Development, validation and reliability of scales and items for heat wave risk assessment of pregnant women.

Ashish Kc, Sujeena Maharjan, Omkar Basnet, Honey Malla, Rejina Gurung, Sunil Mani Pokharel, Gyanu Kumari Ghimire, Masoud Vaezghasemi, Julia Schröders
Author Information
  1. Ashish Kc: School of Public Health and Community Medicine, University of Gothenburg, Medicinaregatan 18, Gothenburg 43190, Sweden. ashish.k.c@gu.se. ORCID
  2. Sujeena Maharjan: Research Division, Golden Community, Jawgal, Lalitpur, Nepal.
  3. Omkar Basnet: Research Division, Golden Community, Jawgal, Lalitpur, Nepal.
  4. Honey Malla: Research Division, Golden Community, Jawgal, Lalitpur, Nepal.
  5. Rejina Gurung: Research Division, Golden Community, Jawgal, Lalitpur, Nepal.
  6. Sunil Mani Pokharel: Bharatpur Hospital, Ministry of Health and Population, Chitwan, Nepal.
  7. Gyanu Kumari Ghimire: Research Division, Golden Community, Jawgal, Lalitpur, Nepal.
  8. Masoud Vaezghasemi: Department of Epidemiology and Global Health, Umeå University, Umeå 90187, Sweden.
  9. Julia Schröders: Department of Epidemiology and Global Health, Umeå University, Umeå 90187, Sweden.

Abstract

INTRODUCTION: The 1.2 °C rise of global ambient temperature since the pre-industrial era has led to an increase the intensity and frequency of heatwaves. Given the heightened vulnerability of pregnant women to heat stress, there is an urgent need for tools which accurately assess the knowledge, risk, and perception of pregnant woman toward heatwaves, enabling effective policy actions. In this research, we developed and validated tools to evaluate pregnant women's perceptions of heat wave risks and behaviors.
METHOD: We developed 50 items across seven constructs using the Health Belief Model, identified through a systematic literature review. The constructs comprised 8 Knowledge(K) items, 4 in Perceived Vulnerability (PV), 5 in Perceived Severity (PS), 6 in Perceived Benefit (PB), 4 in Perceived Barrier (PBa), 5 in Cue to Action(Cu) and 18 in Adaptation(A). Cognitive testing was performed with a separate group of pregnant women(n = 20). The tested tools were then administered to 120 pregnant women residing during the spring-summer 2023. Construct validation utilized exploratory factor analysis.
RESULTS: The Principal Axis Factoring Method was employed in the EFA with oblimin rotation for 51 items, considering communality > 0.20, and aiming to extract three factors. Across the three factors with Cronbach's alpha > 0.70, a total of 11 items were distributed. Factor 1 included Perceived Severity (PS1, PS2, PS3 and PS5); Factor 2 included Cue to Action (Cu1, Cu2, Cu3, and Cu4); and Factor 3 encompassed Perceived Vulnerability (PV1, PV2, PV4). Only two of the retained items had factor loadings > 0.50, namely PV4 and PS5. Consequently, the three constructs measuring Perceived Severity, Cues to Action, and Perceived Vulnerability using the HBM among pregnant women were deemed valid.
CONCLUSION: Our study has successfully validated a highly reliable tool which stands ready for application in assessing pregnant women's risk perception regarding heatwaves.

Keywords

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MeSH Term

Humans
Female
Pregnancy
Adult
Risk Assessment
Reproducibility of Results
Hot Temperature
Young Adult
Surveys and Questionnaires
Health Knowledge, Attitudes, Practice

Word Cloud

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