RISK PERCEPTION IN CHILDHOOD VACCINATION QUESTIONNAIRE: A VALIDATION STUDY ON PREGNANT MOTHERS IN MALAYSIA
DOI:
https://doi.org/10.37268/mjphm/vol.22/no.1/art.1411Keywords:
Risk Perception, Questionnaire Validation, Vaccination, Structural Equation ModellingAbstract
Quantitative study on risk perception in vaccination encompasses various theoretical basis, health context, and psychometric validity and reliability. In the context of basic childhood vaccination, there was a lack of locally validated and reliable instrument to measure risk perception for vaccine-preventable disease. As such, this study aimed to validate and assess reliability of developed instruments in Malay language. Items were generated from available items in previous research and adopting recommendations on operationalising the construct. Generated items were measured for content validity index by seven experts, tested for factorial validity using exploratory (EFA) and confirmatory factor analysis (CFA) using structural equation modelling. Reliability was established using Cronbach’s alpha. Seven items measured perceived likelihood whereas eight items measured perceived severity. Reliability index was 0.97 for perceived likelihood and 0.94 for perceived severity. CFA on second-order measurement model revealed satisfactory model fit ?2/df (1.55), CFI 0.96, TLI 0.95, and RMSEA 0.11. The average variance explained was 0.73 for perceived likelihood and 0.73 for perceived severity and CR was 0.95 and 0.96 for perceived likelihood and perceived severity, respectively. Both constructs showed significant positive correlation (r = 0.19, p < 0.01) with each other indicating divergent validity. Thus, the Malay risk perception questionnaire established good content, factorial, and divergent validity, as well as good reliability on Cronbach’s alpha. The instrument should be valuable to re-examine risk perception’s role in the resurgence of vaccine hesitancy in the local population.
References
Popova L. The Extended Parallel Process Model: Illuminating the Gaps in Research. Heal Educ Behav. 2012;39(4):455-473. doi:10.1177/1090198111418108
Karafillakis E, Larson HJ. The benefit of the doubt or doubts over benefits? A systematic literature review of perceived risks of vaccines in European populations. Vaccine. 2017;35(37):4840-4850. doi:10.1016/j.vaccine.2017.07.061
Guvenc G, Seven M, Akyuz A. Health Belief Model Scale for Human Papilloma Virus and its Vaccination: Adaptation and Psychometric Testing. J Pediatr Adolesc Gynecol. 2016;29(3):252-258. doi:10.1016/j.jpag.2015.09.007
Champion VL, Skinner CS. Health Belief Model. In: Glanz K, Rimer BK, Viswanath K, eds. Health Behaviour and Health Education; Theory, Research and Practice. 4th ed. Jossey-Bass; 2008:45-66.
Janz NK, Becker MH. The Health Belief Model: a decade later. Health Educ Q. 1984;11(1):1-47.
Ferrer R, Klein WM. Risk perception and health behaviour. Curr Opin Psychol. 2015;5:85-89. doi:10.1016/j.copsyc.2015.03.012.
Paek H-J, Hove T. Risk Perceptions and Risk Characteristics. 2017;1(June):1-15. doi:10.1093/acrefore/9780190228613.013.283
Mukherjee S, Madhivanan P, Li T, et al. Correlates of completing routine vaccination among children in Mysore, India. J Infect Public Health. 2015;8(1):62-71. doi:10.1016/j.jiph.2014.05.003
Vrdelja M, Učakar V, Kraigher A. From mandatory to voluntary vaccination: intention to vaccinate in the case of policy changes. Public Health. 2020;180:57-63. doi:10.1016/j.puhe.2019.10.026
Ben Natan M, Kabha S, Yehia M, et al. Factors That Influence Israeli Muslim Arab Parents’ Intention to Vaccinate Their Children Against Influenza. J Pediatr Nurs. 2016;31(3):293-298. doi:10.1016/j.pedn.2015.12.014
Ben Natan M, Midlej K, Mitelman O, et al. Intention of Mothers in Israel to Vaccinate their Sons against the Human Papilloma Virus. J Pediatr Nurs. 2017;33:41-45. doi:10.1016/j.pedn.2017.01.001
Bults M, Beaujean DJMA, Richardus JH, et al. Pandemic influenza A (H1N1) vaccination in The Netherlands: Parental reasoning underlying child vaccination choices. Vaccine. 2011;29(37):6226-6235. doi:10.1016/j.vaccine.2011.06.075
Chen C-H, Chiu P-J, Chih Y-C, et al. Determinants of influenza vaccination among young Taiwanese children. Vaccine. 2015;33(16):1993-1998. doi:10.1016/j.vaccine.2015.01.032
Chen MF, Wang RH, Schneider JK, et al. Using the health belief model to understand caregiver factors influencing childhood influenza vaccinations. J Community Health Nurs. 2011;28(1):29-40. doi:10.1080/07370016.2011.539087
Gerend MA, Barley J. Human papillomavirus vaccine acceptability among young adult men. Sex Transm Dis. 2009;36(1):58-62. doi:10.1097/OLQ.0b013e31818606fc
Hak E, Schönbeck Y, De Melker H, et al. Negative attitude of highly educated parents and health care workers towards future vaccinations in the Dutch childhood vaccination program. Vaccine. 2005;23(24):3103-3107. doi:10.1016/j.vaccine.2005.01.074
Krawczyk A, Knäuper B, Gilca V, et al. Parents’ decision-making about the human papillomavirus vaccine for their daughters: I. quantitative results. Hum Vaccines Immunother. 2015;11(2):322-329. doi:10.1080/21645515.2014.1004030
Lee YM, Riesche L, Lee H, et al. Parental HPV knowledge and perceptions of HPV vaccines among Korean American parents. Appl Nurs Res. 2018;44(September):54-59. doi:10.1016/j.apnr.2018.09.008
Lasseter G, Al-janabi H, Trotter CL, et al. Understanding the role of peace of mind in childhood vaccination : A qualitative study with members of the general public. Vaccine. 2020;38(10):2424-2432. doi:10.1016/j.vaccine.2019.12.009
Tsuchiya Y, Shida N, Izumi S, et al. Factors associated with mothers not vaccinating their children against mumps in Japan. Public Health. 2016;137:95-105. doi:10.1016/j.puhe.2016.03.002
Arriola CS, Vasconez N, Bresee J, et al. Knowledge, attitudes and practices about influenza vaccination among pregnant women and healthcare providers serving pregnant women in Managua, Nicaragua. Vaccine. 2018;36(25):3686-3693. doi:10.1016/j.vaccine.2018.05.013
Low MSF, Tan H, Hartman M, et al. Parental perceptions of childhood seasonal influenza vaccination in Singapore: A cross-sectional survey. Vaccine. 2017;35(45):6096-6102. doi:10.1016/j.vaccine.2017.09.060
Devon HA, Block ME, Moyle-Wright P, et al. A psychometric toolbox for testing validity and reliability. J Nurs Scholarsh. Published online 2007. doi:10.1111/j.1547-5069.2007.00161.x
Cronbach LJ. Coefficient alpha and the internal structure of tests. Psychometrika. Published online 1951. doi:10.1007/BF02310555
Matsunaga M. Item Parceling in Structural Equation Modeling: A Primer. Vol 2.; 2008. doi:10.1080/19312450802458935
Brewer NT, Chapman GB, Gibbons FX, et al. Meta-analysis of the relationship between risk perception and health behavior: The example of vaccination. Heal Psychol. 2007;26(2):136-145. doi:10.1037/0278-6133.26.2.136
Chapman GB, Coups EJ. Emotions and preventive health behavior: Worry, regret, and influenza vaccination. Heal Psychol. 2006;25(1):82-90. doi:10.1037/0278-6133.25.1.82
Kahan DM. Vaccine Risk Perceptions and Ad Hoc Risk Communication: An Empirical Assessment. SSRN Electron J. 2014;(17). doi:10.2139/ssrn.2386034
Weinstein ND, Kwitel A, McCaul KD, et al. Risk perceptions: Assessment and relationship to influenza vaccination. Heal Psychol. 2007;26(2):146-151. doi:10.1037/0278-6133.26.2.146
Dubé E, Laberge C, Guay M, et al. Vaccine hesitancy: An overview. Hum Vaccines Immunother. 2013;9(8):1763-1773. doi:10.4161/hv.24657
Diekema DS. Improving childhood vaccination rates. N Engl J Med. 2012;366(5):391-393. doi:10.1056/NEJMp1113008
Kusnin F. Immunisation Programme in Malaysia. In: Vaccinology 2017 - III Symposium for Asia Pacific Experts. ; 2017. https://www.fondation-merieux.org/wp-content/uploads/2017/10/vaccinology-2017-faridah-kusnin.pdf
