Development and initial validation of the attitudes toward face mask use scale (ATFMUS)

Abstract

Despite availability of instruments for measuring attitudes towards mask use, the psychometric properties of many available instruments are not adequately established which limits their research usefulness across contexts. In three studies, we developed the Attitudes Towards Face Mask Use Scale (ATFMUS) in three phases: item generation, scale development, and scale evaluation. Phase one and two were addressed in study 1 while phase three was addressed in studies 2 and 3. In Study 1, a combined online and pen-and-paper sample of 174 (78% university students) completed a questionnaire with 19 items regarding attitudes towards face mask use derived from theory, previous research, and experience. Responses were subjected to item reduction analysis, exploratory factor analysis and reliability analysis. In Study 2, a student sample of 674 (70.5% high school) completed the new scale together with measures of COVID-19 related anxiety and obsession, personality, affect, social media use, and social desirability. Data from the ATFMUS were analyzed using confirmatory factor analysis and pertinent revisions done. The ATFMUS was then validated using correlation analyses, measurement invariance analyses, and known-group comparisons. In study 3, two samples of university students from Ghana (n = 242) and Kenya (n = 199) were involved in testing the cross-country invariance of the ATFMUS. The results reveal that the 5-item ATFMUS is a reliable and valid scale for assessing attitudes towards face mask use. Invariance analysis revealed that the ATFMUS is fair to use across participants of different age, level of education, and countries. The scale is also sensitive to participants’ actual use of face masks as well as their beliefs about COVID-19 and efficacy of the facemasks. This study offers a foundation for further psychometric evaluation of the ATFMUS.