The Risky Appearance Altering Behaviours Inventory (RAABI): A validated new outcome measure for sociocultural models of body image in English and Spanish speaking women

People worldwide use risky, potentially harmful cosmetic procedures to change their appearance. The newly developed Risky Appearance Altering Behaviours Inventory (RAABI) measures interest and engagement in appearance-altering behaviours, including surgical and non-surgical cosmetic procedures, diet pills, skin bleaching and hair straightening. RAABI items were constructed based on focus groups across diverse cultural contexts. Using exploratory factor analysis (EFA), confirmatory factor analysis (CFA), exploratory structural equation modelling (ESEM) and bifactor ESEM, we examined the psychometric properties of the RAABI among women from the UK (N = 784, M_age = 27.8, SD = 12.09) and Colombia (N = 589, M_age = 21.43, SD = 2.96). We examined construct validity, composite reliability and longitudinal reliability (test-retest and invariance over 2 weeks), and assessed the fit of an extended Tripartite Influence Model (TIM) including the RAABI as an outcome alongside eating disorder (ED) symptoms. The RAABI demonstrated good composite reliability, construct validity, and indications of longitudinal reliability. In both countries, a 12-item, three-factor ESEM structure with good psychometric properties emerged, although item composition differed (UK included tanning, Colombia included skin bleaching items). Bifactor models were psychometrically adequate, showing a strong general factor with three subscales in Colombia, and a moderate general factor in the UK. The extended TIM showed good fit with RAABI included as an outcome measure. Overall, the RAABI (used as a total score or via subscales) is a psychometrically valid measure for assessing additional negative outcomes of sociocultural pressures, appearance ideal internalisation and body dissatisfaction in the UK and Colombia.