Journal of community genetics · 2026
Negotiating genetic risk in Indonesia: Development and psychometric evaluation of the knowledge and attitude toward consanguineous marriage instrument in a mixed-methods cross-sectional study.
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Amina Ikramina Yusti, Zubaidah Siti, Susanto Hendra
Аннотация
BACKGROUND: Consanguineous marriage can increase recessive genetic risks in offspring, yet instruments for examining genetic-risk understanding and attitudes remain limited in Indonesia. This study developed and evaluated a questionnaire assessing knowledge responses and attitudes toward consanguineous marriage in Kalimantan.
METHODS: In a convergent mixed-methods cross-sectional survey, 272 respondents completed ten Yes/No knowledge items with written justifications and 15 Likert-type attitude statements. Knowledge responses were examined using Rasch modeling, attitude items using exploratory and confirmatory factor analyses, and written explanations using thematic analysis. Yes-response totals were compared by gender using an independent-samples t-test and a two-way analysis of variance with parental consanguinity status.
RESULTS: Knowledge items showed stable relative item locations (item reliability = 0.98) but limited respondent differentiation (person reliability = 0.39). A ten-item, one-factor attitude model showed good fit (comparative fit index = 0.988; Tucker-Lewis index = 0.984; root mean square error of approximation = 0.047) and internal consistency (Cronbach's alpha = 0.816). Women selected more Yes responses than men (7.66 vs 7.10; p = 0.015), whereas the factorial gender main effect was not significant (p = 0.954). Written explanations combined genetic-risk reasoning with beliefs about destiny, taboo, and family expectations.
CONCLUSION: The questionnaire provides preliminary psychometric evidence in the surveyed sample. Because the knowledge section combines factual statements, self-reported awareness, preventive endorsement, and hypothetical choice, its summed score should be interpreted as "yes-response" endorsement rather than a uniform count of scientifically correct answers. Further validation across populations and settings is warranted.
METHODS: In a convergent mixed-methods cross-sectional survey, 272 respondents completed ten Yes/No knowledge items with written justifications and 15 Likert-type attitude statements. Knowledge responses were examined using Rasch modeling, attitude items using exploratory and confirmatory factor analyses, and written explanations using thematic analysis. Yes-response totals were compared by gender using an independent-samples t-test and a two-way analysis of variance with parental consanguinity status.
RESULTS: Knowledge items showed stable relative item locations (item reliability = 0.98) but limited respondent differentiation (person reliability = 0.39). A ten-item, one-factor attitude model showed good fit (comparative fit index = 0.988; Tucker-Lewis index = 0.984; root mean square error of approximation = 0.047) and internal consistency (Cronbach's alpha = 0.816). Women selected more Yes responses than men (7.66 vs 7.10; p = 0.015), whereas the factorial gender main effect was not significant (p = 0.954). Written explanations combined genetic-risk reasoning with beliefs about destiny, taboo, and family expectations.
CONCLUSION: The questionnaire provides preliminary psychometric evidence in the surveyed sample. Because the knowledge section combines factual statements, self-reported awareness, preventive endorsement, and hypothetical choice, its summed score should be interpreted as "yes-response" endorsement rather than a uniform count of scientifically correct answers. Further validation across populations and settings is warranted.