Psychometric Properties Of Instrument Research Articles

Unraveling the Concept of Childhood Adversity in Psychosis Research: A Systematic Review.

During the last decades, an abundance of studies has investigated childhood adversity in relation to psychosis. This systematic review critically examines the methodologies employed to investigate childhood adversity in psychosis over the past decade, including operational definitions, measurement tools and characteristics, and psychometric properties of instruments used in these studies. This systematic review followed the PRISMA guidelines (registration number CRD42022307096), and the search used the following electronic databases: PsychINFO, SCOPUS, Web of Science, African Index Medicus (AIM), LILACS, CINAHL, EMBASE, and MEDLINE. The search included variations and combinations of the terms targeting childhood adversity and psychosis. Out of 585 identified studies published between 2010 and 2023, 341 employed a validated instrument to investigate childhood adversity. Our findings show "childhood trauma" being the most frequently examined construct, followed by "child maltreatment" or "child abuse." The short version of the Childhood Trauma Questionnaire was the dominant instrument. Physical abuse, emotional abuse, and sexual abuse were most frequently investigated, and indeed the field appears generally to focus on child abuse and neglect over other adversities. Significant psychometric heterogeneity was observed in the selection and summarization of instrument items, with only 59% of studies documenting original psychometric validation and 22% reporting reliability in their datasets. This review highlights substantial methodological heterogeneity in the field, pointing out biases in the research on childhood adversity and psychosis. These findings underline the need for standardized definitions and high-quality measurement tools to enhance the validity of future research in this area.

Design and validation of the general scale of academic engagement for Spanish adolescents (CAADE)

Academic engagement is considered one of the most essential elements to achieve educational success and decrease levels of school dropout. However, there is a need to develop reliable, practical and valid instruments that evaluate the academic engagement of adolescents taking into account their multidimensionality. The main aim of this research was to design and validate the General Scale of Academic Engagement for Spanish Adolescents that overcomes this limitation. The elaboration process began with the creation of items that are relying on the evaluation of existing literature, then the items were refined thanks to the reviews of the experts and discussion groups with adolescents. Data from 1158 students in compulsory secondary education were analyzed. The instrument's psychometric properties were determined by comprehension validity, analysis of content, reliability and construct validity. An Exploratory Factor Analysis was performed with the first sample (n = 356), while the second sample (n = 802) was used to verify the factor structure identified through Confirmatory Factor Analysis. Evidence of reliability and validity was provided for the instrument using SPSS Version 27 and SPSS AMOS. The results of the analyses resulted in a questionnaire of 17 items grouped into three factors (Cognitive, Affective-Emotional and Behavioral), and confirm that the General Scale of Academic Engagement for Spanish Adolescents (CAADE) has an adequate construct validity and reliability. In summary, this study has resulted in the development of a tool that can be utilized by educators or any institution concerned in evaluating student academic engagement, a construct that does not yet to have consensus.

Climate change perception scale: Adaptation and psychometric properties in the Indonesian context

AbstractOne of the crucial factors in changing behaviour towards pro‐environmental actions is climate change perception. The latest measurement tool for assessing this variable is the Climate Change Perception Scale (CCPS). However, CCPS has not gained widespread adoption and usage across different cultures, including Indonesia, and no analyses have been conducted to adapt and validate CCPS in the Indonesian context. Therefore, this study aimed to adapt, validate, and assess the measurement tool's consistency in Indonesia's cultural context. To investigate the instrument's psychometric properties, two studies (n = 358, 415) were conducted in Indonesia to provide evidence of the internal consistency, convergent validity, and predictive validity of CCPS. The results of a confirmatory factor analysis (CFA) showed that the Indonesian version of CCPS, which consists of 15 items, with three for each dimension, accurately and reliably measured perception of climate change. CCPS also demonstrated good convergent validity, as indicated by the significant correlations with a nature relatedness (r = 0.425, p < 0.01) and biospheric value (r = 0.341, p < 0.01) construct. Furthermore, it exhibited predictive validity by predicting pro‐environmental behaviour, β = 0.243, b = 0.176, t(413) = 5.10, p < 0.01. However, the Indonesian version of CCPS still needs to be tested and confirmed through various studies, considering the poor validity of the temporal dimension and the weak factor loading of the consequence dimension in Study 2.

A hybrid systematic narrative review of instruments measuring home-based care nurses' competency.

The aim of the study was to identify and synthesize the contents and the psychometric properties of the existing instruments measuring home-based care (HBC) nurses' competencies. A hybrid systematic narrative review was performed. The eligible studies were reviewed to identify the competencies measured by the instruments for HBC nurses. The psychometric properties of instruments in development and psychometric testing design studies were also examined. The methodological quality of the studies was evaluated using the Medical Education Research Study Quality Instrument and COSMIN checklist accordingly. Relevant studies were searched on CINAHL, MEDLINE (via PubMed), EMBASE, PsychINFO and Scopus from 2000 to 2022. The search was limited to full-text items in the English language. A total of 23 studies reporting 24 instruments were included. 12 instruments were adopted or modified by the studies while the other 12 were developed and psychometrically tested by the studies. None of the instruments encompassed all of the 10 home-based nursing care competencies identified in an earlier study. The two most frequently measured competencies were the management of health conditions, and critical thinking and problem-solving skills, while the two least measured competencies were quality and safety, and technological literacy. The content and structural validity of most instruments were inadequate since the adopted instruments were not initially designed or tested among HBC nurses. This review provides a consolidation of existing instruments that were used to assess HBC nurses' competencies. The instruments were generally not comprehensive, and the content and structural validity were limited. Nonetheless, the domains, items and approaches to instrument development could be adopted to develop and test a comprehensive competency instrument for home-based nursing care practice in the future. This review consolidated instruments used to measure home-based care nurses' competency. The instruments were often designed for ward-based care nurses hence a comprehensive and validated home-based nursing care competency instrument is needed. Nurses, researchers and nursing leaders could consider the competency instruments identified in this review to measure nurses' competencies, while a home-based nursing care competency scale is being developed. No patient or public contribution was required in this review.

Evaluation of Standard Precautions Compliance Instruments: A Systematic Review Using COSMIN Methodology.

Standard precautions (SPs) are first-line strategies with a dual goal: to protect health care workers from occupational contamination while providing care to infected patients and to prevent/reduce health care-associated infections (HAIs). This study aimed at (1) identifying the instruments currently available for measuring healthcare professionals' compliance with standard precautions; (2) evaluating their measurement properties; and (3) providing sound evidence for instrument selection for use by researchers, teachers, staff trainers, and clinical tutors. We carried out a systematic review to examine the psychometric properties of standard precautions self-assessment instruments in conformity with the COSMIN guidelines. The search was conducted on the databases PubMed, CINAHL, and APA PsycInfo. Thirteen instruments were identified. These were classified into four categories of tools assessing: compliance with universal precautions, adherence to standard precautions, compliance with hand hygiene, and adherence to transmission-based guidelines and precautions. The psychometric properties of instruments and methodological approaches of the included studies were often not satisfactory. Only four instruments were classified as high-quality measurements. The available instruments that measure healthcare professionals' compliance with standard precautions are of low-moderate quality. It is necessary that future research completes the validation processes undertaken for long-established and newly developed instruments, using higher-quality methods and estimating all psychometric properties.

Emergence of Social Media as an antecedent of Employability: A PLS-SEM Approach

Purpose : This study intended to investigate the influence of social media on the perceived employability of students, with a special emphasis on the use of social networking sites (SNS) such as Facebook, LinkedIn, and Twitter. Other independent variables of this study are the contacts of students, which can help them find and attain the desired job. Methodology : Using descriptive research design, data were collected through a structured questionnaire using a 7-point Likert scale from 339 management students. The psychometric properties of instruments were determined through validity and reliability. Furthermore, structural assessments were conducted using hypothesis testing, model fit estimates, and predictive relevance (r - square). Findings : The results showed a positive and significant influence of SNS and contacts on the perceived employability of students. SNS and contacts were found to create a variance of 33% in perceived employability. Moreover, the reliability and validity of the adapted instrument were well established, supporting its use and application in the Indian context. Practical Implications : The theoretical implication of this study is for social capital theory and the unified theory of acceptance and use of technology model. The implications of this study are meant for management students, higher education institutes, career educationalists, and policymakers. Originality : The novelty of this research lies in the fact that it aims at capturing the perception of Indian students regarding the usage of SNS for employability.

Assessing customers' attitude towards online apparel shopping: A three-way interaction model

This paper aims to explore the attitude-intention-purchase behavior mechanism for the online purchase of apparel. Using the theory of planned behavior (TPB) as an underpinning theory, the moderating effects of electronic word of mouth (EWOM), perceived risk, and perceived behavioral control in the relationships have been examined. Data were collected from 432 online apparel consumers using a survey questionnaire. First, the instrument's psychometric properties were checked, and then data was analyzed using Hayes's PROCESS macros. The results indicate that online purchase intention mediates the relationship between consumers' attitudes toward online shopping and actual purchase behavior. In addition, the results found strong support for the three-way interactions between attitude, perceived risk, and EWOM on purchase intention, and (ii) attitude, EWOM, and perceived behavioral control on actual purchase behavior mediated through purchase intention. The three-way interactions involving the double-moderation of EWOM make significant contributions to the growing literature on online buying.

Assessing validity of the EQ-5D-5L proxy in children and adolescents with Duchenne muscular dystrophy or spinal muscular atrophy.

To assess the psychometric properties of the EuroQol-5-Dimension five-level instrument (EQ-5D-5L) proxy in caregivers of children and adolescents with Duchenne muscular dystrophy (DMD) or spinal muscular atrophy (SMA). Data were collected using the EQ-5D-5L proxy for individuals with DMD or SMA, as reported by their caregivers. Ceiling and floor effects, reliability (Cronbach's alpha), convergent and divergent validity (Spearman's correlation coefficient and Bland-Altman plot) and known-group validity (analysis of variance) was used to assess the instrument's psychometric properties. Totally, 855 caregivers completed the questionnaire. Significant floor effects were observed for most dimensions of the EQ-5D-5L in both SMA and DMD samples. The EQ-5D-5L was strongly correlated with the hypothesized subscales of the SF-12, which confirmed satisfactory convergent and divergent validity. The EQ-5D-5L can significantly differentiate between impaired functional groups for individuals, demonstrating satisfactory discriminative ability. The agreement between the EQ-5D-5L utility and EQ-VAS scores was poor. Based on the measurement properties assessed in this study, the EQ-5D-5L proxy is a valid and reliable tool for measuring the health-related quality of life of individuals with DMD or SMA rated by caregivers. Further studies should examine the content validity of the EQ-5D as well as the performance of its young version in these two patient groups.

Examining concurrent validity and item selection of the Session Wants and Needs Outcome Measure (SWAN-OM) in a children and young people web-based therapy service.

Single-session mental health interventions are frequently attended by children and young people (CYP) in both web-based and face-to-face therapy settings. The Session "Wants" and "Needs" Outcome Measure (SWAN-OM) is an instrument developed in a web-based therapy service to overcome the challenges of collecting outcomes and experiences of single-session therapies (SSTs). It provides pre-defined goals for the session, selected by the young person prior to the intervention, on which progress toward achievement is scored at the end of the session. The objective of this study was to evaluate the instrument's psychometric properties, including concurrent validity against three other frequently used outcome and experience measures, at a web-based and text-based mental health service. The SWAN-OM was administered for a period of 6 months to 1,401 CYP (aged 10-32 years; 79.3% white; 77.59% female) accessing SST on a web-based service. Item correlations with comparator measures and hierarchical logistic regressions to predict item selection were calculated for concurrent validity and psychometric exploration. The most frequently selected items were "Feel better" (N = 431; 11.61%) and "Find ways I can help myself" (N = 411; 11.07%); unpopular items were "Feel safe in my relationships" (N = 53; 1.43%) and "Learn the steps to achieve something I want" (N = 58; 1.56%). The SWAN-OM was significantly correlated with the Experience of Service Questionnaire, particularly the item "Feel better" [rs(109) = 0.48, p < 0.001], the Youth Counseling Impact Scale, particularly the item "Learn the steps to achieve something I want" [rs(22) = 0.76, p < 0.001], and the Positive and Negative Affect Schedule, particularly the items "Learn how to feel better" [rs(22) = 0.72, p < 0.001] and "Explore how I feel" [rs(70) = -0.44, p < 0.001]. The SWAN-OM demonstrates good concurrent validity with common measures of outcome and experience. Analysis suggests that lesser-endorsed items may be removed in future iterations of the measure to improve functionality. Future research is required to explore SWAN-OM's potential to measure meaningful change in a range of therapeutic settings.

Internal validity evidence of a knowledge questionnaire on alcohol use, abuse and dependence and associated questions.

to perform content validity and verify the psychometric properties of the adapted version of an alcohol knowledge questionnaire and associated questions. a methodological study, in which a committee of judges analyzed the questionnaire item representativeness, clarity and relevance. Item response theory was used to assess the instrument psychometric properties applied to a sample of 240 health professionals. the questions were adjusted according to judges' assessment, obtaining a satisfactory Content Validity Index (0.98). High discrimination ability and adequate difficulty levels were observed in 75% of multiple-choice questions and in 25% of statements. the instrument presented content validity with satisfactory indices. However, it is recommended that the questionnaire adapted in this study be used in different samples of health professionals from other parts of Brazil, in order to provide greater robustness to its reliability.

Multinational evaluation of the measurement invariance of the Level of Personality Functioning Scale-brief form 2.0: Comparison of student and community samples across seven countries.

The Diagnostic and Statistical Manual of Mental Disorders-fifth Edition's (DSM-5) Level of Personality Functioning Scale (LPFS) was introduced as a dimensional rating of impairments in self- and interpersonal functioning, and the LPFS-Brief Form (LPFS-BF) was the first published corresponding self-report. The updated LPFS-BF 2.0 has been translated into several languages and international research supports many of the instrument's psychometric properties; however, its measurement invariance has only been evaluated across a few countries. This study expands previous studies as an introductory step in a global evaluation of the LPFS-BF 2.0s measurement invariance. Archival data (N = 5,618, 57% female) from seven countries (Canada, Chile, Denmark, Germany, Italy, United Arab Emirates, United States of America) were used for this study. Participants were recruited from both community (n = 4,677) and student (n = 941) populations. After confirming adequate model fit separately in the community and student samples, we evaluated a series of increasingly stringent model comparisons to test three aspects of measurement invariance (configural, metric, scalar) and then examined latent mean differences across countries. Full scalar invariance was supported in the community sample and partial scalar invariance was supported in the student sample. Evaluation of latent mean differences revealed multiple significant differences. Overall, the LPFS-BF 2.0 appears to assess self- and interpersonal functioning impairment similarly across the included countries. Findings are discussed through the lenses of the cultures from which participants were recruited, as well as in the context of alternative explanations. Limitations, plans for future research, and implications for both research and clinical practice are offered. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

"Consumer innovativeness scale": Adaptation and validation with undergraduate students

This research aimed to adapt and validate Goldsmith and Hofacker's scale of Consumer Innovativeness. We employed a cross-cultural adaptation and assessment of the instrument's psychometric properties from the original scale, including content validity, face validity, semantic validity, and statistical analysis with exploratory and confirmatory factor analysis. The sample consisted of 318 participants. We present a six-item validated scale for application with undergraduate students in several scenarios of innovativeness of consumption, adapted and validated theoretically and empirically. The results showed satisfactory evidence of the scale's validity and reliability. The validation with undergraduate students can be considered a limitation of the study, while the broad scope of application of scale can foster posterior research on consumer innovativeness. The results presented are the first validated version of Goldsmith and Hofacker for undergraduate students in Portuguese as far as we are concerned.

Role of social currency in customer experience and co-creation intention in online travel agencies: Moderation of attitude and subjective norms

This study investigates the relationship between social currency and customer experience concerning online travel agencies. Riding on the theory of planned behavior (TPB), we explore the moderating effect of attitude and subjective norms on customer experience. First, a conceptual model is developed and tested using the data collected from 392 respondents from India. Then, after checking the instrument's psychometric properties, we used hierarchical regression to test hypotheses. The results indicate that (a) social currency, (b) attitude, and (c) subjective norms are positively associated with customer experience. Furthermore, the findings also support attitude and subjective norms moderating the relationship between social currency and customer experience. Finally, customer experience positively predicts co-creation intention by customers. The implications for theory and practice are discussed.

Investigating method effects associated with the wording direction of items of the Social Physique Anxiety Scale.

PurposeThe use of psychometric instruments to measure latent concepts is common. The development of these instruments usually involves mechanisms to reduce response bias, such as the inclusion of reversed items. The aim of this study was to investigate method effects related to the wording direction of the Social Physique Anxiety Scale (SPAS) items, a one-dimensional instrument that assesses individual’s level of anxiety when others observe their body.MethodsIn total, 152 Brazilian adults (65.8% female) answered 2 formats of the SPAS: the original with 12 items (7 regular and 5 reversed); and a new format with all items written in the same direction (i.e., regular). Both formats were filled out at different times and alternately. Differential item functioning analysis (DIF) and confirmatory factor analysis were conducted.ResultsThe original SPAS did not fit the data, but after allowing covariances between all reversed items, the fit improved. The wording effect was supported by the DIF, indicating a better fit to the data for the new format with all items worded in the same direction.ConclusionThe wording of the SPAS items had effect on the psychometric properties of instrument. When the wording of the reversed items was modified, the factor model fitted the data. Future studies should take these findings into account and evaluate the SPAS with all items worded in the same direction in different contexts.Level of evidenceDescriptive (cross-sectional) study, Level V.Supplementary InformationThe online version contains supplementary material available at 10.1007/s40519-022-01439-x.

Recognition and rewards as moderators in the relationships between antecedents and performance of women teachers: evidence from India

PurposeAs teachers are considered “knowledge workers,” the present study explores teacher performance in schools. A particular emphasis is given to assessing the performance of female teachers in the rural part of South India.Design/methodology/approachAfter collecting data from 563 female teachers from four blocks in Nilgiris District (Ooty, Kotagiri, Coonoor and Gudalur) consisting of 37 government schools in the southern part of India, all the female teachers were surveyed, and the data were analyzed after checking the instrument's psychometric properties by performing confirmatory factor analysis. Hierarchical regression was employed to test the hypotheses.FindingsThe findings revealed that (1) empowerment, organizational communication and work–life balance (WLB) and recognition and rewards are positively and significantly related to teacher performance; (2) recognition and rewards moderate the relationship between (a) empowerment and performance, (b) organizational communication and performance, (c) WLB and performance, (d) organizational culture and performance and (e) quality of work-life (QWL) and performance.Research limitations/implicationsAs with any survey research, common method bias and social desirability bias may be potential limitations. However, proper care is taken to minimize these biases. The findings from this study contribute to the growing literature on education and training. In addition, the study highlights the importance of creating a climate for empowerment, recognition and rewards to foster teacher performance.Practical implicationsThe study helps administrators and policymakers to understand the antecedents of teacher performance and take necessary steps to motivate the teachers for superior performance.Originality/valueThe conceptual model the authors developed and tested is, according to the authors' knowledge, the first of the model's kind. A clear understanding of the predictors of teacher performance may guide the administrators and teaches in fostering performance in schools. The exclusive focus on female teachers is considered in this study because of the several problems the female teachers encounter in rural areas. Despite the disadvantages, female teachers perform well and contribute to students and the country as a whole.

Instruments used to measure knowledge and attitudes of healthcare professionals towards antibiotic use for the treatment of urinary tract infections: A systematic review.

Urinary tract infections (UTIs) are the second most common condition (after upper respiratory tract infections) for which adults receive antibiotics, and this prevalence may contribute to antibiotic resistance. Knowledge and attitudes have been identified as potential determinants of antibiotic prescribing behaviour among healthcare professionals in the treatment and management of UTIs. An instrument that captures prescribers' baseline knowledge of and attitudes towards antibiotic prescribing for UTIs could inform interventions to enhance prescribing. The current systematic review evaluates the psychometric properties of instruments already available and describes the theoretical constructs they measure. Five electronic databases were searched for published studies and instruments. The Consensus-based Standards for the selection of health status Measurement Instruments checklist was used to assess the psychometric quality reporting of the instruments. The items included in each instrument were mapped onto the theoretical constructs underlying knowledge and attitudes using a mixed-theoretical model developed for this study. Fourteen studies met the review inclusion criteria. All instruments were available for review. None of the instruments had all the psychometric properties evaluated. Most of the instruments sought to identify knowledge and/or attitude factors influencing antibiotic prescribing for UTIs rather than to measure/assess knowledge and attitudes. Few instruments for the assessment of knowledge and attitudes of healthcare professionals towards antibiotic use and UTI treatment are available. None of the instruments underwent the full development process to ensure that all psychometric properties were met. Furthermore, none of the instruments assessed all domains of knowledge and attitudes. Therefore, the ability of the instruments to provide a robust measurement of knowledge and attitudes is doubtful. There is a need for an instrument that fully and accurately measures the constructs of knowledge and attitude of healthcare professionals in the treatment of UTIs.

Psychometric properties of the healthy aging brain care monitor self-report tool in patients discharged from the intensive care unit.

Intensive care unit survivors experience new and ongoing physical, psychological, and cognitive complications known as postintensive care syndrome. The study aimed to investigate the psychometric properties of the healthy aging brain care monitor self-report tool for assessing postintensive care syndrome in Iranian patients. The study is a methodological study investigating the psychometric properties of the healthy aging brain care monitor self-report tool in 153 patients discharged from the intensive care unit. The instrument's psychometric properties were examined to determine content validity, construct validity (factor analysis, convergent validity, and discriminant validity), concurrent validity, and internal consistency. The factor structure of the healthy aging brain care monitor self-report tool was examined in the form of two models: the three-factor model with 27 items and the three-factor model with 19 items. Regarding fit indices and results of the convergent, discriminant validities and the internal consistency the 19-item model is better than the original 27-item model. The study showed that the appropriate model for the healthy aging brain care monitor self-report tool in Iranian society is a tool with 19 items with the best conditions in terms of factor structure, internal consistency, and overall psychometric characteristics. The present study led to the introduction of a valid instrument with a 19-item factor structure to assess the postintensive care syndrome by nurses and other healthcare providers in hospitals, clinics, palliative care centers, and home care centers.

Lifestyle and Life Expectancy Questionnaire: validation and assessment in an Italian sample.

The objective of this study was to evaluate the relia-bility and validity of the lifestyle (Miller-Smith) and life expectancy (Schneider) questionnaires in the Italian setting in order to make this instrument available for the determination of lifestyle and hope level in the different domains of everyday life. Before testing their psychometric properties, the original versions of the two questionnaires, lifestyle (Miller-Smith) and life expectancy (Schneider), were translated into the Italian language. We tested the instrument's psychometric properties on a sample of 18 patients over 60 years old with Alzheimer's disease in the Sapienza University of Rome teaching hospital, policlinico Umberto 1. Internal consistency was considered to assess the reliability of the results across items within the adopted scale by using Cronbach's α coefficient. Using Kolmogorov-Smirnov's test, the normality distribution was evaluated to guarantee the applicability of a parametric or non-parametric test. The software used to analyze data was SPSS version 26 for Windows. According to the outcome of our statistical analysis, the lifestyle scale showed high overall internal consistency, and the Cron-bach's α coefficient for the total 20-item scale was 0.80 in the Italian population. On the other hand, using the 12-item questionnaire about life expectancy resulted in a high overall internal consistency of 0.93, according to the Cronbach's alpha test. The outcome of our study shows that the Italian versions of the lifestyle (Miller-Smith) and life expectancy (Schneider) questionnaires demonstrated good psychometric properties and good characteristics of factorial validity for future epidemiological studies aimed at evaluating lifestyle and lifestyle expectancy in the Italian population and can as well be used in clinical practice and research.

Psychometric Properties of Self-Regulated Learning Strategies in Learning English Grammar and English Grammar Self-Efficacy Scales

The study reports on the psychometric properties of instruments that can measure EFL students’ self-regulated learning strategy use and English grammar self-efficacy and examines the relationship between these two constructs. 350 male and 432 female students, aged between 16 and 17, from two high schools in Vietnam participated in the survey. The participants answered the Questionnaire of Self-Regulated Learning Strategies in Learning English Grammar (QSRLSLEG), and the Questionnaire of English Grammar Self-Efficacy (QEGSE). The disjoint two-stage approach for Partial Least Square-Structural Equation was used to analyze the data. The results showed that the 24-item QSRLSLEG and 8-item QEGSE have face, content, and construct validity and reliability. A moderate relationship between SRL strategies in English grammar learning and English grammar SE was found. Both instruments are reliable and valid assessment tools, providing useful information for researchers and English teachers to investigate important aspects of students’ self-regulation in learning English grammar.

A school-based educational on-site vaccination intervention for adolescents in an urban area in Germany: feasibility and psychometric properties of instruments in a pilot study

BackgroundVaccination rates for measles, mumps, and rubella (MMR) and diphtheria, tetanus, pertussis, and polio (Tdap-IPV) are not optimal among German adolescents. Education in combination with easy access to vaccination may be a promising approach to improve vaccination rates. The present paper describes a pilot study of a planned cluster randomized controlled trial (cRCT) in which we aim to improve MMR and Tdap-IPV vaccination rates together with knowledge and self-efficacy in a school setting.MethodsThe study covered 863 students from 41 classes of four schools. The optimization and feasibility of access to schools, recruitment strategies, intervention, and assessment procedures were examined. The course and content of the educational unit were evaluated with a mixed-methods approach. A pre-post measurement design was tested for the vaccination rate in all schools. Additionally, at two schools, improvement in vaccination-related knowledge and perceived self-efficacy were measured by questionnaire pre-educational unit (n=287) and post-educational unit (n=293). The remaining two schools provided only postintervention data. Finally, we evaluated the psychometric properties (i.e., reliability, retest reliability, and change rates) of the questionnaire, applying Cronbach’s alpha, factor analyses, generalized estimating equations and linear mixed models.ResultsThe findings of the pilot study indicated good feasibility. Of the total sample, 437 students (50.9%) brought their vaccination cards to school, 68 students received Tdap-IPV vaccinations, and 11 received MMR vaccinations. Out of six knowledge questions, on average, the students had M=2.84 (95% CI [2.69, 3.10]) correct answers before and M=4.45 (95% CI [4.26, 4.64]) after the class. Ranging from 1 to 4, the self-efficacy scale changed by 0.3 points (p <.001); Cronbach’s alpha was 0.67 and 0.76 pre- and post-educational unit, respectively, and a one-factor solution was found. Content analysis of the five semistructured group interviews (n=12, 58.3% female) showed that all students found the length of the intervention to be appropriate. The teaching methods, including interactive and social media components, were perceived as very good.ConclusionsA school-based educational and on-site vaccination intervention appears to be feasible in terms of procedures and the adequacy of the instruments for the adolescent target group.Trial registrationISRCTN, ISRCTN18026662. Pilot study for main trial registered 8 December 2017.