Development and Psychometric Validation of the Human Papillomavirus Prevention Health Literacy Scale for College Students in Taiwan

Vollständiger Abstract

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Background: Human papillomavirus (HPV) is a common sexually transmitted virus associated with several types of cancer. Because college students are a high-risk group, understanding their health literacy with regard to HPV prevention is critical. However, no suitable measurement tools are currently available for this purpose. Purpose: In this study, an HPV Prevention Health Literacy Scale (HPV-HLS) was developed, and its reliability and validity were assessed. Methods: A cross-sectional design was used, and the developed scale was validated on a sample of 372 college students from two universities in northern Taiwan and one university in central Taiwan. The initial scale comprised 49 items, developed from qualitative interviews and a literature review. After content validity assessment and item analysis, the scale was refined to 37 items. Exploratory factor analysis (EFA) was conducted with 150 participants, followed by confirmatory factor analysis (CFA) with 222 participants. Concurrent validity and internal consistency reliability were assessed. Data were collected from November 2021 to December 2022. Results: The results of the EFA revealed a two-factor model accounted for 60.30% of the total variation, and those of the CFA demonstrated favorable goodness-of-fit indices (GFI = .81, CFI = .92, TLI = .91, RMSEA = .07, and SRMR = .02). Moreover, the average variance extracted (AVE) for the two factors were .56 and .64, respectively, with corresponding composite reliability (CR) values of .96 and .93, indicating excellent convergent validity. Notably, the AVE surpassed the squared product-moment correlation of the corresponding factors, affirming good discriminant validity. The final iteration of the HPV-HLS comprised 21 items with two subscales: comprehension and evaluation of general information and seeking information from health care professionals. Concurrent validity was found between the proposed scale and the Mandarin Multidimensional Health Literacy Questionnaire ( r = .68, p < .001). The HPV-HLS demonstrated good internal consistency (Cronbach’s α = .959). Conclusions/Implications for Future Practice: After rigorous psychometric testing, the newly developed HPV-HLS demonstrated excellent reliability and validity, establishing it as an objective tool for evaluating HPV prevention health literacy among college students. This HPV-HLS may be used by health care providers and educators to assess health literacy and evaluate the effectiveness of clinical interventions to prevent HPV infection.