COVID-19 Response-Related Discrimination Scale

Abstract

The COVID-19 Response-Related Discrimination Scale (CRRDS) is a concise, four-item psychometric instrument developed by Algarin and colleagues in 2023. This measure was specifically designed to quantify the experiences of discrimination associated with the public health response to the COVID-19 pandemic, focusing primarily on vulnerable populations.

The scale was validated among People Who Inject Drugs (PWID) in the United States, addressing a recognized need for validated tools capable of assessing pandemic-specific discriminatory experiences that may be compounded by pre-existing stigma. Its development was conceptually informed by established instruments such as the Everyday Discrimination Scale. Psychometric evaluation confirmed a robust unidimensional structure via Principal Component Analysis, alongside acceptable internal reliability and strong evidence of construct validity through correlation with relevant psychological variables like anxiety and resilience.

Keywords

COVID-19, COVID-19 Response-Related Discrimination, Discrimination Experiences, People Who Inject Drugs (PWID), Self-Report, Social Discrimination, Substance Use and Addiction Measures, Psychometrics.

Authors

Algarin, Angel B., Yeager, Samantha, Patterson, Thomas L., Strathdee, Steffanie A., Harvey-Vera, Alicia, Vera, Carlos F., Stamos-Buesig, Tara, Artamanova, Irina, Abramovitz, Daniela, Smith, Laramie R.

Purpose

The primary purpose of the COVID-19 Response-Related Discrimination Scale is to systematically evaluate the frequency and nature of perceived discrimination experienced by individuals during the ongoing societal and public health response to the COVID-19 pandemic. It specifically captures fears of harassment and actual experiences of verbal or physical harm related to pandemic conditions or regulations.

This tool is essential for research targeting marginalized groups, such as People Who Inject Drugs, as it allows for the quantification of how pandemic measures and associated societal prejudice contribute to negative health outcomes, psychological distress, and engagement in risky behaviors within these populations.

Construct

The scale measures the psychological construct of Perceived COVID-19 Response-Related Discrimination. This construct is defined as the subjective experience of being targeted for unfair treatment, harassment, or physical threat due to factors associated with the pandemic environment, such as changes in public visibility, adherence to mandates (like mask-wearing), or the general social climate of fear and suspicion.

The items capture both anticipatory worry (fear of harassment by police or others) and actual experiences of verbal or physical harassment that occurred during the pandemic, recognizing that these experiences are often intensified for populations already subject to high levels of structural discrimination.

Validity

The scale demonstrated robust construct validity through analyses showing significant correlations with theoretically related measures. Higher levels of perceived COVID-19 response-related discrimination were positively associated with several adverse outcomes.

Key positive correlations were observed with increased endorsement of COVID-19 disinformation (r = 0.18; p = 0.007), elevated anxiety (r = 0.33; p < 0.001), recent experiences of physical assault (r = 0.14; p = 0.006), and having undergone a COVID-19 test (r = 0.17; p = 0.001). Conversely, the scale showed a significant negative correlation with resilience (r = -0.18; p < 0.001), indicating that discrimination acts as a stressor that diminishes coping capacity.

Reliability

The CERRDS exhibited acceptable internal consistency reliability within the sample of PWID. The reliability was calculated using two primary metrics: Cronbach’s Alpha (𝛼 = 0.66) and McDonald’s Omega (ω = 0.66).

For a brief, four-item scale measuring a newly defined, specific type of discrimination, these coefficients are considered satisfactory, suggesting that the items are closely related and consistently measure the latent construct of pandemic-related discrimination.

Factor Analysis

Structural validity was assessed using Principal Component Analysis (PCA). The analysis confirmed that the COVID-19 Response-Related Discrimination Scale operates as a unidimensional measure.

The factor extraction identified a single component solution, characterized by a substantial Eigenvalue of 2.59, which accounted for 85% of the total variance in the scale items. This finding strongly supports the use of a single, summed composite score for the measure.

Instrument

Test Type: Original self-report instrument

Format: The scale uses a two-part response mechanism. The four core discrimination items are answered dichotomously (Yes = 1, No = 0), yielding a composite discrimination score ranging from 0 to 4. If a respondent affirms experiencing discrimination, they are then asked to indicate the degree to which status-based attributes contributed to the experience using a 5-point Likert scale (1 = “not at all related to the discrimination experience” to 5 = “a lot to do with the discrimination experience”).

Language Available: English

Population Group: Human (Male; Female)

Age Group: Adulthood (18 years and older)

Population Details: The validation study was conducted in the United States with respondents being People Who Inject Drugs.

Test Methodology: Test Validity, Construct Validity, Test Reliability, Internal Consistency, Factor Analysis, Principal Component Analysis.

Keywords

COVID-19, Discrimination, Stigma, Public Health Response, People Who Inject Drugs, Self-Report, Anxiety, Resilience, Disinformation, Internal Consistency, Psychometric Scale, Principal Component Analysis.

Authors

Author ORCID Identifier: Samantha Yeager: http://orcid.org/0000-0002-0533-1875; Steffanie A. Strathdee: http://orcid.org/0000-0002-7724-691X

Affiliation Email addresses: Laramie R. Smith: [email protected]

Correspondence Address: Smith, Laramie R.: University of California San Diego, Department of Medicine, Division of Infectious Diseases and Global Public Health, 9500 Gilman Drive, Mail Code 0507, San Diego, California, United States, 92093-0507, [email protected]

Permissions & Fee and Test Year

• Permissions: May be used for Research/Teaching.

• Commercial Use: No

• Fee: No

• Test Year: 2023

Reference’s

Algarin, A. B., Yeager, S., Patterson, T. L., Strathdee, S. A., Harvey-Vera, A., Vera, C. F., Stamos-Buesig, T., Artamanova, I., Abramovitz, D., & Smith, L. R. (2023). The moderating role of resilience in the relationship between experiences of Covid-19 response-related discrimination and disinformation among people who inject drugs. Drug and Alcohol Dependence, 246, 1–8. https://doi.org/10.1016/j.drugalcdep.2023.109831

Items of the COVID-19 Response-Related Discrimination Scale

IMPORTANT: The following scale items must be preserved in their original language and must not be changed in any way.

This measure consists of 4 items. The specific items are available in the source reference: Algarin et al. (2023), Table 1, Page 3.

Items

When the COVID-19 pandemic began in March 2020 were you worried that you might be verbally or physically harassed by others (including the police) …

1. because there were fewer people in public?

2. if you wore a mask?

During the COVID-19 pandemic…

3. did you experience more verbal harassment than before (called names or insulted)?

4. were you physically threatened or harmed more than before?

Note. Response options are Yes (=1) and No (=0). Responses are summed to create a composite discrimination score (range from 0 to 4), where higher scores indicate greater experiences of COVID-19 response-related discrimination. For each COVID-19 response-related discrimination experience answered in the affirmative, participants are asked to indicate the degree of which they believe that each status-based attribute was the reason for the discrimination from 1 = “not at all related to the discrimination experience” to 5 = “a lot to do with the discrimination experience.”