CrossRefPubMed Anderson K, Austin JC: Effects of a documentary film on public stigma related to mental illness among genetic counselors. J Genet Couns. 2012, 21: 573-581. 10.1007/s10897-011-9414-5.CrossRefPubMed
55.
go back to reference Mann CE, Himelein MJ: Putting the person back into psychopathology: an intervention to reduce mental illness stigma in the classroom. Soc Psychiatry Psychiatr Epidemiol. 2008, 43: 545-551. 10.1007/s00127-008-0324-2.CrossRefPubMed Mann CE, Himelein MJ: Putting the person back into psychopathology: an intervention to reduce mental illness stigma in the classroom. Soc Psychiatry Psychiatr Epidemiol. 2008, 43: 545-551. 10.1007/s00127-008-0324-2.CrossRefPubMed
56.
go back to reference Weiss MG, Ramakrishna J: Stigma interventions and research for international health. Lancet. 2006, 367: 536-538. 10.1016/S0140-6736(06)68189-0.CrossRefPubMed Weiss MG, Ramakrishna J: Stigma interventions and research for international health. Lancet. 2006, 367: 536-538. 10.1016/S0140-6736(06)68189-0.CrossRefPubMed
Metadata
Title
Opening Minds Stigma Scale for Health Care Providers (OMS-HC): Examination of psychometric properties and responsiveness
Authors
Geeta Modgill
Scott B Patten
Stephanie Knaak
Aliya Kassam
Andrew CH Szeto
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2014
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/1471-244X-14-120

Other articles of this Issue 1/2014

BMC Psychiatry 1/2014 Go to the issue