Developing and validating a quantitative measure of daily intersectional stigma experiences for Black people with disabilities

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PROJECT SUMMARY/ABSTRACT Black people with disabilities (PWD) disproportionately experience poor physical and behavioral health outcomes due to compounding socioeconomic challenges and stigma-related stressors. Intersectionality theory suggests that such magnified health inequities may be in part driven by intersectional stigma (i.e., experiences shaped by both racism and ableism), though few quantitative measures exist to capture this dynamic, multifaceted construct as it fluctuates over time and across contexts. To address this empirical gap, the proposed project will develop and validate a brief self-report measure of daily intersectional stigma experiences for Black PWD via a three-phase, multimethod approach. In Aim 1, we will generate an initial pool of items by drawing upon available literature, expert input, and feedback from Black PWD. In addition to consulting extant empirical research on ableism, racism, and their intersection, we will conduct semi-structured interviews with 20 Black PWD community members and 10 content experts. In Aim 2, we will refine this initial item pool by gathering feedback from Black PWD via an iterative process of cognitive interviewing and pilot testing. We will conduct an initial round of cognitive interviews with 20 Black PWD, followed by a 7-day pilot daily diary study and a second round of cognitive interviews with the same participants to further ascertain that the items adequately capture contextual and temporal variability in intersectional stigma experiences. In Aim 3, we will psychometrically evaluate the newly developed intersectional stigma measure by examining its scale structure and predictive validity in relation to stigma-relevant psychosocial outcomes using a probability-based sample of Black PWD recruited from the NORC AmeriSpeak panel. We will conduct a 2-week daily diary study with 200 Black PWD, who will complete the finalized intersectional stigma measure, along with measures of emotion regulation difficulties, psychological distress, perceived social support, connection with the disability and Black communities, and experiences of racism and ableism in isolation. We will examine the prevalence of intersectional stigma as a function of demographic and disability characteristics; additionally, we will investigate the concurrent and prospective associations between intersectional stigma and psychological distress, while also exploring potential mediators and moderators of these associations. Results from this project will provide a novel measurement tool for use in future observational and intervention research geared towards addressing the deleterious health impact of intersectional stigma for Black PWD. Findings will also yield valuable insights into the psychosocial consequences of intersectional stigma among a representative sample of Black PWD across the U.S., directly addressing NIMHD's priority in understanding the intersectional lived experiences of PWD from health disparity populations.