Development of the adult age group Tetanus Knowledge Scale: Validity and reliability study

The aim of this study was to develop a valid and reliable measurement tool to assess tetanus knowledge levels in the adult age group. The data collection process was carried out between February 2025 and June 2025 with a total of 400 participants aged 18 years and older who applied to Family Health Centers in the city center of Edirne. Data were collected using a questionnaire form consisting of 53 questions, including 13 items on sociodemographic variables and 40 items belonging to the Adult Age Group Tetanus Knowledge Scale. During the scale development process, content validity was evaluated using the Lawshe technique, and the content validity index of the scale was calculated as 0.94. For construct validity, the dataset was divided into two; exploratory factor analysis was applied to the first group of 200 participants, and confirmatory factor analysis to the other 200 participants. As a result of the exploratory factor analysis, the scale consisted of 7 sub-dimensions and 23 items, with factor loadings above 0.40. In the confirmatory factor analysis, 7 sub-dimensions and 22 items showed acceptable fit indices. Reliability analyses included Cronbach's alpha coefficient, item-total correlations, 27% upper–lower group comparisons, and Split-Half Reliability. The Cronbach's alpha coefficient for the entire scale was 0.873, and the coefficients for the sub-dimensions were within acceptable limits. In the Split-Half Reliability analysis, the Spearman-Brown coefficient was calculated as 0.918. All item-total correlation values were above 0.30, and the 27% upper–lower group comparisons were statistically significant (p < 0.001). It was concluded that the "Adult Age Group Tetanus Knowledge Scale" is a valid and reliable measurement tool. The scale can be used in the field of public health to assess tetanus knowledge levels and to plan educational programs.