Development and validation of the air pollution exposure protective behavior scale for toddlers

Abstract

Abstract Objectives: This study aimed to develop the air pollution exposure protective behavior scale for toddlers and test its psychometric properties, to provide a tool for the assessment of air pollution exposure protective behaviors for toddlers. Methods: A draft scale containing 39 items was constructed based on an evidence summary, an interview, and a literature review. The scale was revised according to the comments from 16 experts in public health, environmental science, and nursing through a modified Delphi method, and the results of a pilot test of air pollution exposure protective behaviors for toddlers (n = 57). A formal survey was conducted using the revised scale (n = 876). Factor structure and model fit of the scale were examined using exploratory factor analysis and confirmatory factor analysis. An expert consultation was conducted to assess the content validity. Known-groups validity, internal consistency, test-retest reliability, and split-half reliability of the scale were also calculated. Results: A 5-point Likert Scale of 4 dimensions, consisting of 25 main items, 2 additional items, and 4 validation items, was developed in this study, to assess the air pollution exposure protective behaviors for toddlers. In the formal survey, the 4 factors of the scale explained 63.0% of the variance, with a good model fit and acceptable convergence. The scale Cronbach α was 0.93. The test-retest correlation coefficients for all 4 dimensions and the whole scale scores were above 0.70 and statistically significant, with a Spearman-Brown coefficient of 0.85. Conclusion: This study developed and validated an assessment scale, the air pollution exposure protective behavior scale for toddlers, with good reliability and validity. This scale can provide a basis for clarifying the current situation of air pollution exposure protective behaviors for toddlers and for implementing precision nursing on respiratory symptoms and diseases for toddlers.