Abstract
BACKGROUND: The COVID-19 outbreak and the measures to contain the global pandemic can have an impact on the well-being and mental health status of individuals. Parents of young children are particularly at risk for high levels of parental stress due to the current public health crisis, which can impact parenting behaviors and children's well-being. Although different initial scales have been developed to measure COVID-19-related anxiety, they have not yet been tested sufficiently in parent samples. A brief measure of COVID-19-related anxiety is necessary for both quick assessment in practice and in larger epidemiological studies of parents. OBJECTIVE: The purpose of this study is to compare the distributions, validities, and reliabilities of four different COVID-19 anxiety scales: Fear of COVID-19 Scale, Coronavirus Anxiety Scale, Pandemic Anxiety Scale, and one subscale of the COVID Stress Scales. Based on the psychometric properties of these scales, we aim to provide recommendations for a brief unidimensional inventory to assess COVID-19-related anxiety among parents. METHODS: A cross-sectional web-based survey of 515 German-speaking parents (465 mothers, 90.3%) with at least one child aged 0-6 years was conducted during a 6-week period (June 29 to August 9, 2020). Half of the parents were recruited via Facebook parenting groups, while the other half were recruited through childcare centers. We psychometrically tested 25 items on COVID-19-related anxiety using the framework of classical test theory, including item analysis, correlational analysis of family variables, and exploratory factor analysis. Moreover, an item response theory approach was applied to estimate item discriminations and item difficulties. RESULTS: Based on the psychometric properties, three items of the Pandemic Anxiety Scale were identified as a single unidimensional factor. The adapted scale demonstrated acceptable internal consistency (α=.79), moderate to high item discrimination, strong positive intercorrelation with two other COVID-19 anxiety scales, and a small positive association with parenting stress. Mothers and fathers did not differ in total scores (t(513)=-0.79, P=.42). CONCLUSIONS: Factor analysis suggests that existing COVID-19-related anxiety scales measure different latent constructs of anxiety. Furthermore, all scales showed only small to moderate correlations with trait health anxiety, suggesting that COVID-19-related anxiety is distinct from general health anxiety. The adapted "disease anxiety" subscale of the Pandemic Anxiety Scale is an economical measure for assessing COVID-19-related anxiety in parents. Directions for future research are outlined.