Department of Hygiene, Social-Preventive Medicine and Medical Statistics, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Research Committee of Greek Association of General Practitioners, Thessaloniki, Greece.
Health Soc Care Community. 2021 May;29(3):818-828. doi: 10.1111/hsc.13317. Epub 2021 Feb 17.
Despite the unequivocal value of vaccination in reducing the global burden of infectious diseases, the anti-vaccination movement thrives. The vast majority of the existing validated tools explore attitudes regarding vaccination in children. The aim of our study was to develop and validate a scale assessing attitudes towards adult immunisation. This national cross-sectional study included adult healthcare users who visited 23 Greek Primary Healthcare Units. The development of the scale was the result of literature review, semi-structured interviews and pilot testing of its preliminary versions. The initial version contained 15 items measuring respondents' attitudes on a 6-point Likert scale. The sample was randomly split into two halves. Exploratory factor analysis, performed in the first sample, was used for the creation of multi-item scales; confirmatory factor analysis was used in the second sample to assess goodness of fit. Moreover, concurrent validity, internal consistency reliability, test-retest reliability and ceiling and floor effects were explored. The total sample consisted of 1,571 individuals. Overall 'Cronbach's alpha' (0.821) indicated good internal consistency. The initial exploratory factor analysis resulted in a three-factor model. The subsequent confirmatory factor analysis indicated that an 11-item version of the scale provided the best fit of the model to the data (RMSEA = 0.050, SRMR = 0.053, TLI = 0.937, CFI = 0.955, AIC = 24,999.949). All subscales ('value of adult vaccination', 'safety concerns' and 'perceived barriers') demonstrated strong concurrent associations with participants' attitudes and behaviour regarding vaccination (p < .001). No ceiling or floor effects were noted for any of the subscales (0.13%, 2.61% and 0.51%; 0.13%, 0.57% and 0.45% respectively). The 11-item ATAVAC scale proved to be a reliable and valid tool, suitable for assessing attitudes towards adult vaccination.
尽管疫苗接种在降低传染病全球负担方面具有明确的价值，但反疫苗运动却在蓬勃发展。现有的大多数经过验证的工具都在探讨儿童对疫苗接种的态度。我们的研究目的是开发和验证一种评估成人免疫接种态度的量表。这项全国性的横断面研究包括访问希腊 23 个初级保健单位的成年医疗保健使用者。该量表的开发是文献回顾、半结构化访谈和初步版本试点测试的结果。初始版本包含 15 个项目，采用 6 点李克特量表衡量受访者的态度。样本被随机分为两半。在第一部分样本中进行的探索性因子分析用于创建多项目量表；在第二部分样本中进行验证性因子分析以评估拟合优度。此外，还探讨了同时效度、内部一致性信度、重测信度以及上限和下限效应。总样本由 1571 人组成。总体“Cronbach's alpha”（0.821）表示良好的内部一致性。初始探索性因子分析得出了三因素模型。随后的验证性因子分析表明，量表的 11 项版本为数据提供了最佳的模型拟合（RMSEA=0.050，SRMR=0.053，TLI=0.937，CFI=0.955，AIC=24999.949）。所有子量表（“成人疫苗接种的价值”、“安全问题”和“感知障碍”）均与参与者对疫苗接种的态度和行为表现出强烈的同时相关性（p<0.001）。任何子量表均未出现上限或下限效应（分别为 0.13%、2.61%和 0.51%；0.13%、0.57%和 0.45%）。11 项 ATAVAC 量表被证明是一种可靠有效的工具，适用于评估成人疫苗接种态度。
