Development and psychometric evaluation of the women's HPV prevention questionnaire based on the theory of planned behavior (W-HPV-TPBQ); a Persian version.

BACKGROUND

The prevention of HPV requires a multifaceted approach that combines behavioral, social, and biomedical sciences. Therefore, focusing on creating positive attitudes and promoting healthy behaviors against HPV is essential. However, there are a few tools in this field that are not without limitations. This study aimed to design and validate the reproductive-age women’s HPV cognitive-behavioral questionnaire based on the theory of planned behavior (TPB), including attitude, subjective norms, perceived behavioral control, and behavioral intention constructs.

METHODS

This mixed-methods study focused on designing and validating the questionnaire of reproductive-age Women’s HPV Cognitive-Behavioral, based on TPB. First, a comprehensive item pool was created through a rapid scoping review. The psychometric properties of the questionnaire were subsequently evaluated, including face validity (IIM) (by 28 women), content validity (CVR, CVI, S-CVI/UA, and S-CVI/Ave) (by 10 experts), and construct validity (EFA and CFA) (by 600 women into two independent and non-overlapping datasets). Reliability was assessed using three indices: composite reliability (CR), Cronbach’s alpha, and maximum reliability (MaxR). Also, to assess test-retest reliability, the intraclass correlation coefficient (ICC) was calculated. A purposive Sampling method was used.

RESULTS

Rapid scoping review identified 312 items from 57 studies, which were refined to a theoretically-driven pool of 54 items based on the TPB. A preliminary 54-item questionnaire underwent face validity assessment, prompting revisions to 17 items for clarity. The collection of 41 items showed strong content validity (S-CVI/Ave = 0.99; S-CVI/UA = 0.93). Ultimately, the EFA and CFA validated the construct validity of a 14-item questionnaire. The values of CR, Cronbach’s α, and MaxR for all four dimensions were above 0.75, indicating convenient reliability for the questionnaire. The test-retest reliability of the questionnaire was demonstrated by the ICC coefficient, which was 0.85 (95% confidence interval: 0.73 to 0.92; p < 0.001).

CONCLUSION

The developed questionnaire has convenient and acceptable validity and reliability. Therefore, the tool designed in this study, which was developed to measure the women’s HPV cognitive-behavioral in Iran, after further validation, could help public health professionals and educational planners in subsequent studies to identify attitude and behavioral gaps in different populations, design educational interventions, and evaluate the effectiveness of awareness-raising programs.