A psychometric assessment of a novel scale for evaluating vaccination attitudes amidst a major public health crisis

Linan Cheng · Jianhui Kong · Xiaofeng Xie · Fengying Zhang

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Vaccine Coverage and Hesitancy Psychometric Methodologies and Testing Health Education and Validation

Abstract

Despite abundant scientific evidence supporting immunization benefits, vaccine hesitancy remains a significant global health concern, particularly during public health crises. Exploring public attitudes towards vaccination is crucial. This study aimed to develop and validate a tailored Public Vaccination Attitudes Scale specifically under the unique circumstances of a public health crisis. A psychometric evaluation was conducted using a cross-sectional study during the peak of a major public health crisis. The scale was developed and its psychometric properties validated using three approaches: (1) generating the item pool through literature research and focus group discussions; (2) assessing the items through expert consultation; and (3) evaluating construct validity, content validity, and internal consistency reliability through exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Data from a total of 3921 respondents were randomly divided into two subsets, one for EFA (n = 1935) and the other for CFA (n = 1986). A 22-item draft scale with five factors was created after literature research and focus group discussion. The content validity of this scale ranged between 0.88 and 1.00. EFA showed a 17-item scale with four factors (Cronbach's α > 0.7) accounting for 68.044% of the total variance. CFA showed that the values of the fit indices, including convergent validity and discriminant validity, were excellent or acceptable. The overall Cronbach's α was 0.874, and each factor ranged from 0.726 to 0.885. This study introduces a valuable tool for assessing vaccination attitudes during public health crises, aiding researchers, policymakers, and nurses in combating vaccine hesitancy. Emphasizing the importance of fostering vaccine acceptance, it enhances disease control during emergencies, contributing to the knowledge needed for more effective public health strategies and crisis responses.

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References

2012Principles and Practice of Structural Equation Modeling 2007Is the CVI an acceptable indicator of content validity? Appraisal and recommendations 2021Measuring the impact of COVID-19 vaccine misinformation on vaccination intent in the UK and USA 2021COVID-19 vaccine acceptance and hesitancy in low- and middle-income countries 2021Vaccine Hesitancy, Acceptance, and Anti-Vaccination: Trends and Future Prospects for Public Health 2017Understanding the Dimensions of Anti-Vaccination Attitudes: the Vaccination Attitudes Examination (VAX) Scale 2020A Proactive Approach for Managing COVID-19: The Importance of Understanding the Motivational Roots of Vaccination Hesitancy for SARS-CoV2 2021Covid-19 vaccine acceptance, hesitancy, and refusal among Canadian healthcare workers: A multicenter survey

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