The Development and Validation of a Modesty Measure for Diverse Muslim Populations

Padela, Aasim I.; Nageeb, Shaheen; Vu, Milkie; Quinn, Michael T.

doi:10.1007/s10943-018-0734-8

Original Paper
Published: 21 November 2018

The Development and Validation of a Modesty Measure for Diverse Muslim Populations

Aasim I. Padela ORCID: orcid.org/0000-0003-4834-2889^1,2,3,
Shaheen Nageeb^1,2,
Milkie Vu^1,2 &
Michael T. Quinn³

Journal of Religion and Health volume 58, pages 408–425 (2019)Cite this article

393 Accesses
3 Citations
Metrics details

Abstract

This paper reports on the multi-phase development of an English-language modesty measure for use among Muslim populations. The process yielded a 10-item measure that has high levels of internal consistency reliability (Cronbach’s α of 0.83), and has acceptable discriminant and predictive validity. Specifically although our modesty measure for Muslim women was found to be significantly correlated with measures of positive and negative religious (Islamic) coping, it was not significantly correlated with religious practice-based religiosity (discriminant validity). Further logistic modeling revealed higher modesty levels positively associated with forgoing mammography because of concerns about lack of same-sex providers (predictive validity).

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

43,34 €

Price includes VAT (Finland)
Tax calculation will be finalised during checkout.

References

al-Qaradawi, Y. (2013). The lawful and the prohibited in Islam: الإسلام في والحرام الحلال: The Other Press.
Andrews, C. S. (2006). Modesty and healthcare for women: Understanding cultural sensitivities. Psychosocial Oncology, 3(7), 443–446.
Google Scholar
Andrews, C. S. (2011). Defining and exploring modesty in Jewish American women. Journal of Religion and Health, 50(4), 818–834. https://doi.org/10.1007/s10943-010-9435-7.
Article PubMed Google Scholar
Antoun, R. T. (1968). On the modesty of women in Arab Muslim villages: A study in the accommodation of traditions. Newsletter of the American Anthropological Associatoin, 70, 671–697.
Google Scholar
Austin, L. T., Ahmad, F., McNally, M. J., & Stewart, D. E. (2002). Breast and cervical cancer screening in Hispanic women: A literature review using the health belief model. Womens Health Issues, 12(3), 122–128.
Article PubMed Google Scholar
Bewley, A. (1989). Al-Muwatta of Imam Malik Ibn Anas: The first formulation of Islamic law. Retrieved from http://www.usc.edu/dept/MSA/fundamentals/hadithsunnah/muwatta.
Boulanouar, A. W. (2006). The notion of modesty in Muslim women’s clothing: An Islamic point of view. New Zealand Journal of Asian Studies, 8(2), 134–156.
Google Scholar
Burnham, K. P., & Anderson, D. R. (2004). Multimodel inference: Understanding AIC and BIC in model selection. Sociological Methods & Research, 33(2), 261–304. https://doi.org/10.1177/0049124104268644.
Article Google Scholar
Carteret, M. (2011). Modesty in health care: A cross-cultural perspective. Retrieved from http://www.dimensionsofculture.com/2010/11/modesty-in-health-care-a-cross-cultural-perspective/.
Chen, S. X., Bond, M. H., Bacon, C., Donghui, T., & Buchtel, E. E. (2009). Behavioral manifestations of modesty. Journal of Cross-Cultural Psychology, 40(4), 603–626. https://doi.org/10.1177/0022022108330992.
Article Google Scholar
Chen, F. F., West, S. G., & Sousa, K. H. (2006). A comparison of bifactor and second-order models of quality of life. Multivariate Behavioral Research, 41(2), 189–225. https://doi.org/10.1207/s15327906mbr4102_5.
Article PubMed Google Scholar
Cialdini, R. B., & De Nicholas, M. E. (1989). Self-presentation by association. Journal of Personality and Social Psychology, 57, 626–631.
Article Google Scholar
Cialdini, R. B., Wosinska, W., Dabul, A. J., Whetstone-Dion, R., & Heszen, I. (1998). When social role salience leads to social role rejection: Modest self-presentation among women and men in two cultures. Personality and Social Psychology Bulletin, 24(5), 473–481.
Article Google Scholar
Costa, P. T., & McCrae, R. R. (1992). Four ways five factors are basic. Personality and Individual Differences, 13, 653–665.
Article Google Scholar
Costello, A. B., & Osborne, J. W. (2005). Best practices in exploratory factor analysis: Four recommendations for getting the most from your analysis. Practical Assessment, Research & Evaluation, 10(7), 173–178.
Google Scholar
Dareng, E. O., Jedy-Agba, E., Bamisaye, P., Isa Modibbo, F., Oyeneyin, L. O., Adewole, A. S., et al. (2015). Influence of spirituality and modesty on acceptance of self-sampling for cervical cancer screening. PLos ONE, 10(11), e0141679. https://doi.org/10.1371/journal.pone.0141679.
Article CAS PubMed PubMed Central Google Scholar
Deaux, K., & Major, B. (1987). Putting gender into context. Psychological Review, 94, 369–389.
Article Google Scholar
Epstein, R. M., & i Carrió, F. B. (2001). Pudor, honor, and autoridad: The evolving patient–physician relationship in Spain. Patient Education and Counseling, 45(1), 51–57.
Article CAS PubMed Google Scholar
Exline, J. J., & Lobel, M. (1999). The perils of outperformance: Sensitivity about being the target of threatening upward comparison. Psychological Bulletin, 125, 307–337.
Article CAS PubMed Google Scholar
Florez, K. R., Aguirre, A. N., Viladrich, A., Cespedes, A., De La Cruz, A. A., & Abraido-Lanza, A. F. (2009). Fatalism or destiny? A qualitative study and interpretative framework on Dominican women’s breast cancer beliefs. Journal of Immigrant and Minority Health, 11(4), 291–301. https://doi.org/10.1007/s10903-008-9118-6.
Article PubMed Google Scholar
Guadagnoli, E., & Velicer, W. F. (1988). Relation of sample size to the stability of component patterns. Psychological Bulletin, 103(2), 265–275.
Article PubMed Google Scholar
Hair, J. F. J., Anderson, R. E., Tatham, R. L., & Black, W. C. (1998). Multivariate data analysis (5th ed., p. 111). Upper Saddle River, NJ: Prentice Hall.
Google Scholar
Hasnain, M., Connell, K. J., Menon, U., & Tranmer, P. A. (2011). Patient-centered care for Muslim women: Provider and patient perspectives. Journal of Women’s Health, 20(1), 73–83.
Article PubMed Google Scholar
Isa, N. M. (2015). Darurah (necessity) and its application in Islamic ethical assessment of medical applications: A review on Malaysian Fatwa. Science and Engineering Ethics, 22(5), 1319–1332. https://doi.org/10.1007/s11948-015-9698-1.
Article PubMed Google Scholar
Isa Modibbo, F. D., Bamisaye, P., Jedy-Agba, E., Adewole, A., Oyeneyin, L., Olaniyan, O., et al. (2016). Qualitative study of barriers to cervical cancer screening among Nigerian women. British Medical Journal Open. https://doi.org/10.1136/bmjopen-2015-008533.
Article Google Scholar
Jennrich, R. I., & Bentler, P. M. (2011). Exploratory bi-factor analysis. Psychometrika, 76(4), 537–549. https://doi.org/10.1007/s11336-011-9218-4.
Article PubMed PubMed Central Google Scholar
Kamali, M. H. (2007). Qawa‘id al-fiqh: The legal maxims of Islamic law. Journal of the Association of Muslim Lawyers. http://www.sunnah.org/fiqh/usul/Kamali_Qawaid_al-Fiqh.pdf. Accessed 17 Oct 2015.
Koenig, H. G., & Bussing, A. (2010). The Duke University Religion Index (DUREL): A five-item measure for use in epidemological studies. Religions, 1, 78–85. https://doi.org/10.3390/rel1010078.
Article Google Scholar
Lee, H. Y., & Vang, S. (2010). Barriers to cancer screening in Hmong Americans: The influence of health care accessibility, culture, and cancer literacy. Journal of Community Health, 35(3), 302–314. https://doi.org/10.1007/s10900-010-9228-7.
Article PubMed Google Scholar
Mahmassani, S. (1961). Falsafat Al-Tashri’ Fi Al-Islām: The Philosophy of Jurisprudence in Islam (translated into English by Farhat Ziadeh). In: E. J. Brill, Leiden.
Modesty gowns for female patients. (2006). Retrieved from 9 May 2006. http://news.bbc.co.uk/go/pr/fr/-/2/hi/uk_news/england/lancashire/5315306.stm.
Nasa’i, & bin Su‘aib, A. (2007). English translation of Sunan an-Nasa’i. In H. Khattab (Ed.), English Translation of Sunan an-Nasa’i (Vol. 6, pp. 29) Darussalam.
Osborne, J. W. (2015). What is rotating in exploratory factor analysis? Practical Assessment, Research & Evaluation, 20(2), 7.
Google Scholar
Padela, A. I. (2007). Can you take care of my mother? Reflections on cultural competency and clinical accommodation. Academic Emergency Medicine, 14(3), 275–277. https://doi.org/10.1197/j.aem.2006.10.003.
Article PubMed Google Scholar
Padela, A., & Curlin, F. (2012). Religion and disparities: Considering the influences of Islam on the health of American Muslims. Journal of Religion Health. https://doi.org/10.1007/s10943-012-9620-y.
Article Google Scholar
Padela, A., & Del Pozo, P. R. (2011). Muslim patients and cross-gender interactions in medicine: An Islamic bioethical perspective. Journal of Medical Ethics, 37(1), 40–44. https://doi.org/10.1136/jme.2010.037614.
Article PubMed Google Scholar
Padela, A., Gunter, K., & Killawi, A. (2011). Meeting the healthcare needs of American Muslims: Challenges and strategies for healthcare settings. Retrieved from Washington, DC: http://www.ispu.org/pdfs/620_ISPU_Report_Aasim%20Padela_final.pdf.
Padela, A. I., Gunter, K., Killawi, A., & Heisler, M. (2012). Religious values and healthcare accommodations: Voices from the American Muslim community. Journal of General Internal Medicine. https://doi.org/10.1007/s11606-011-1965-5.
Article PubMed PubMed Central Google Scholar
Padela, A. I., Murrar, S., Adviento, B., Liao, C., Hosseinian, Z., Peek, M., & Curlin, F. (2015). Associations between religion-related factors and breast cancer screening among American Muslims. Journal of Immigrant and Minority Health, 17(3), 660–669.
Article PubMed PubMed Central Google Scholar
Padela, A. I., Peek, M., Johnson-Agbakwu, C. E., Hosseinain, Z., & Curlin, F. (2014). Associations between religion-related factors and cervical cancer screening among American Muslims in Greater Chicago. Journal of Lower Genital Tract Disease, 18, 326–332.
Article PubMed PubMed Central Google Scholar
Padela, A. I., & Raza, A. (2015). American Muslim health disparities: The state of the medline literature. Journal of Health Disparities Research and Practice, 8(1), 1–9.
Google Scholar
Raiya, H. A., Pargament, K., Mahoney, A., & Stein, C. (2008). A psychological measure of Islamic religiousness: Development and evidence for reliability and validity. International Journal for the Psychology of Religion, 18(4), 291–315.
Article Google Scholar
Raiya, H. A., Pargament, K., Stein, C., & Mahoney, A. (2007). Lessons learned and challenges faced in developing the psychological measure of Islamic religiousness. Journal of Muslim Mental Health, 2(2), 133–154.
Article Google Scholar
Ratner, B. (2009). The correlation coefficient: Its values range between +1/−1, or do they? Journal of Targeting, Measurement and Analysis for Marketing, 17(2), 139–142. https://doi.org/10.1057/jt.2009.5.
Article Google Scholar
Salman, K. F. (2012). Health beliefs and practices related to cancer screening among Arab Muslim women in an urban community. Health Care for Women International, 33(1), 45–74. https://doi.org/10.1080/07399332.2011.610536.
Article PubMed Google Scholar
Scheler, M. (1987). Shame and feelings of modesty. In Person and self-value. Dordrecht: Springer.
Sedikedes, C., Gaertner, L., & Toguchi, Y. (2003). Pancultural self-enhancement. Journal of Personality and Social Psychology, 84, 60–79.
Article Google Scholar
Simon, J. R., Padela, A. I., & Brooks, C. B. (2009). A return to virtue. Academic Emergency Medicine, 16(1), 63–66. https://doi.org/10.1111/j.1553-2712.2008.00309.x.
Article PubMed Google Scholar
Thomas, W. I. (1899). The psychology of modesty and clothing. American Journal of Sociology, 5(2), 246–262. https://doi.org/10.1086/210885.
Article Google Scholar
Vahabi, M., & Lofters, A. (2016). Muslim immigrant women’s views on cervical cancer screening and HPV self-sampling in Ontario, Canada. BMC Public Health. https://doi.org/10.1186/s12889-016-3564-1.
Article PubMed PubMed Central Google Scholar
Vu, M., Azmat, A., Radejko, T., & Padela, A. I. (2016). Predictors of delayed healthcare seeking among American Muslim women. J Womens Health (Larchmt), 25(6), 586–593. https://doi.org/10.1089/jwh.2015.5517.
Article Google Scholar
Whetstone, M., Okun, M., & Cialdini, R. (1992). The modest responding scale. Paper presented at the convention of the American Psychological Society, San Diego, CA.
Yosef, A. R. (2008). Health beliefs, practice, and priorities for health care of Arab Muslims in the United States. Journal of Transcultural Nursing, 19(3), 284–291. https://doi.org/10.1177/1043659608317450.
Article PubMed Google Scholar

Download references

Acknowledgements

A Mentored Research Scholar Grant in Applied and Clinical Research, MRSG-14-032-01-CPPB from the American Cancer Society supported AIP’s time-effort and provided project funding including the time-effort of SN and MV. This project was supported by a Cancer Center Support Grant (#P30CA14599). Data warehousing was supported by the RED Cap project at the University of Chicago, managed by the Center for Research Informatics, and funded by the Biological Sciences Division and the Institute for Translational Medicine CTSA Grant (UL1 RR024999). We are grateful to research assistants in implementing the study: Hadiyah Muhammad, Akila Ally, and Ahamed Milhan. We also thank Dr. Monica Peek for her mentorship in study design, project implementation, Drs. L. Philip Schumm for his immense help with factor analyses and interpretation, and Sang Mee Lee for her help with data analysis. Finally, we are immensely grateful for the critical support and advice of our community advisory board, imams, and mosque staff without which the project could not have been accomplished: Fatema Mirza, Nancy Romanchek, Shehla Diba, Anam Eljabali, MahRukh Mian, Kifah Shukair, Masood Iqbal, Luma Mahairi, Lynn Salahi, Beenish Manzoor, Ayesha Sultana, Shaykh Kifah Mustapha, Mufti Nazim Mangera, Kamran Hussain, Amanat Ansari, Ali Tai, Lila Zegar, Rula Zegar, Aisha Rahima, Badie Ali, and Elham Atieh.

Author information

Affiliations

Initiative on Islam and Medicine, Program on Medicine and Religion, Department of Medicine, The University of Chicago, 5841 S Maryland Ave, Chicago, IL, 60637, USA
Aasim I. Padela, Shaheen Nageeb & Milkie Vu
Section of Emergency Medicine, Department of Medicine, The University of Chicago, Chicago, IL, USA
Aasim I. Padela, Shaheen Nageeb & Milkie Vu
Section of General Medicine, Department of Medicine, The University of Chicago, Chicago, IL, USA
Aasim I. Padela & Michael T. Quinn

Authors

Aasim I. Padela
View author publications
You can also search for this author in PubMed Google Scholar
Shaheen Nageeb
View author publications
You can also search for this author in PubMed Google Scholar
Milkie Vu
View author publications
You can also search for this author in PubMed Google Scholar
Michael T. Quinn
View author publications
You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Aasim I. Padela.

Appendix

See Table 7.

Table 7 Phase 2: focus group analyses

Full size table

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Padela, A.I., Nageeb, S., Vu, M. et al. The Development and Validation of a Modesty Measure for Diverse Muslim Populations. J Relig Health 58, 408–425 (2019). https://doi.org/10.1007/s10943-018-0734-8

Download citation

Published: 21 November 2018
Issue Date: 01 April 2019
DOI: https://doi.org/10.1007/s10943-018-0734-8

Keywords

Muslim health
Scale development
Women’s health

Abstract

Access options

Buy single article

References

Acknowledgements

Author information

Affiliations

Corresponding author

Appendix

Appendix

Rights and permissions

About this article

Cite this article

Share this article

Keywords