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Data collected from sample 2 were used to assess the
generalizability of the scale to a sample of community-recruited
adults living with chronic illness. Internal consistency was re-tested within
sample 2. An analysis of factorial invariance was also conducted to test for
measurement equivalence among samples 1 and 2.

In the start, the CIASS
included 53 items: 17 items representing anticipated stigma from friends and
family members, 19 items representing anticipated stigma from work colleagues,
and 17 items representing anticipated stigma from healthcare workers. Their items
were developed based on reviewing different literature stigma anticipated and
experienced by people living with a variety of chronic illnesses. Qualitative representations
of stigmatizing treatment & the context in which the treatment occurred
were also noted. Participants were asked to rate the possibility that they
would encounter these stigmatizing experiences in the future on a scale ranging
from 1 (very unlikely) to maximum 5 (very likely). Each item was evaluated for presence
in the ?nal version of the scale. The evaluation involved examining the
item-scale correlations, item variances, and item means. Items were also chosen
that correlated well with the overall scale, had relatively high variance, and
had means that were far from the extremes of the scale. The process resulted in
the selection of 12 items, 4 per each scale, that were evaluated for
reliability and validity.

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Indicators of reliability were calculated for both the entire
12-item scale and each 4-item subscale using the data from sample 1. The entire
CIASS was highly internally consistent with an ordinal alpha of 0.95.
Additionally, the friends and family, work colleagues, and healthcare workers
subscales were internally consistent, with ordinal alphas of 0.92, 0.95, and
0.95 respectively.

Test-retest reliability was also calculated by comparing the time 1 & 2
scores of the 38 participants from sample 1 who completed the CIASS twice.
Participant scores on the entire scale were highly correlated at 0.82
(P<0.001). Additionally, participant scores on the friends and family, healthcare workers, and work colleagues subscales were correlated at 0.67, 0.61, and 0.83 (all P <0.001) respectively. The structural validity and construct validity of the CIASS were evaluated using a con?rmatory factor analysis (CFA) with the data from sample 1. The Chi-square was small but statistically signi?cant, X2 (51) = 88.59, p = 0.0008. However, the root mean square residual (RMR) was 0.05 and the goodness-of-?t index (GFI) was 0.99, it shows that the model is strong to for the data. The entire scale was again highly consistent with an ordinal alpha of 0.93. The friends and family, work colleagues, and healthcare workers subscales were also highly consistent with ordinal alphas of 0.93, 0.93, and 0.95 respectively

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