Adapting the COVID Stress Scale (CSS) to investigate the level of stress among Hong Kong Chinese people 1 year after the COVID-19 pandemic

Background: Stress is a crucial driver that affects hygiene behavior. The Hong Kong population lacks a COVID-19 or pandemic related stress measure investigating the COVID-19 related stress after one year of outbreak. Design and methods: The original COVID Stress Scale (CSS) was translated and culturally adapted into the Chinese (Cantonese) version (CSS-C). Six hundred and twenty-four participants were recruited from the general public to examine the internal consistency, and concurrent and convergent validity of the CSS-C. The test-retest reliability of CSS-C was examined using 39 university students. Results: People with old age, women, single, low educational level and borderline and abnormal levels of anxiety and depression were likely to perceive high level of COVID-19 related stress. All CSS-C subscales demonstrated good internal consistency, moderate to good test-retest reliability, and weak to moderate correlations with various mental health-related measures. Discussion: The CSS could help monitor the stress associated the current and potential future pandemics.