Validation of an instrument to measure facilitators and barriers for influenza vaccination among nurse educators

Abstract

Purpose: The purpose of this research is to develop and evaluate the reliability and validity of a survey tool to assess nurse educators' knowledge, attitudes, beliefs, and barriers towards influenza vaccine. Background: There have been multiple studies of influenza vaccine by healthcare workers (HCWs) that reveal that nurses are reluctant to accept an annual influenza vaccine. There have been no studies on nurse educators. Nurse educators have the potential to influence future generations of nurses' acceptance of influenza vaccine therefore it is important that we evaluate their knowledge, attitudes, beliefs and practices toward influenza vaccine. Methods: A 36-item scale based on constructs from the Health Belief Model (HBM) and Theory of Reasoned Action (TRA) was psychometrically tested for reliability and validity on N=191 nurse educators recruited from Hawaiʻi, California, and Oregon. Reliability testing was utilized using Cronbach's alpha and Spearman-Brown prophecy formula to measure internal consistency. Scale validity was assessed by content validity, construct validity using factor analysis, and criterion validity using logistic regression. All procedures were done using the Statistical Package for Social Sciences for the Mac. Conclusion: The original 36-item scale was reduced to a 26-item scale that consisted of 3 components reflecting (1) Attitudes and Beliefs Towards Influenza Vaccines; (2) Knowledge and Beliefs of Influenza Disease; and (3) Barriers Towards Influenza Vaccine. The item performance was satisfactory. The model was successful in predicting 91.6% of participants who refused the vaccine and 91.5% of participants who took the vaccine. Items 37, 38, and 39 were open-ended questions and were reviewed for themes to allow for further revisions of the scale in the future.