Psychometric validation of the Korean versions of the Vaccine Hesitancy Scale and Vaccination Attitudes Examination Scale

PurposeStrategies for reducing vaccine hesitancy and negative attitudes toward vaccination and measures to accurately assess them have been developed worldwide. The Vaccine Hesitancy Scale (VHS) and Vaccination Attitudes Examination Scale (VAX) are reliable and valid tools. This study evaluates the validity and reliability of the Korean versions of the Vaccine Hesitancy Scale (K-VHS) and Vaccination Attitudes Examination Scale (K-VAX).MethodsWe translated the VHS and VAX into Korean using forward and backward translations and tested their psychometric attributes. We collected data from a sample of 2,292 Koreans, recruited in June 2021 from a large online panel using quotas for age and gender. We used content validity, construct validity with confirmatory factor analysis, concurrent validity, and convergent validity to assess the validity of the scales, and tested their reliability with evaluations of internal consistency and stability.ResultsThe K-VHS and K-VAX showed good model fits in the validity tests, with seven items for one factor and 12 items for four factors, respectively. The internal consistency (Cronbach’s alpha = 0.94 for the K-VHS, and 0.86 for the K-VAX) and stability (ICC = 0.86 for the K-VHS, and 0.88 for the K-VAX) of the measures indicated that they are reliable.ConclusionsBoth tools are effective psychometric instruments for assessing vaccine hesitancy and vaccination attitudes in Korean adults. K-VHS and K-VAX would be useful for predicting vaccination behaviors in novel infectious disease contexts and communicating the evidence needed to develop related policies or programs.     

Psychometric properties and Dutch norm data of the PedsQL Multidimensional Fatigue Scale for Young Adults

Purpose

The aim of this study was to assess internal consistency and construct validity (known-groups validity) and to provide Dutch norm data for the Dutch Pediatric Quality of Life Inventory Multidimensional Fatigue Scale for Young Adults ages 18–30 years (PedsQL fatigue_YA).

Methods

A Dutch sample of 649 young adults completed online a sociodemographic questionnaire and the PedsQL fatigue_YA including three subscales: general fatigue, sleep/rest fatigue and cognitive fatigue (0–100: Higher scores indicate less fatigue symptoms).

Results

The PedsQL fatigue_YA showed satisfactory to good internal consistency (Cronbach’s alpha = .70–.94), except for one scale (.68). The mean scale scores were 68.23 (SD 19.15) for ‘general fatigue,’ 67.04 (SD 15.54) for ‘sleep/rest fatigue’ and 74.62 (SD 19.02) for ‘cognitive fatigue.’ Men reported significantly higher scores on ‘general fatigue’ and ‘sleep/rest fatigue’ than women. The PedsQL fatigue_YA distinguished between healthy young adults and young adults with chronic health conditions, with higher scores on all scales in healthy young adults than in those with a chronic health condition.

Conclusion

The results demonstrate good psychometric properties of the PedsQL fatigue_YA in a sample of Dutch young adults. With the current norms available, it is possible to evaluate fatigue in the Netherlands from childhood to adulthood with the PedsQL Multidimensional Fatigue Scale.     

Exploratory factor analysis and psychometric evaluation of the Healthcare Provider Attitudes Toward Child Maltreatment Reporting Scale

There currently is not a well-established, psychometrically sound measure for assessing health care provider concerns about and attitudes toward reporting maltreatment. The purpose of this study is to examine the psychometric properties of the Healthcare Provider Attitudes Toward Child Maltreatment Reporting Scale. The factor structure and reliability of the scale were analyzed. Two subscales, Reporting Responsibilities and Concerns about Reporting, were identified. The total scale and the subscales were shown to have good internal consistency. Potential uses for the scale in evaluating and improving mandated reporting by health care providers are proposed.     

Development of an Attitudes Toward Health Care Teams Scale.

The authors describe the development and psychometric testing across three study phases of an Attitudes Toward Health Care Teams Scale. The measure contains two subscales: Quality of Care/Process (14 items) and Physician Centrality (6 items). The Quality of Care/Process subscale measures team members' perceptions of the quality of care delivered by health care teams and the quality of teamwork to accomplish this. The Physician Centrality subscale measures team members' attitudes toward physicians' authority in teams and their control over information about patients. Tests of reliability and validity demonstrate that each subscale is a strong measure of its respective underlying concept. The measure has potential for use as a research tool and as a pre- and posttest tool for educational interventions with teams and for evaluating clinically based team training programs for medical and health professions students and residents.     

Measuring Attitudes About Genomic Medicine: Validation of the Genomic Orientation Scale (GO Scale)

ObjectivesAssessing public attitudes about genomic medicine is critical for anticipating patient receptivity to clinical applications of genomics. Although scholars have highlighted the importance of assessing stakeholder opinions and views regarding advances in clinical genomics, to date there has not been a robust tool for measuring these attitudes. We designed a study to evaluate the validity of an instrument we developed for measuring attitudes about genomic medicine.MethodsWe used psychometric methods to validate the Genomic Orientation Scale (GO Scale). Our goal was to create an easy-to-use tool for evaluating positive and negative attitudes about genomic medicine.ResultsWe describe the validation testing of the GO Scale in a nationally representative sample of 1536 individuals residing in the United States. We report results from convergent and divergent validity testing and Rasch modeling analysis. The study produced a 26-item scale with 2 dimensions—optimism and pessimism.ConclusionsThe GO Scale may be used to characterize attitudinal perspectives among patients, clinicians, and the public. The GO Scale may also be useful in evaluating shifts in attitude over time, for example, following educational interventions, which has not been feasible to date.     

Testing the psychometric properties of the Participation Scale in Eastern Nepal

Purpose

To test the psychometric properties of the Participation Scale (P-scale) among people with various disabling conditions in Eastern Nepal.

Methods

A sample of 153 individuals with disabling conditions was selected through systematic random sampling. The following psychometric properties were tested: structural validity (explanatory and confirmatory factor analyses), internal consistency, inter-tester reliability, construct validity and floor and ceiling effects.

Results

The explanatory factor analysis indicated a two-factor structure (‘work-related participation’ and ‘general participation’). The confirmatory factor analysis suggested good model fit. The internal consistency measured with Cronbach’s alpha was 0.93 for the whole scale and 0.78 and 0.93 for the subscales. The inter-tester reliability coefficient was 0.90. All hypothesized correlations were as expected confirming the construct validity of the scale. No floor or ceiling effects were identified for the whole scale; only the subscale ‘work-related participation’ showed a ceiling effect.

Conclusion

The results of the analyses suggest that the psychometric properties of the P-scale are sufficient in the context of Eastern Nepal. Use of the P-scale will require (re-) confirmation of its validity in each new cultural context.     

Validation of Brief Condom Use Attitudes Scales for Spanish-Speaking People Who Use Crack Cocaine in El Salvador

People who use crack cocaine (PWUCC) are a population severely impacted by a concentrated epidemic of HIV. Behavioral interventions to prevent and treat HIV among PWUCC have been implemented around the world including in low- and middle-income countries which have been disproportionately affected by HIV. However, few studies have validated and assessed psychometric properties of measures on PWUCC, especially in transnational populations. Our sample was comprised of 1324 PWUCC, Spanish mono-lingual speakers, residing in the metropolitan area of San Salvador, El Salvador. Exploratory factor analysis and subsequent confirmatory factor analysis using statistical softwares SPSS and Amos were conducted on three abbreviated and translated condom use attitude measures (i.e., Condom Use Attitudes Scale—Spanish Short Form, Condom Use Social Norm—Spanish Short Form [CUSN-SSF], Condom Use Self-Efficacy—Spanish Short Form). Convergent validity was examined by computing bivariate correlations between the scales and condom use and sexually transmitted disease diagnosis. Results indicated that a two-factor, 8-item correlated model for the CUAS-SSF scale had an excellent fit and adequate reliability (α?=?.76). The confirmatory factor analysis for the 5-item CUSN-SSF scale indicated a satisfactory fit with 3 of 6 fit indices indicating adequate fit. Analysis of the two-factor 5-item CUSE-SSF scale indicated satisfactory fit and adequate reliability (α?=?.84). There were significant correlations between all measures and with self-reported condom use. Results indicate that these brief measures are reliable and valid and can be utilized to assess the effectiveness of HIV risk reduction interventions among Spanish-speaking PWUCC.

     

The Hopkins Rehabilitation Engagement Rating Scale – Reablement Version (HRERS‐RV): Development and psychometric properties

Patient or user engagement with health and social care interventions is receiving increased attention and interest within practice settings and research. An English evaluation of three reablement services wished to include a measure of user‐engagement so as to explore its association with outcomes. As no measure of reablement engagement existed, an existing measure designed for use with physical rehabilitation patients (the Hopkins Rehabilitation Engagement Rating Scale) was adapted and its psychometric properties were tested. The adapted version was completed by reablement staff at the time an individual (n = 129) was discharged from one of the three reablement services. Outcomes data (Barthel Index, Nottingham Extended Activities of Daily Living Scale, General Health Questionnaire‐12) collected by the evaluation study at baseline (that is, at entry into reablement), discharge and 6 months postdischarge was used for some psychometric testing. Internal consistency and construct, predictive and discriminant validity were investigated. The adapted scale measured a single construct and had good internal consistency. Tests of predictive and discriminant validity were positive. Findings from a separate, small‐scale (n = 31) test–retest study offer an early indication that this is acceptable. There was, however, evidence of a ceiling effect and we consider ways this may be ameliorated. The Hopkins Rehabilitation Engagement Rating Scale – Reablement Version offers a means by which user engagement in reablement can be measured using a staff‐completed instrument. The association between engagement and reablement outcomes, revealed when testing for predictive validity, supports the argument for greater attention and investment in research on user engagement in reablement. More broadly, researching engagement within the context of an intervention often delivered by multiple practitioners offers the opportunity to further understand this concept which, in the past, has particularly focused on interventions delivered by a single practitioner. In addition, future work should include developing a companion measure completed by service users.     

Psychometric Properties of the Problematic Pornography Use Scale in a Japanese Sample

Problematic pornography use (PPU) is the inability to control the use of pornography and is considered a form of compulsive sexual behavior. It can have a negative effect on one’s life and is an important clinical and social issue. In Japan, there is no assessment tool to measure PPU and very little research has been done. The Problematic Pornography Use Scale is one of the scales assessing the severity of PPU. This study validated a Japanese version of the Problematic Pornography Use Scale (PPUS-J) and examined its psychometric properties in a sample of 1011 individuals through an online survey (502 men, 509 women; M_age?=?35.9 years, SD?=?13.75). The results of the confirmatory factor analysis indicated that the four factors in the original scale were consistent with the factors in the PPUS-J, and strict invariance could be assumed for male and female participants. With regard to reliability, internal consistency indices were appropriate both at the overall and subscale levels for male and female participants. The PPUS-J showed good convergent and divergent validity due to the relationship between the subscales and other measures such as the Sexual Compulsivity Scale. These results demonstrate the validity of the PPUS-J for assessing problematic pornography use in a Japanese sample. Given the paucity of studies conducted in non-Western cultures and on women, this study will be useful in advancing research on PPU across different cultures. Future studies should examine test–retest reliability of the PPUS-J and its use with clinical groups.

     

Psychometric Properties of the Turkish Version of the Internalized Homophobia Scale

The current study examined the psychometric properties of the Turkish version of the Internalized Homophobia Scale (IHS; Herek, Cogan, Gillis, & Glunt, 1997) in gay men living in Turkey. Participants were 132 men in romantic, intimate, or sexual relationships with men, and they identified themselves as homosexual (n=112) or bisexual (n=20). Alpha and split-half reliability coefficients revealed good internal consistency of the scale. Consistent with the original scale, the construct validity revealed a single factor for the scale. Regarding convergent validity, the IHS had significant correlations with psychological problems, particularly with symptoms of depression and anxiety; the scale also had a significant positive correlation with negative affect and a negative correlation with self-esteem. Regarding discriminant validity, the IHS had very low correlations with positive affect and hostility attitudes. The association between internalized homophobia and psychological problems remained significant even after controlling for the variance explained by self-esteem, negative affect, and positive affect. Hence, the psychometric properties of the Turkish version of IHS appear quite promising.     

Health Care Students’ Attitudes Towards Addressing Sexual Health in Their Future Professional Work: Psychometrics of the Danish version of the Students’ Attitudes Towards Addressing Sexual Health Scale

Students’ attitudes and educational needs regarding sexual health are important, since their ability to promote sexual health in their future profession can be challenged by their attitudes and knowledge of sexuality and sexual health. There are no existing Danish instruments able to measure students’ attitudes towards working with and communicating about sexual health; thus, to be able to use the Students’ Attitudes Towards Addressing Sexual Health (SA-SH) questionnaire in a Danish context, it is necessary to translate and test the translated questionnaire psychometrically. The aim of the project was to translate and psychometrically test the Danish version of the SA-SH. Translation and psychometric testing of a Danish version of the SA-SH included testing of internal consistency reliability, content validity construct validity, and analysis of floor and ceiling effects. The Danish version of the SA-SH (SA-SH-D) had a Cronbach’s alpha of 0.67. The content validity index showed high relevance (item context validity index 0.82–1.0), and item scale correlation was satisfactory. The SA-SH-D is a valid and reliable questionnaire, which can be used to measure health care professional students’ attitudes towards working with sexual health in their future profession.     

Measurement and analysis of knowledge and attitudes toward epilepsy and persons with epilepsy

The Scale of Knowledge and Attitudes Toward Epilepsy and Persons with Epilepsy (ATPE) was developed as a contemporary, brief, easy to administer and score, psychometrically sound instrument. The 32 item scale consists of 25 statements from which an attitude score is derived and 13 statements from which a knowledge score is derived. Data were collected and analyzed which indicate satisfactory item characteristics, scale reliability and internal consistency. Scale development supports the content validity of the scale, while data from multiple regression and factor analyses support its construct validity. The scale should be useful for the investigation of questions concerning the formation, structure, correlates and modification of knowledge and attitudes regarding epilepsy and persons with epilepsy.     

Turkish Version of the Reliability and Validity Study of the Sexual Attitudes and Belief Survey

There is not enough information about beliefs and attitudes of the nursing students regarding giving sexual counseling to the patients. This study examined the validity and reliability of the Turkish Sexual Attitudes and Belief Survey, to determine barriers and their possible causes that affect evaluation of the sexual problems that occur because of illnesses or treatments of patients. The Cronbach’s alpha reliability coefficient of the survey and re-test text correlation value was found as 0.73 and 0.90, respectively (P < 0.05). Turkish version of the Sexual Attitudes and Belief Survey is a valid and reliable scale to evaluate nursing students’ beliefs and attitudes that affect giving sexual counseling to the patients.     

Understanding what people think and feel about adult vaccinations and the associated barriers in Greece: Development and validation of the attitude towards adult vaccination (ATAVAC) scale

Despite the unequivocal value of vaccination in reducing the global burden of infectious diseases, the anti-vaccination movement thrives. The vast majority of the existing validated tools explore attitudes regarding vaccination in children. The aim of our study was to develop and validate a scale assessing attitudes towards adult immunisation. This national cross-sectional study included adult healthcare users who visited 23 Greek Primary Healthcare Units. The development of the scale was the result of literature review, semi-structured interviews and pilot testing of its preliminary versions. The initial version contained 15 items measuring respondents’ attitudes on a 6-point Likert scale. The sample was randomly split into two halves. Exploratory factor analysis, performed in the first sample, was used for the creation of multi-item scales; confirmatory factor analysis was used in the second sample to assess goodness of fit. Moreover, concurrent validity, internal consistency reliability, test–retest reliability and ceiling and floor effects were explored. The total sample consisted of 1,571 individuals. Overall ‘Cronbach's alpha’ (0.821) indicated good internal consistency. The initial exploratory factor analysis resulted in a three-factor model. The subsequent confirmatory factor analysis indicated that an 11-item version of the scale provided the best fit of the model to the data (RMSEA = 0.050, SRMR = 0.053, TLI = 0.937, CFI = 0.955, AIC = 24,999.949). All subscales (‘value of adult vaccination’, ‘safety concerns’ and ‘perceived barriers’) demonstrated strong concurrent associations with participants’ attitudes and behaviour regarding vaccination (p < .001). No ceiling or floor effects were noted for any of the subscales (0.13%, 2.61% and 0.51%; 0.13%, 0.57% and 0.45% respectively). The 11-item ATAVAC scale proved to be a reliable and valid tool, suitable for assessing attitudes towards adult vaccination.     

The Safety Attitudes Questionnaire: psychometric properties, benchmarking data, and emerging research

Background  

There is widespread interest in measuring healthcare provider attitudes about issues relevant to patient safety (often called safety climate or safety culture). Here we report the psychometric properties, establish benchmarking data, and discuss emerging areas of research with the University of Texas Safety Attitudes Questionnaire.     

Measuring cognitive,affective, and behavioral components of homophobic reaction

Comprehensive, reliable, and valid measurement of prejudicial attitudes and behaviors toward lesbians and gay males has been identified as a priority. A sample of undergraduate (N=97) and high school students (N=40) completed three reliable measures of cognitive (Modified Attitudes Toward Homosexuality Scale), affective (Affective Reactions to Homosexuality Scale), and behavioral (Homophobic Behavior of Students Scale) reactions to homosexuals. Undergraduate students' responses confirmed the three-factor structure (homophobic guilt, homophobic anger, delight) of affects in this domain, and supported the concurrent validity of the behavioral measure. Predictive validity of the behavioral scale was demonstrated by findings of the high school study which showed that students subsequently acted in accordance with their responses to this paper-and-pencil test. LISREL confirmatory factor analysis of the overarching model indicated that a tripartite (cognition-affectbehavior) measurement strategy was appropriate. This strategy may be used in future research to provide comprehensive indication of which educational interventions make a difference in improving understanding and acceptance of homosexuality. An earlier version of this paper was presented at the annual conference of the Australian Association for Research in Education, Perth, Western Australia, November 21–25, 1993.     

Validation of the Greek Maternal Adjustment and Maternal Attitudes Scale for Assessing Early Postpartum Adjustment

The Maternal Adjustment and Maternal Attitudes Scale is a self- administered scale, designed for use in primary care settings to identify postpartum maternal adjustment problems regarding body image, sex, somatic symptoms, and marital relationships. Women were recruited within four weeks of giving birth. Responses to the Maternal Adjustment and Maternal Attitudes Scale were compared for agreement with responses to the Edinburgh Postnatal Depression Scale as a gold standard. Psychometric measurements included: reliability coefficients, explanatory factor analysis, and confirmatory analysis by linear structural relations. A receiver operating characteristic analysis was carried out to evaluate the global functioning of the scale. Of 300 mothers screened, 121 (40.7%) were experiencing difficulties in maternal adjustment and maternal attitudes. Scores on the Maternal Adjustment and Maternal Attitudes Scale correlated well with those on the Edinburgh Postnatal Depression Scale. The internal consistency of the Maternal Adjustment and Maternal Attitudes Scale, Greek version—tested using Cronbach's alpha coefficient—was 0.859, and that of Guttman split-half coefficient was 0.820. Findings confirmed the multidimensionality of the Maternal Adjustment and Maternal Attitudes Scale, demonstrating a six-factor structure. The area under the receiver operating characteristic curve was 0.610, and the logistic estimate for the threshold score of 57/58 fitted the model sensitivity at 68% and model specificity at 64.6%. Data confirmed that the Greek version of the Maternal Adjustment and Maternal Attitudes Scale is a reliable and valid screening tool for both clinical practice and research purposes to detect postpartum adjustment difficulties.     

Assessing attitude: the case of health-enhancing physical activity

OBJECTIVES: The basic phases of constructing compact questionnaire scales for health-promotion interventions are demonstrated in the case of attitudes towards two modes of physical activity, outdoor aerobic exercise (OAE) and everyday commuting activity (ECA). The scales were to show good psychometric properties and to provide adequate indicators of attitude. METHODS: Behaviours and criteria were specified for both OAE and ECA. The items describing the emotional (affect) and cognitive (outcome-expectations) aspects of attitude towards OAE and ECA behaviours were selected on the basis of a pilot study. The scales under development were used in a Finnish population survey on health, personal resources and physical activity (n = 1,516). Item analyses were completed for purposes of refining the scale; principal component analyses and factor analyses were used to establish the dimensional structure of the scales. Evidence of discriminatory validity was provided by comparing the scale scores of the different groups of respondents with regular, with sub-criterion, and without any OAE and ECA behaviours, respectively. RESULTS: The purported psychometric properties were met in the case of the affective and, less obviously, the positive outcome-expectation scales. The negative expectation scales need to be reconstructed with additional items. CONCLUSIONS: The psychometric properties of the affective scales and the positive expectation scales allow conclusions to be drawn regarding group differences in attitudes towards OAE or ECA behaviours. These scales are ready to be cross-validated in a new sample. Test-retest reliability should also be established.     

The effects of an undergraduate programme of preschool teaching on preservice teachers' attitudes towards early mathematics education in Turkey: a longitudinal study

The aim of this study is to set forth preservice teachers' attitudes towards early mathematics education. For this purpose, quantitative and qualitative research methods were used conjunctively and the research was planned in accordance with a ‘screening model’. The longitudinal screening model, one of the screening models, was used in the study. The study group of the research consisted of 58 preservice teachers studying at Giresun University, Faculty of Education, Department of Preschool Teaching. ‘Scale for Determining Preschool Teachers’ Attitudes towards Early Mathematics Education’ and ‘Form for Opinions about Early Mathematics Education’ were used to collect data of the study. Data of the investigation were collected from the same study group for four years, namely in 2010, 2011, 2012 and 2013. The results of the study revealed that preservice preschool teachers' ‘Attitudes towards children's mathematical skills’, ‘Attitudes towards early mathematics education setting’, ‘Attitudes towards early mathematics education’ and ‘Total attitude’ scores varied statistically significantly by years. In view of preservice teachers' opinions, it is clear that some of the courses that they took in undergraduate study positively influenced their attitudes towards mathematics.