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    Development and psychometric evaluation of the vaccine knowledge test for childhood vaccinations: Using Rasch analysis
    (BioMed Central Ltd, 2025) Kocoğlu Tanyer, Deniz; Yorulmaz Demir, Deniz S.
    Background: There is a clear need for an up-to-date, comprehensive, and methodologically tested tool to assess parents’ knowledge of childhood immunization. The aim of this study was to develop a vaccine knowledge test for childhood immunization and to evaluate its validity and reliability. Methods: This methodological study consists of three phases: creating an item pool, preparing a draft form, and psychometric evaluation. The draft form was developed with the help of a table of specifications and expert opinions. The psychometric assessment includes classical item analysis, Rasch analysis, KR-20, Cronbach’s alpha, and multiple regression analysis. Results: The Vaccine Knowledge Test had an average item difficulty index of 0.498 and an average item discrimination index of 0.447. The WMS values of the items ranged from 0.81 to 1.14, and the UMS values ranged from 0.80 to 1.35, indicating good dispersion. The person separation index and the person number of strata of the Rasch analysis were 2.3 and 3.4. Cronbach’s alpha was 0.84. It was found that receiving vaccine education, having confidence in vaccines, being a parent, and having a university education were the determinants of vaccine knowledge, and these variables accounted for 29% of the variance in vaccine knowledge. Conclusion: The Vaccine Knowledge Test, consisting of a single dimension and 28 items, is a valid and reliable measurement tool. It can reliably discriminate between individuals with different levels of knowledge or skills as low and high. It can be used as part of public health education and programs aimed at reducing vaccine hesitancy and preventing the destructive effects of vaccine misinformation in the community.
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    Development of a vaccine advocacy scale for childhood vaccines and psychometric evaluation: A methodological study
    (John Wiley and Sons Inc, 2025) Yorulmaz Demir, Deniz S.
    Aim: This study developed the Vaccine Advocacy Scale for childhood vaccines for adults and evaluated its psychometric properties. Method: This methodological study involved 211 adults. A literature review was conducted to create the item pool of the scale, and 12 items were prepared. While evaluating the scale's psychometric properties, the researchers performed content validity, explanatory factor analysis (factor loadings of the items, eigenvalues of the sub-dimensions, and explained variance rates), confirmatory factor analysis (factor loadings and common fit indices), and criterion validity (predictive validity) in the validation phase. In the predictive validity assessment, the distribution of scores on the scale was examined according to some behaviours related to vaccine advocacy. Additionally, we analysed the item-total score correlation, Cronbach's alpha coefficient, and split-half test consistency in the reliability phase. Results: The study's calculated Kaiser-Meyer-Olkin value was 0.868, and Bartlett's test of sphericity resulted in significant results (X² = 1724.166; p < 0.001). The explanatory factor analysis revealed that the items' factor loadings were between 0.451 and 0.949 and explained 58.29% of the total variance of the structure, which consisted of 12 items and two sub-dimensions. The confirmatory factor analysis found the factor loadings of the items between 0.62 and 0.85 and identified ‘common fit indices’ within acceptable ranges and close to the perfect fit values (X²/df, GFI, CFI, RMSEA, RMR, NFI, TLI and IFI were 1.906, 0.950, 0.952, 0.093, 0.059, 0.906, 940 and 0.953, respectively). The Cronbach's alpha value for the scale was 0.92, and the Spearman-Brown coefficient, Guttman's split-half coefficient, and split-half correlation coefficients were 0.843, 0.842 and 0.713, respectively. The study findings indicated that individuals who had talked to other parents about vaccines, recommended vaccinations, and communicated vaccine-related issues with medical professionals had significantly higher total scale scores (p < 0.005). Conclusion: Considering the study findings and evaluations, the Vaccine Advocacy Scale was a valid and reliable measurement tool to assess adults’ vaccine advocacy behaviour for childhood vaccines.
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    The relationship between human papillomavirus knowledge and health literacy in university students: Descriptive correlational study
    (Turkiye Klinikleri, 2025) Yorulmaz Demir, Deniz S.
    Objective: This study aimed to assess the level of knowledge about human papillomavirus (HPV), the health literacy status, and the HPV vaccination status of university students in Türkiye, and to examine the relationship between HPV knowledge and health literacy. Material and Methods: This study was based on a descriptive-relational design and involved 387 university students. The study utilized a descriptive characteristics questionnaire, HPV Knowledge Scale, and Health Literacy Scale to collect the research data. It also used descriptive analyses (number, percentage), chi-square analyses, and Pearson correlation analyses to evaluate the research data. Results: Of the participant students, 65.6% were women, 30.5% of their mothers had primary school education, and 34.4% had difficulty accessing health institutions. The study results indicated that 8.5% of the student’s received education on HPV, 6.5% contacted healthcare professionals about HPV vaccines, and 7.2% and 10.1% received advice from their families and healthcare professionals, respectively, about the application of HPV vaccination. The average score of the students on the HPV Knowledge Scale was 6.06±7.09 (minimum: 0, maximum: 33), and 7.5% of the participant students reported receiving the HPV vaccine. The study also identified a positive and significant relationship between HPV knowledge and health literacy (r=0.113, p=<0.001). Conclusion: The students have a low level of knowledge about HPV, and only a small portion of them have received training on the subject. Given that HPV infection-related health problems, including cervical cancer, are a critical public health concern, this study recommends providing education and information about HPV infection prevention and HPV vaccine application.