Abstract
BackgroundThe psychosocial consequences of obesity are important but often underrated. The Attitudes Toward Obese Persons (ATOP) and Beliefs About Obese Persons (BAOP) scales used to measure weight-related bias have little psychometric information, especially in East Asian contexts. The objective of this study was to use rigorous statistical methods to demonstrate the psychometric properties of these two instruments in Hong Kong and Taiwanese college students.MethodsA convenience sample of 707 students was recruited from the universities in Hong Kong and Taiwan. Several competing confirmatory factor analyses (CFAs) were conducted to confirm the factorial structure of the ATOP and BAOP. The best fit models for the ATOP and BAOP were chosen for the examination of the measurement invariance across subcultures. We then compared configurable models with or without loading and/or intercept constrained before correlating the latent constructs between the best models for the ATOP and BAOP.ResultsThe comparison in multiple CFAs found that the model with one factor and two correlated-wording-method factors outperformed the other models for both the ATOP and BOAP. However, the internal consistency was suboptimal (ATOP: α = .56 to .80; BTOP: α = .57 to .65) and the measurement invariance was somewhat unsupported among the Hong Kong and Taiwan samples. Moreover, after controlling wording effects, the latent construct of the ATOP was moderately associated with that of BAOP (r = .356; p < .001).ConclusionChinese versions of the ATOP and BAOP can be treated as a unidimensional factor for use in Hong Kong and Taiwan university students. However, further refinements of both instruments may be needed before using them to capture the social attitudes and beliefs toward obesity individuals, which is expected to advance our understanding of weight-related bias in East Asian contexts.
Highlights
The psychosocial consequences of obesity are important but often underrated
The Hong Kong participants had lower scores than did the Taiwan participants on both the Attitudes Toward Obese Persons (ATOP) and Beliefs About Obese Persons (BAOP); a significant difference was found in BAOP (Cohen’s d = 0.24) but not in the ATOP (Cohen’s d = 0.07)
Based on the confirmatory factor analysis (CFA) results, we suggest that the common practice of treating the ATOP and BAOP as unidimensional structures [22, 23] may be acceptable
Summary
The psychosocial consequences of obesity are important but often underrated. The Attitudes Toward Obese Persons (ATOP) and Beliefs About Obese Persons (BAOP) scales used to measure weight-related bias have little psychometric information, especially in East Asian contexts. 35% of Hong Kong adults are overweight [2] and 43% of Taiwanese adults are overweight [3]. These rising rates pose public health challenges given the negative effects of overweight and obesity on physical health (e.g., high risk of cardiovascular disease, type II diabetes, and hypertension) [4, 5] and psychosocial well-being (e.g., high risk of depressive symptoms and decreased quality of life) [6,7,8]. Given that weight bias (or weight stigma) is a major contributor to psychosocial difficulties affecting people with obesity, it is imperative that public health professionals begin to tackle this issue. As revealed in recent studies, Hong Kong and Taiwan populations have a similar issue on weightrelated stigma, which is linked to negative psychological outcomes [11,12,13]
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