Development and validation of a novel Widowhood Stigma Scale.

The United Nations has identified stigma as one of the three burdens faced by widowed women, alongside sexual and economic vulnerabilities.Despite its recognized importance, no multidimensional validated tool currently exists to measure widowhood stigma.We used a mixed methods exploratory sequential design.First, we combined findings from a literature review and a qualitative study on widowed women in Gem Sub-County in western Kenya to generate an item pool for the widowhood stigma measure.Then, 10 widowhood experts reviewed the item pool that was subsequently tested and revised through cognitive interviews with six widowed women.The revised item pool was included in a cross-sectional survey with an age-stratified random sample of 480 widowed women.Data were analyzed using exploratory factor analysis, reliability, and validity tests to develop the Widowhood Stigma Scale.The final Widowhood Stigma Scale comprised three subscales (Internalized Stigma, Loss of Social Status, and Social Isolation) and demonstrated excellent internal consistency (Cronbach's α = .93).The items were measured on 4-point Likert scales, with higher scores showing greater levels of widowhood stigma.The 19-item scale demonstrated preliminary construct validity with a strong positive correlation with depression (rs = 0.51) and a moderate negative correlation with functional social support (rs = -0.41).This study presents the first validated multidimensional Widowhood Stigma Scale.It offers a critical tool that can be applied in future research to understand the experience, prevalence, and health effects of widowhood stigma and to inform the development of widowhood stigma-reduction interventions and policies. Clinical Impact StatementOur work provides the first multidimensional measurement tool for widowhood stigma in sub-Saharan Africa.This makes widowhood stigma a measurable social determinant for health.It creates opportunities for further research on trends, regional comparisons, and the effects of widowhood stigma on multiple health behaviors and outcomes.It also facilitates evaluation of widowhood stigma-reduction interventions and policies.