Risk Perception in Childhood Vaccination Questionnaire: A Validation Study on Pregnant Mothers in Malaysia

Abstract

Quantitative study on risk perception in vaccination encompasses various theoretical basis, health context, and psychometric validity and reliability. In the context of basic childhood vaccination, there was a lack of locally validated and reliable instrument to measure risk perception for vaccine-preventable disease. As such, this study aimed to validate and assess reliability of developed instruments in Malay language. Items were generated from available items in previous research and adopting recommendations on operationalising the construct. Generated items were measured for content validity index by seven experts, tested for factorial validity using exploratory (EFA) and confirmatory factor analysis (CFA) using structural equation modelling. Reliability was established using Cronbach’s alpha. Seven items measured perceived likelihood whereas eight items measured perceived severity. Reliability index was 0.97 for perceived likelihood and 0.94 for perceived severity. CFA on second-order measurement model revealed satisfactory model fit χ2/df (1.55), CFI 0.96, TLI 0.95, and RMSEA 0.11. The average variance explained was 0.73 for perceived likelihood and 0.73 for perceived severity and CR was 0.95 and 0.96 for perceived likelihood and perceived severity, respectively. Both constructs showed significant positive correlation (r = 0.19, p < 0.01) with each other indicating divergent validity. Thus, the Malay risk perception questionnaire established good content, factorial, and divergent validity, as well as good reliability on Cronbach’s alpha. The instrument should be valuable to re-examine risk perception’s role in the resurgence of vaccine hesitancy in the local population.