Zhongguo quanke yixue (Apr 2022)
Development, Validity and Reliability of High-risk People's Intention to Use Stroke Screening Scale
Abstract
Background The program of screening for stroke in high-risk populations is being carried out vigorously in Chinese communities, the implementation effectiveness of which is closely associated with residents' intention to use the program. However, there is no reliable scale for measuring high-risk residents' intention to use stroke screening. Objective To develop a scale for measuring high-risk people's intention to use stroke screening, and to assess its reliability and validity, providing a reliable tool for assessing high-risk residents' intention to use stroke screening. Methods The Theory of Planned Behavior, literature review, field survey and brainstorming were used to develop the item pool of the scale. Then the items were used to form an initial version of High-risk People's Intention to Use Stroke Screening Scale (three domains covering 28 items) after being revised in accordance with the assessment results of two rounds of expert survey with five experts (four stroke researchers and one with a good command of developing a scale) from July to August 2021. After that, the reliability and validity of the initial version of the scale was tested in August to September 2021 with a convenience sample of community residents from Hubei's Xiangyang, Wuhan, Jingmen, and Guangdong's Guangzhou, Huizhou, Shenzhen. Results Altogether, 535 residents attended the survey for testing the reliability and validity of the initial version of the scale, and 524 of them (98%) returned responsive questionnaires. The final revised version consists of four domains (positive attitude, negative attitude, subjective norms, perceived behavioral control) with 25 items. The Cronbach's α of the scale was 0.904. And its ICC for test-retest reliability was 0.810. The content validity index of each item (I-CVI) ranged from 0.80 to 1.00. The scale-level CVI/universal agreement (S-CVI/UA) and average scale-level CVI (S-CVI/Ave) were 0.93 and 0.99, respectively. By exploratory factor analysis, four common factors were extracted, and they explained 61.945% of the total variance. The loading for each factor was 0.482-0.828. Confirmatory factor analysis showed that the scale's fit indices were: χ2=361.040, df=267, χ2/df=1.352, RMSEA=0.038, GFI=0.897, CFI=0.958, AGFI=0.875, IFI=0.959, TLI=0.953, NFI=0.859. Conclusion The scale has proven to be highly reliable and valid, which could be used as a tool for measuring high-risk community-dwelling residents' intention to use stroke screening.
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