Turkish Validity and Reliability Study of the Digital Vaccine Literacy Scale
Year 2025,
Issue: Kabul Edilen Makaleler
Ahmet Doğan Kuday
,
Özcan Erdoğan
Abstract
Objectives: This study aimed to assess the validity and reliability of the Turkish version of the Digital Vaccine Literacy (DVL) scale.
Methods: This methodological study was conducted with 236 staff working at a foundation university hospital between September 2023 and April 2024. Data were collected using the Personal Information Form and DVL scale. The linguistic validity, content validity, exploratory factor analysis, and confirmatory factor analysis of the scale were conducted. Reliability was evaluated through item-total correlations, Cronbach's alpha coefficient, and test-retest reliability. Data were analyzed in SPSS 27.0 and AMOS 22.0 package programs.
Results: The study revealed 3 dimensions comprising 7 items, with factor loadings ranging from 0.612 to 0.851, explaining 78.63% of the total variance. The fit measures were acceptable (χ2/df = 3.271; RMSEA = 0.072; CFI = 0.912; NFI = 0.875; GFI = 0.874; TLI = 0.889; IFI = 0.876; p < 0.001) in confirmatory factor analysis. The overall Cronbach's alpha value of the scale was 0.730, while the sub-dimensions were 0.791, 0.891 and 0.781, respectively. The test-retest reliability correlation was positive, very strong and statistically significant (r=0.962, p<0.001).
Conclusions: It was found that the factor structure of the Turkish version of the DVL is the same as the factor structure of the original version, and it is a valid and reliable tool. Measurement of digital vaccine literacy will play a significant role in developing education strategies, accessing accurate information, preserving public health, supporting vaccine decision-making, and enhancing digital health skills.
Ethical Statement
Approval was secured via email from the creators of the scale to conduct a validity and reliability study in Turkish. Following this, ethical clearance was obtained from the XXX University Ethics Committee (dated March 22, 2023, reference number 101249), and permission to conduct the study was granted by the hospital where the research was conducted (dated March 1, 2023, reference number 98706). Participants were informed about the study, and both written and verbal consent were obtained.
References
- 1. Fan J, Toth I, Stephenson RJ. Recent Scientific Advancements towards a Vaccine against Group A Streptococcus. Vaccines (Basel). 2024;12(3):272. https://doi.org/10.3390/vaccines12030272.
- 2. Zasada AA, Darlińska A, Wiatrzyk A, et al. COVID-19 Vaccines over Three Years after the Outbreak of the COVID-19 Epidemic. Viruses. 2023;15(9):1786. https://doi.org/10.3390/v15091786.
- 3. Goel RK, Nelson MA. COVID-19 internet vaccination information and vaccine administration: evidence from the United States. Journal of Economics and Finance. 2021;45(4):716-734. https://doi.org/10.1007/s12197-021-09551-x.
- 4. Loomba S, De Figueiredo A, Piatek SJ, De Graaf K, Larson HJ. Measuring the impact of COVID-19 vaccine misinformation on vaccination intent in the UK and USA. Nature Human Behaviour. 2021;5(3):337-348. https://doi.org/10.1038/s41562-021-01056-1.
- 5. MacDonald NE. Vaccine hesitancy: Definition, scope and determinants. Vaccine. 2015;33(34):4161-4164. https://doi.org/10.1016/j.vaccine.2015.04.036.
- 6. Machingaidze S, Wiysonge CS. Understanding COVID-19 vaccine hesitancy. Nature Medicine. 2021;27(8):1338-1339. https://doi.org/10.1038/s41591-021-01459-7.
- 7. Fitzpatrick M. The Cutter Incident: How America's First Polio Vaccine Led to a Growing Vaccine Crisis. J R Soc Med. 2006;99(3):156.
- 8. Halstead SB. Dengvaxia sensitizes seronegatives to vaccine enhanced disease regardless of age. Vaccine. 2017;35(47):6355-6358. https://doi.org/10.1016/j.vaccine.2017.09.089.
- 9. Elkalmi RM, Dyab E, Mohd Suhaimi A, et al. Attitude, Familiarity and Religious Beliefs about Vaccination among Health Science and Non-Health Science Students in a Malaysian Public University. Eur J Investig Health Psychol Educ. 2021;11(4):1462-1473. https://doi.org/10.3390/ejihpe11040104.
- 10. Betsch C, Schmid P, Heinemeier D, Korn L, Holtmann C, Böhm R. Beyond confidence: Development of a measure assessing the 5C psychological antecedents of vaccination. PloS One. 2018;13(12):e0208601. https://doi.org/10.1371/journal.pone.0208601.
- 11. Smith BR, Magnani JW. New technologies, new disparities: The intersection of electronic health and digital health literacy. International Journal of Cardiology. 2019;292:280-282. https://doi.org/10.1016/j.ijcard.2019.05.066.
- 12. Berkman ND, Davis TC, McCormack L. Health literacy: what is it?. J Health Commun. 2010;15 Suppl 2:9-19. https://doi.org/10.1080/10810730.2010.499985.
- 13. Gusar I, Konjevoda S, Babić G, et al. Pre-Vaccination COVID-19 Vaccine Literacy in a Croatian Adult population: A Cross-Sectional Study. International Journal of Environmental Research and Public Health/International Journal of Environmental Research and Public Health. 2021;18(13):7073. https://doi.org/10.3390/ijerph18137073.
- 14. Biasio LR, Giambi C, Fadda G, Lorini C, Bonaccorsi G, D'Ancona F. Validation of an Italian tool to assess vaccine literacy in adulthood vaccination: a pilot study. Ann Ig. 2020;32(3):205-222. https://doi.org/10.7416/ai.2020.2344.
- 15. Polit, D. F., Beck, C. T., & Owen, S. V. (2007). Is the CVI an acceptable indicator of content validity? Appraisal and recommendations. Research in Nursing & Health, 30(4), 459–467. https://doi.org/10.1002/nur.20199.
- 16. Gorsuch, R. L. (2014). Factor Analysis. Routledge. https://doi.org/10.4324/9781315735740.
- 17. Doğan N, Soysal S, Karaman H. Aynı örnekleme açımlayıcı ve doğrulayıcı faktör analizi uygulanabilir mi? In: Demirel Ö, Dinçer S, eds. Küreselleşen Dünyada Eğitim. Pegem Akademi; 2017:373-400. https://doi.org/10.14527/9786053188407.25.
- 18. Montagni I, Pouymayou A, Pereira E, et al. Measuring Digital Vaccine Literacy: Development and Psychometric Assessment of the Digital Vaccine Literacy Scale. J Med Internet Res. 2022;24(12):e39220. Published 2022 Dec 14. https://doi.org/10.2196/39220.
- 19. Ponnam, A., Sahoo, D., Sarkar, A., & Mohapatra, S. N. (2014). An exploratory study of factors affecting credit card brand and category selection in India. Journal of Financial Services Marketing, 19(3), 221–233. https://doi.org/10.1057/fsm.2014.17.
- 20. Hair, J., Black, W. C., Babin, B. J., & Anderson, R. E. (2010). Multivariate data analysis: a global perspective (7th ed.). Pearson Education.
- 21. Can, A. (2014). SPSS Ile Bilimsel araştırma sürecinde nicel veri analizi. Pegem Akademi.
- 22. Watkins MW. Exploratory Factor Analysis: A Guide to Best Practice. Journal of Black Psychology. 2018;44(3):219-246. https://doi.org/10.1177/0095798418771807.
- 23. Finch HW. Exploratory Factor Analysis. SAGE Publications; 2019
- 24. Boateng GO, Neilands TB, Frongillo EA, Melgar-Quiñonez HR, Young SL. Best Practices for Developing and Validating Scales for Health, Social, and Behavioral Research: A Primer. Front Public Health. 2018;6. https://doi.org/10.3389/fpubh.2018.00149.
- 25. Kriston, L., Günzler, C., Harms, A., & Berner, M. (2008). Confirmatory Factor Analysis of the German Version of the International Index of Erectile Function (IIEF): A Comparison of Four Models. The Journal of Sexual Medicine, 5(1), 92–99. https://doi.org/10.1111/j.1743-6109.2007.00474.x.
- 26. Cristobal, E., Flavián, C., & Guinalíu, M. (2007). Perceived e‐service quality (PeSQ): Measurement validation and effects on consumer satisfaction and web site loyalty. Managing Service Quality: An International Journal, 17(3), 317–340. https://doi.org/10.1108/09604520710744326.
- 27. Taber, K. S. (2018). The use of cronbach’s alpha when developing and reporting research instruments in science education. Research in Science Education, 48(6), 1273–1296. https://doi.org/10.1007/s11165-016-9602-2.
- 28. Wyse, A. E. (2020). How days between tests impacts alternate forms reliability in computerized adaptive tests. Educational and Psychological Measurement, 81(4), 001316442097965. https://doi.org/10.1177/0013164420979656.
- 29. Ratner, B. (2009). The correlation coefficient: Its values range between +1/−1, or do they? Journal of Targeting, Measurement and Analysis for Marketing, 17(2), 139–142. https://doi.org/10.1057/jt.2009.5.
- 30. Rattray J, Jones MC. Essential elements of questionnaire design and development. J Clin Nurs. 2007;16(2):234-243. https://doi.org/10.1111/j.1365-2702.2006.01573.x.
Year 2025,
Issue: Kabul Edilen Makaleler
Ahmet Doğan Kuday
,
Özcan Erdoğan
References
- 1. Fan J, Toth I, Stephenson RJ. Recent Scientific Advancements towards a Vaccine against Group A Streptococcus. Vaccines (Basel). 2024;12(3):272. https://doi.org/10.3390/vaccines12030272.
- 2. Zasada AA, Darlińska A, Wiatrzyk A, et al. COVID-19 Vaccines over Three Years after the Outbreak of the COVID-19 Epidemic. Viruses. 2023;15(9):1786. https://doi.org/10.3390/v15091786.
- 3. Goel RK, Nelson MA. COVID-19 internet vaccination information and vaccine administration: evidence from the United States. Journal of Economics and Finance. 2021;45(4):716-734. https://doi.org/10.1007/s12197-021-09551-x.
- 4. Loomba S, De Figueiredo A, Piatek SJ, De Graaf K, Larson HJ. Measuring the impact of COVID-19 vaccine misinformation on vaccination intent in the UK and USA. Nature Human Behaviour. 2021;5(3):337-348. https://doi.org/10.1038/s41562-021-01056-1.
- 5. MacDonald NE. Vaccine hesitancy: Definition, scope and determinants. Vaccine. 2015;33(34):4161-4164. https://doi.org/10.1016/j.vaccine.2015.04.036.
- 6. Machingaidze S, Wiysonge CS. Understanding COVID-19 vaccine hesitancy. Nature Medicine. 2021;27(8):1338-1339. https://doi.org/10.1038/s41591-021-01459-7.
- 7. Fitzpatrick M. The Cutter Incident: How America's First Polio Vaccine Led to a Growing Vaccine Crisis. J R Soc Med. 2006;99(3):156.
- 8. Halstead SB. Dengvaxia sensitizes seronegatives to vaccine enhanced disease regardless of age. Vaccine. 2017;35(47):6355-6358. https://doi.org/10.1016/j.vaccine.2017.09.089.
- 9. Elkalmi RM, Dyab E, Mohd Suhaimi A, et al. Attitude, Familiarity and Religious Beliefs about Vaccination among Health Science and Non-Health Science Students in a Malaysian Public University. Eur J Investig Health Psychol Educ. 2021;11(4):1462-1473. https://doi.org/10.3390/ejihpe11040104.
- 10. Betsch C, Schmid P, Heinemeier D, Korn L, Holtmann C, Böhm R. Beyond confidence: Development of a measure assessing the 5C psychological antecedents of vaccination. PloS One. 2018;13(12):e0208601. https://doi.org/10.1371/journal.pone.0208601.
- 11. Smith BR, Magnani JW. New technologies, new disparities: The intersection of electronic health and digital health literacy. International Journal of Cardiology. 2019;292:280-282. https://doi.org/10.1016/j.ijcard.2019.05.066.
- 12. Berkman ND, Davis TC, McCormack L. Health literacy: what is it?. J Health Commun. 2010;15 Suppl 2:9-19. https://doi.org/10.1080/10810730.2010.499985.
- 13. Gusar I, Konjevoda S, Babić G, et al. Pre-Vaccination COVID-19 Vaccine Literacy in a Croatian Adult population: A Cross-Sectional Study. International Journal of Environmental Research and Public Health/International Journal of Environmental Research and Public Health. 2021;18(13):7073. https://doi.org/10.3390/ijerph18137073.
- 14. Biasio LR, Giambi C, Fadda G, Lorini C, Bonaccorsi G, D'Ancona F. Validation of an Italian tool to assess vaccine literacy in adulthood vaccination: a pilot study. Ann Ig. 2020;32(3):205-222. https://doi.org/10.7416/ai.2020.2344.
- 15. Polit, D. F., Beck, C. T., & Owen, S. V. (2007). Is the CVI an acceptable indicator of content validity? Appraisal and recommendations. Research in Nursing & Health, 30(4), 459–467. https://doi.org/10.1002/nur.20199.
- 16. Gorsuch, R. L. (2014). Factor Analysis. Routledge. https://doi.org/10.4324/9781315735740.
- 17. Doğan N, Soysal S, Karaman H. Aynı örnekleme açımlayıcı ve doğrulayıcı faktör analizi uygulanabilir mi? In: Demirel Ö, Dinçer S, eds. Küreselleşen Dünyada Eğitim. Pegem Akademi; 2017:373-400. https://doi.org/10.14527/9786053188407.25.
- 18. Montagni I, Pouymayou A, Pereira E, et al. Measuring Digital Vaccine Literacy: Development and Psychometric Assessment of the Digital Vaccine Literacy Scale. J Med Internet Res. 2022;24(12):e39220. Published 2022 Dec 14. https://doi.org/10.2196/39220.
- 19. Ponnam, A., Sahoo, D., Sarkar, A., & Mohapatra, S. N. (2014). An exploratory study of factors affecting credit card brand and category selection in India. Journal of Financial Services Marketing, 19(3), 221–233. https://doi.org/10.1057/fsm.2014.17.
- 20. Hair, J., Black, W. C., Babin, B. J., & Anderson, R. E. (2010). Multivariate data analysis: a global perspective (7th ed.). Pearson Education.
- 21. Can, A. (2014). SPSS Ile Bilimsel araştırma sürecinde nicel veri analizi. Pegem Akademi.
- 22. Watkins MW. Exploratory Factor Analysis: A Guide to Best Practice. Journal of Black Psychology. 2018;44(3):219-246. https://doi.org/10.1177/0095798418771807.
- 23. Finch HW. Exploratory Factor Analysis. SAGE Publications; 2019
- 24. Boateng GO, Neilands TB, Frongillo EA, Melgar-Quiñonez HR, Young SL. Best Practices for Developing and Validating Scales for Health, Social, and Behavioral Research: A Primer. Front Public Health. 2018;6. https://doi.org/10.3389/fpubh.2018.00149.
- 25. Kriston, L., Günzler, C., Harms, A., & Berner, M. (2008). Confirmatory Factor Analysis of the German Version of the International Index of Erectile Function (IIEF): A Comparison of Four Models. The Journal of Sexual Medicine, 5(1), 92–99. https://doi.org/10.1111/j.1743-6109.2007.00474.x.
- 26. Cristobal, E., Flavián, C., & Guinalíu, M. (2007). Perceived e‐service quality (PeSQ): Measurement validation and effects on consumer satisfaction and web site loyalty. Managing Service Quality: An International Journal, 17(3), 317–340. https://doi.org/10.1108/09604520710744326.
- 27. Taber, K. S. (2018). The use of cronbach’s alpha when developing and reporting research instruments in science education. Research in Science Education, 48(6), 1273–1296. https://doi.org/10.1007/s11165-016-9602-2.
- 28. Wyse, A. E. (2020). How days between tests impacts alternate forms reliability in computerized adaptive tests. Educational and Psychological Measurement, 81(4), 001316442097965. https://doi.org/10.1177/0013164420979656.
- 29. Ratner, B. (2009). The correlation coefficient: Its values range between +1/−1, or do they? Journal of Targeting, Measurement and Analysis for Marketing, 17(2), 139–142. https://doi.org/10.1057/jt.2009.5.
- 30. Rattray J, Jones MC. Essential elements of questionnaire design and development. J Clin Nurs. 2007;16(2):234-243. https://doi.org/10.1111/j.1365-2702.2006.01573.x.