Turkiye Klinikleri Journal of Nursing Sciences

.: ORIGINAL RESEARCH
Validity and Reliability of the Turkish Version of the Health Belief Model Based Bicycle Helmet Attitudes Scale Among University Students
Sağlık İnanç Modeli Temelli Bisiklet Kaskı Tutum Ölçeği'nin Türkçe Versiyonunun Üniversite Öğrencilerinde Geçerlik ve Güvenirliği
Asiye KARTALa, Eda KILINÇa, Nazan KOŞTUa
aDepartment of Public Health Nursing, Pamukkale University Faculty of Health Sciences, Denizli, TURKEY
Turkiye Klinikleri J Nurs Sci. 2021;13(2):275-86
doi: 10.5336/nurses.2020-78656
Article Language: EN
ABSTRACT
Objective: Measuring health beliefs and attitudes that support bicycle helmet use assists healthcare professionals in increasing the use. This study aimed to provide the Turkish society with an instrument that can measure students' attitudes related to health beliefs in bicycle helmet use and to analyze its validity-reliability. Material and Methods: This methodological research was carried out in psychological counseling and guidance department of Pamukkale University in Turkey among students between January and March 2019 (n=326). The data were collected in face-to-face interviews with the socio-demographic question form and the Bicycle Helmet Attitudes Scale. Internal consistency coefficient and test-retest analyses were used for the reliability of the scale, and content validity index and confirmatory factor analyses for its validity. Results: Turkish form of the scale is composed of 56 items and 10 factors. Cronbach alpha values of the sub-dimensions ranged from 0.70 to 0.88. The confirmatory factor analysis concluded χ2/df=2.18; root mean square error of approximation=0.06; comparative fit index=0.94; incremental fit index=0.94. The test-retest correlation value of the sub-dimensions is between 0.50 and 1.00. The confirmatory factor analysis showed acceptable values and acceptable fit for the model fit statistics. Conclusion: Turkish form is an instrument with sufficient validity and reliability indicators. The Turkish form which can be easily applied to individuals of all age groups can determine health belief levels associated with individuals' bicycle helmet use and identify vulnerability, severity, benefit, barrier and cues to action.

Keywords: Head protective devices; attitude to health; nursing
ÖZET
Amaç: Bisiklet kaskı kullanımını engelleyen/destekleyen; sağlık, inanç ve tutumları ölçmek, bisiklet kaskı kullanımını artırmada, sağlık profesyonellerine destek sağlamaktadır. Bu çalışmada amaç, öğrencilerin bisiklet kaskı kullanımında sağlık inancıyla ilişkili tutumlarını ölçebilen bir ölçüm aracını Türk toplumuna kazandırmak ve geçerlik- güvenirliğini analiz etmektir. Gereç ve Yöntemler: Bu metodolojik araştırma, Türkiye'de bulunan Pamukkale Üniversitesinin psikolojik danışma ve rehberlik bölümünde öğrenim gören öğrenciler arasında Ocak ve Mart 2019 tarihlerinde yapılmıştır (n=326). Veriler, sosyodemografik veri formu ve Bisiklet Kaskı Tutum Ölçeği kullanılarak yüz yüze görüşme yöntemi ile toplanmıştır. Ölçeğin, güvenirliği için iç tutarlılık katsayısı ve test-tekrar test analizleri, geçerliliği için kapsam geçerliği indeksi ve doğrulayıcı faktör analizi kullanılmıştır. Bulgular: Ölçeğin Türkçe uyarlaması 56 madde ve 10 faktörden oluşmuş olup, alt boyutların Cronbach alfa katsayısı ise sırasıyla 0,70 ile 0,88 arasındadır. Doğrulayıcı faktör analizi sonucunda χ2/df=2,18; ortalama hata karakök yaklaşımı=0,06; karşılaştırmalı uyum indeksi=0,94; artımlı uyum indeksi= 0,94 değerindedir. Alt boyutların test-tekrar test korelasyon değeri 0,50 ile 1,00 arasındadır (p<0,01). Doğrulayıcı faktör analizi sonucunda, model uyum istatistikleri için kabul edilebilir değer ve uyum göstermiştir. Sonuç: Türkçe ölçek yeterli geçerlik ve güvenirlik göstergeleri olan bir ölçüm aracıdır. Tüm yaş grubundaki bireylere kolaylıkla uygulanabilen Türkçe ölçek, bireylerin bisiklet kaskı kullanımına ilişkin sağlık inanç düzeylerini belirlenmekle birlikte duyarlılık, ciddiyet, yarar, engel ve onları eyleme geçirecek algıların neler olduğu saptanabilir.

Anahtar Kelimeler: Baş koruyucu cihazlar; sağlık tutumu; hemşirelik
REFERENCES:
  1. Constant A, Lagarde E. Protecting vulnerable road users from injury. PLoS Med. 2010;7(3):e1000228. [Crossref] [PubMed] [PMC] 
  2. Poulos RG, Hatfield J, Rissel C, Flack LK, Murphy S, Grzebieta R, et al. An exposure based study of crash and injury rates in a cohort of transport and recreational cyclists in New South Wales, Australia. Accid Anal Prev. 2015;78:29-38. [Crossref] [PubMed] 
  3. Olivier J, Radun I. Bicycle helmet effectiveness is not overstated. Traffic Inj Prev. 2017;18(7):755-60. [Crossref] [PubMed] 
  4. CDC. Nonfatal traumatic brain injuries related to sports and recreation activities among persons aged≤19 years-united states, 2001-2009. Morbidity and Mortality Weekly Report: 2011;60(39):1337-42. [Link] 
  5. CDC [Internet]. [Cited 06/08/2018]. Injury Prevention & Control. Available from: [Link] 
  6. Sataloğlu ND, Aydın B, Turla A. Bisiklet ve motorsiklet kazasi sonucu yaralanma ve ölümler. [Injuries and deaths that resulting from bicycle and motorcycle accidents]. The Bulletin of Legal Medicine. 2010;15(1):13-20. [Crossref] 
  7. Matsui Y, Oikawa S, Hosokawa N. Effectiveness of wearing a bicycle helmet for impacts against the front of a vehicle and the road surface. Traffic Inj Prev. 2018;19(7):773-7. [Crossref] [PubMed] 
  8. Axelsson A, Stigson H. Characteristics of bicycle crashes among children and the effect of bicycle helmets. Traffic Inj Prev. 2019;20(sup3):21-6. [Crossref] [PubMed] 
  9. Bonander C, Nilson F, Andersson R. The effect of the Swedish bicycle helmet law for children: an interrupted time series study. J Safety Res. 2014;51:15-22. [Crossref] [PubMed] 
  10. Kılınç E, Gür K. Behaviours of adolescents towards safety measures at school and in traffic and their health beliefs for injuries. International Journal of Nursing Practice. 2020;e12861. [Crossref] 
  11. Ross TP, Ross LT, Rahman A, Cataldo S. The bicycle helmet attitudes scale: using the health belief model to predict helmet use among undergraduates. J Am Coll Health. 2010;59(1):29-36. [Crossref] [PubMed] 
  12. Brand S, Otte D, Petri M, Müller C, Stübig T, Krettek C, et al. Bicyclist-bicyclist crashes--a medical and technical crash analysis. Traffic Inj Prev. 2013;14(1):56-60. [Crossref] [PubMed] 
  13. National Highway Traffic Safety Administration (NTSA). Traffic Safety Facts, 2015 data-bicyclists and other cyclists. Washington, DC: US Department of Transportation. 2017. [Link] 
  14. Coron J, McLaughlin G, Dorman SM. Factors influencing use of bicycle helmets among undergraduate students. Journal of American College Health. 1996;44(6):294-7. [Crossref] [PubMed] 
  15. Zavareh MF, Hezaveh A, Nordfjaern T. Intention to use bicycle helmet as explained by the Health Belief Model, comparative optimism and risk perception in an Iranian sample. Transportation Research Part F: Traffic Psychology and Behaviour. 2018;54:248-63. [Crossref] 
  16. Janz NK, Becker MH. The health belief model: a decade later. Health Educ Q. 1984;11(1):1-47. [Crossref] [PubMed] 
  17. Gottwald M, Goodman-Brown JG. Health belief model. A Guide to Practical Health Promotion. England: McGraw-Hill Education; 2012. p.73-8.
  18. Kılınç E, Gür K. Okul yaralanmalarını önlemede sağlık inanç modeli temelli girişimlerin etkisi. [Effect of health belief model in prevention of school injuries]. Journal of Health Science and Profession. 2018;5(3):467-75. [Crossref] 
  19. Glanz K, Rimer BK, Viswanath K. The Health Belief Model. In: Champion VL, Skinner CS, eds. Health Behavior and Health Education: Theory, Research, and Practice. 4st ed. San Francisco: Jossey-Bass; 2008. p.45-62. [Link] 
  20. Morowatisharifabad MA. The Health Belief Model variables as predictors of risky driving behaviors among commuters in Yazd, Iran. Traffic Inj Prev. 2009;10(5):436-40. [Crossref] [PubMed] 
  21. Grove SK, Burns N, Gray J. Measurement concepts. The Practice of Nursing Research: Appraisal, Synthesis, and Generation of Evidence. 7nd ed. St. Louis, Missouri: Elsevier Saunders; 2013. p.382-406. [Link] 
  22. Erdoğan S, Nahcivan N, Esin MN. Veri toplama yöntem ve araçları: veri toplama araçlarının güvenirlik ve geçerliği. Esin MN, editör. Hemşirelikte Araştırma: Süreç, Uygulama ve Kritik. 2. Baskı. İstanbul: Nobel; 2015. p.716-30.
  23. Wolf EJ, Harrington KM, Clark SL, Miller MW. Sample size requirements for structural equation models: an evaluation of power, bias, and solution propriety. Educ Psychol Meas. 2013;76(6):913-34. [Crossref] [PubMed] [PMC] 
  24. Çokluk Ö, Şekercioğlu G, Büyüköztürk. Doğrulayıcı Faktör Analizi. Sosyal Bilimler için Çok Değişkenli İstatistik: SPSS ve LISREL Uygulamaları. 3. Baskı. Ankara: Pegem Akademi; 2014. p.275-332. [Link] 
  25. İlhan M, Çetin B. LISREL ve AMOS programları kullanılarak gerçekleştirilen yapısal eşitlik modeli (YEM) analizlerine ilişkin sonuçların karşılaştırılması. [Comparing the analysis results of the structural equation models (SEM) conducted using LISREL and AMOS] Journal of Measurement and Evaluation in Education and Psychology. 2014;5(2):26-42. [Crossref] 
  26. Sass DA, Schmitt TA. Testing measurement and structural invariance: implications for practice. In: Teo T, eds. Handbook of Quantitative Methods for Educational Research. 1st ed. Rotterdam, Netherlands: Sense Publishers; 2013. p.315-46. [Crossref] 
  27. Davis LL. Instrument review: getting the most from a panel of experts. Applied Nursing Research.1992;5(4):194-97. [Crossref] 
  28. Seçer İ. Faktör analizi. SPSS ve LISREL ile Pratik Veri Analizi Analiz ve Raporlaştırma. 3. Baskı. Ankara: Anı Yayıncılık; 2017. p.153-201. [Link] 
  29. Streiner DL, Norman GR, Cairney J. Selecting the items. Health Measurement Scales a Practical Guide to their Development and Use. 5th ed. United Kingdom: Oxford University Press; 2015. p.74-94. [Crossref] 
  30. Gürbüz S, Şahin F. Yapısal eşitlik modellemesi. Sosyal Bilimlerde Araştırma Yöntemleri. 2. Baskı. Ankara: Seçkin Yayıncılık; 2015. p.323-44. [Link] 
  31. Harrington D. Creating a confirmatory factor analysis model. Confirmatory Factor Analysis. 1st ed. New York: Oxford University Press; 2009. p.21-35. [Crossref] 
  32. Williams M, Vogt WP. Convergence of structural equation modeling and multilevel modeling. In: Kline RB eds. The SAGE Handbook of Innovation in Social Research Methods. 1st ed. Thousand Oaks, CA: Sage; 2011. p.562-90. [Link] 

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