Developing AIDS Knowledge and AIDS Attitude Scales and Assessing their Reliability and Validity
Nuran Aydemir, İbrahim Yakın, Hatice Sevgi ArslanThe present study aims to develop de novo scales to assess the level of knowledge of and attitude toward acquired immunodeficiency virus (AIDS) among the Turkish population. For this purpose, a 37-item knowledge scale and a 23-item attitude scale were developed and tested by using convenience sampling of undergraduate students (N = 1025) aged ≥17 years from five universities in Izmir. After evaluating item difficulty and item discrimination, 12 items were excluded, and during factor analyses, four additional items were omitted from the knowledge scale. Oblique rotation resulted in three underlying factors that explain 34% of the variance. As a reliability assessment, the Kuder–Richardson-20 coefficient was found to be .76. For the attitude scale, six items were omitted after factor analyses. Oblique rotation showed two underlying components that explained 42.43% of the variance. For internal reliability, Cronbach’s alpha was found as.90. Additionally, to test the relation between the scales, correlation analyses were performed, and it was found that the more knowledge of AIDS people have, the more positive their attitudes are toward it. As a conclusion, both a 21-item AIDS Knowledge scale and a 17-item AIDS Attitude scale have acceptable psychometric values and both can be used in future research.
AIDS Bilgi ve Tutum Ölçeklerinin Geliştirilmesi ve Psikometrik Özelliklerinin Sınanması
Nuran Aydemir, İbrahim Yakın, Hatice Sevgi ArslanBu çalışma, AIDS’e dair bilgi ve tutumları ölçmek için kullanılabilecek Türkiye’ye has iki ayrı ölçek geliştirmeyi ve bunları psikometrik açıdan değerlendirmeyi hedeflemektedir. Bu amaçla, 37 maddelik bir bilgi ölçeği ve 23 maddelik bir tutum ölçeği, İzmir’in farklı üniversitelerinde okuyan yaşları 17 ve üstü olan 1025 öğrenciye kolay ulaşılabilir durum örneklemesi yöntemi kullanılarak test edilmiştir. Bilgi ölçeğinin madde ve faktör analizlerinden sonra ölçekten 16 madde çıkarılmıştır. Oblik döndürme sonucu, varyansın %34’ünü açıklayan üç temel bileşen olduğunu göstermiştir. Bilgi ölçeğinin güvenirliğini sınamak için Kuder-Richardson-20 katsayısı hesaplanmış ve .76 olarak bulunmuştur. Tutum ölçeği için faktör analizi yapıldıktan sonra 6 madde çıkarılmıştır. Oblik döndürme, varyansın %42.43’ünü açıklayan iki temel bileşeni ortaya çıkarmıştır. Ölçeğin Cronbach alfa değeri .90 olarak bulunmuştur. İki ölçek arasındaki ilişki incelendiğinde ise, AIDS konusunda daha fazla bilgiye sahip kişilerin AIDS’e karşı daha olumlu tutuma sahip olduğu gözlenmiştir. Özgün olarak geliştirilmiş 21 maddeden oluşan AIDS Bilgi ve 17 maddeden oluşan AIDS Tutum ölçeklerinin geçerlik ve güvenirliğine dair elde edilen bulgular, ölçeklerin ileride yapılacak araştırmalarda kullanılmak için uygun olduklarını göstermektedir.
Acquired immunodeficiency virus (AIDS) is an infection caused by human immunodeficiency virus (HIV) that gradually destroys the human immune system and therefore can be fatal. HIV can be contracted through certain bodily fluids including blood, semen, vaginal secretions, and breast milk (Kelly, 2008). According to most experts, HIV infection is a pandemic. A 2017 report by the Joint United Nations Programme on HIV/AIDS (UNAIDS) states that 36.7 million people worldwide are living with HIV (UNAIDS, 2017). Fifty percent of new infections are occurring among adolescents and young adults aged 15–24 years (Wilson, Wright, Safrit, & Rudy, 2010). In Turkey, the total number of new HIV+ and AIDS cases were 2573, and the cases were most commonly seen in ages 25-29 and 30-34 (Turkish Ministry of Health, 2016). Per these findings, it seems obvious that specifically young adults should be targeted to decrease the HIV epidemic. The most common strategy to protect the youth from contracting HIV is the dissemination of accurate knowledge about how the disease is transmitted and how people can protect themselves. Another issue related to HIV/AIDS is its social costs on the lives of the infected people. As previously indicated, AIDS is one of the most stigmatized illnesses (Fernandes et al., 2007). People with HIV/AIDS face prejudice, social isolation, and loss of status. Hence, it is also important to assess society’s attitudes toward HIV/AIDS. Previous studies in the literature from both Turkey and other countries have investigated the level of knowledge of and attitudes toward HIV/AIDS (Avcıkurt, 2014; Haroun, Saleh, Wood, Morzouqi, & Anouti, 2016; Peltzer & Pengpid, 2017; Rickles, Furtek, Malladi, & Zhou, 2016; Siyez & Siyez, 2009). However, none of the Turkish studies used de novo AIDS knowledge and attitude scales which were psychometrically tested. Therefore, the first goal of this study is to develop de novo AIDS knowledge and AIDS attitude scales. Further, because the HIV epidemic is affecting mostly the youth, the second aim is to apply the scales to undergraduate students in order to determine their level of knowledge of and attitudes toward AIDS. The last aim of the study is to assess whether the knowledge of and attitudes toward AIDS are different depending on age, gender, and income level. Method The items for both the scales were developed in four phases: (1) literature review and concept development; (2) item development; (3) data collection; (4) item difficulty/discrimination analyses of the knowledge scale and reliability and validity assessment of both scales. For this purpose, 37 items for the knowledge scale and 23 items for the attitude scale were developed. For the latter, 14 items from a previously developed epilepsy attitude scale (Aydemir, 2008) were adapted to AIDS in addition to nine completely new AIDS-specific items. Both the scales were administered using convenience sampling to 1025 undergraduate students enrolled at five universities in Izmir. Results The age range of the participants varied between 17 and 54 years (M = 20.58, SD = 2.32); only 0.8% of the participants were between the ages of 31 and 54, and almost three-fourths of the participants were females (74.5%). Sexual experience was reported by 35.1% of the participants, and the average age of the first sexual experience was 17.94 ± 2.28 years. Almost all the participants (98.3%) reported that they had heard about AIDS, and 76.1% reported they had read about AIDS; however, only 2.8% reported that they knew an AIDS patient. In the first step of the knowledge scale, item discrimination and item difficulty analyses were conducted, and 12 items were omitted. Next, exploratory factor analysis was performed. In this step, four additional items were omitted from the scale. A three-factor solution was the most appropriate and understandable solution that explains 34% of the variance. The factors were named as “ways of transmission,” “general knowledge and protection,” and “treatment.” Kuder–Richardson-20 was performed to test the knowledge scale’s reliability that was found to be .76. The internal validity of transmission was .85; general knowledge and protection was .62; and treatment was .63. The final version of the Turkish AIDS Knowledge scale comprised 21 items, and higher scores represent more knowledge. To test the validity of the attitude scale, exploratory factor analysis was conducted. During this phase, six items were omitted from the scale. After the factor analysis, a two-factor solution yielded the most appropriate and interpretable solution, which explains 42.43% of the variance. The factors were labeled as stigma and negative attitude toward contact with people with AIDS patients. Internal validity of the AIDS Attitude scale was found to be .90. The Cronbach’s alpha of the first factor was .91 and that of the second factor was .75. The final version of the Turkish attitude scale toward AIDS comprises 17 items with higher scores indicating a more positive attitude. In terms of differences caused by age, gender and income on knowledge and attitude it was found that as the age increase the total knowledge score and the scores of factors of the knowledge scale increase as well. On the other hand, there was no relation between age and attitude. Gender creates an approached significant difference in the “protection” factor of the knowledge scale (t(993) = -1,92, p = 0,55), in which males have better knowledge. On the other hand, gender creates a significant difference in the total attitude score (t(980) = 4,49, p < 0.01) and in the negative attitude about contact with people with AIDS factor (t(983) = 4,91, p < 0.01), both of which are in favor of females. Income also creates a significant difference in the total knowledge score (F (2,959) = 3,43, p < .05) in the “protection” factor (F(2,982) = 8,81, p < .01). Finally, to test the construct validity of the scales, correlation analyses were conducted. As expected, both the total scores of the knowledge and attitude scales and their factors were all significantly correlated. These findings are also concordant with the literature in which the better the knowledge, the more positive is the attitude (Çuhardaroğlu, 2016). Conclusion As a conclusion, both scales have acceptable psychometric values. On the basis of the scales’ number of items, ease of application, and ease of scoring, it is believed that many researchers would benefit from them in future studies.
