Hindi Translation, Cultural Adaptation, and Validation of Modified Weight Bias Internalization Scale (WBIS-M): A Cross-Sectional Study from the Metabolic Surgery Clinic in North India

Abstract

Background: The lack of culturally-sensitive tool masks the epidemiology of weight-bias and internalized-stigma. This study aimed to translate, adapt, and validate the Modified Weight-Bias Internalization Scale (WBIS-M) into Hindi.

Methods: The translation and adaptation process followed the World Health Organization guidelines. Three psychiatrists translated the original WBIS-M into Hindi. The bilingual panel comprised four psychiatrists, two laparoscopic bariatric surgeons, a professor of English, and an individual with severe obesity (with an International English Language Testing System (IELTS) score of Band 8.5) who was familiar with Western culture. The panel identified and resolved inadequate expressions of translations or discrepancies. An independent translator, whose mother tongue was English, back-translated it into the English language. Focused group discussions with individuals with severe obesity were conducted. The final H-WBIS-M was administered to undergraduates (n = 120) after seven days. Test-retest reliability was assessed. The original WBIS-M, Eating Disorder Diagnostic Screen, and Fat Phobia Scale-Short Form were administered to 120 undergraduates and 55 individuals with severe obesity (n = 175)]. Reliability and validity of H-WBIS-M were analyzed.

Results: Kaiser-Meyer-Olkin measure of sampling adequacy was 0.788, and Bartlett's test of sphericity was χ² = 1381.892, p = 0.000. The exploratory factor analysis extracted three components. Spearman-Brown coefficient for H-WBIS-M was 0.875. The internal consistency was α = 0.875 (p = 0.000), intraclass correlation coefficient was 0.857 (95% confidence interval [CI] = 0.812-0.893) (p = 0.000), and Pearson correlation ranged from 0.869 to 0.989 (p = 0.000). Cross-language concordance revealed a significant intraclass correlation coefficient (0.877-0.986) (p = 0.000) and Pearson correlation ranging from 0.781 to 0.972 (p = 0.000).

Conclusions: The H-WBIS-M demonstrated good psychometric properties based on standard testing procedures.

Keywords: Weight-bias internalization; epidemiology; scale development; weight stigma.

Figure 1.. Algorithm for Hindi Translation, Validation, and Cultural Adaptation of Hindi. Modified Weight Bias Internalization Scale (WBIS-M).

^@EDDS: Eating Disorder Diagnostic Screen; ^#FPS-SF: Fat Phobia Scale-Short Form; WBIS-M: Modified Weight Bias Internalization Scale.

Figure 2.. A Scree Plot Showing Principal Component Numbers on the X-axis and Eigenvalues on the Y.