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
Full Text
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] 

.: Up To Date

Login

 Forgot your password?

 New Registration  

Contact

Ortadoğu Reklam Tanıtım Yayıncılık Turizm Eğitim İnşaat Sanayi ve Ticaret A.Ş.

.: Address

Turkocagi Caddesi No:30 06520 Balgat / ANKARA
Phone: +90 312 286 56 56
Fax: +90 312 220 04 70
E-mail: info@turkiyeklinikleri.com

.: Manuscript Editing Department

Phone: +90 312 286 56 56/ 2
E-mail: yaziisleri@turkiyeklinikleri.com

.: English Language Redaction

Phone: +90 312 286 56 56/ 145
E-mail: tkyayindestek@turkiyeklinikleri.com

.: Marketing Sales-Project Department

Phone: +90 312 286 56 56/ 142
E-mail: reklam@turkiyeklinikleri.com

.: Subscription and Public Relations Department

Phone: +90 312 286 56 56/ 118
E-mail: abone@turkiyeklinikleri.com

.: Customer Services

Phone: +90 312 286 56 56/ 118
E-mail: satisdestek@turkiyeklinikleri.com

1. TERMS OF USE

1.1. To use the web pages with http://www.turkiyeklinikleri.com domain name or the websites reached through the sub domain names attached to the domain name (They will be collectively referred as "SITE"), please read the conditions below. If you do not accept these terms, please cease to use the "SITE." "SITE" owner reserves the right to change the information on the website, forms, contents, the "SITE," "SITE" terms of use anytime they want.

1.2. The owner of the "SITE" is Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. (From now on it is going to be referred as "Turkiye Klinikleri", shortly) and it resides at Turkocagi cad. No:30, 06520 Balgat Ankara. The services in the "SITE" are provided by "Turkiye Klinikleri."

1.3. Anyone accessing the "SITE" with or without a fee whether they are a natural person or a legal identity is considered to agree these terms of use. In this contract hereby, "Turkiye Klinikleri" may change the stated terms anytime. These changes will be published in the "SITE" periodically and they will be valid when they are published. Any natural person or legal identity benefiting from and reaching to the "SITE" are considered to be agreed to any change on hereby contract terms done by "Turkiye Klinikleri."

1.4. The "Terms of Use" hereby is published in the website with the last change on March 30th 2014 and the "SITE" is activated by enabling the access to everyone. The "Terms of Use" hereby is also a part of the any "USER Contract" was and/or will be done with the users using "Turkiye Klinikleri" services with or without a fee an inseparable.

2. DEFINITIONS

2.1. "SITE": A website offering different kind of services and context with a certain frame determined by "Turkiye Klinikleri" and it is accessible on-line on http://www.turkiyeklinikleri.com domain name and/or subdomains connected to the domain name.

2.2. USER: A natural person or a legal identity accessing to the "SITE" through online settings.

2.3. LINK: A link enabling to access to another website through the "SITE", the files, the context or through another website to the "SITE", the files and the context.

2.4. CONTEXT: Any visual, literary and auditory images published in the "Turkiye Klinikleri", "SITE" and/or any website or any accessible information, file, picture, number/figures, price, etc.

2.5. "USER CONTRACT": An electronically signed contract between a natural or a legal identity benefiting from special services "Turkiye Klinikleri" will provide and "Turkiye Klinikleri".

3. SCOPE OF THE SERVICES

3.1. "Turkiye Klinikleri" is completely free to determine the scope and quality of the services via the "SITE".

3.2. To benefit the services of "Turkiye Klinikleri" "SITE", the "USER" must deliver the features that will be specified by "Turkiye Klinikleri". "Turkiye Klinikleri" may change this necessity any time single-sided.

3.3. Not for a limited number, the services "Turkiye Klinikleri" will provide through the "SITE" for a certain price or for free are;

- Providing scientific articles, books and informative publications for health industry.

- Providing structural, statistical and editorial support to article preparation stage for scientific journals.

4. GENERAL PROVISIONS

4.1. "Turkiye Klinikleri" is completely free to determine which of the services and contents provided in the "SITE" will be charged.

4.2. People benefiting from the services provided by "Turkiye Klinikleri" and using the website can use the "SITE" only according to the law and only for personal reasons. Users have the criminal and civil liability for every process and action they take in the "SITE". Every USER agrees, declares and undertakes that they will not proceed by any function or action infringement of rights of "Turkiye Klinikleri"s and/or other third parties', they are the exclusive right holder on usage, processing, storage, made public and revealing any written, visual or auditory information reported to Turkiye Klinikleri" and/or "SITE" to the third parties. "USER" agrees and undertakes that s/he will not duplicate, copy, distribute, process, the pictures, text, visual and auditory images, video clips, files, databases, catalogs and lists within the "SITE", s/he will not be using these actions or with other ways to compete with "Turkiye Klinikleri", directly or indirectly.

4.3. The services provided and the context published within the "SITE" by third parties is not under the responsibility of "Turkiye Klinikleri", institutions collaborated with "Turkiye Klinikleri", "Turkiye Klinikleri" employee and directors, "Turkiye Klinikleri" authorized salespeople. Commitment to accuracy and legality of the published information, context, visual and auditory images provided by any third party are under the full responsibility of the third party. "Turkiye Klinikleri" does not promise and guarantee the safety, accuracy and legality of the services and context provided by a third party.

4.4. "USER"s cannot act against "Turkiye Klinikleri", other "USER"s and third parties by using the "SITE". "Turkiye Klinikleri" has no direct and/or indirect responsibility for any damage a third party suffered or will suffer regarding "USER"s actions on the "SITE" against the rules of the hereby "Terms of Use" and the law.

4.5. "USER"s accept and undertake that the information and context they provided to the "SITE" are accurate and legal. "Turkiye Klinikleri" is not liable and responsible for promising and guaranteeing the verification of the information and context transmitted to "Turkiye Klinikleri" by the "USER"s, or uploaded, changed and provided through the "SITE" by them and whether these information are safe, accurate and legal.

4.6. "USER"s agree and undertake that they will not perform any action leading to unfair competition, weakening the personal and commercial credit of "Turkiye Klinikleri" and a third party,  encroaching and attacking on personal rights within the "SITE" in accordance with the Turkish Commercial Code Law.

4.7. "Turkiye Klinikleri" reserves the right to change the services and the context within the "SITE"  anytime. "Turkiye Klinikleri" may use this right without any notification and timelessly. "USER"s have to make the changes and/or corrections "Turkiye Klinikleri" required immediately. Any changes and/or corrections that are required by "Turkiye Klinikleri", may be made by "Turkiye Klinikleri" when needed. Any harm, criminal and civil liability resulted or will result from changes and/or corrections required by "Turkiye Klinikleri" and were not made on time by the "USER"s belongs completely to the users.

4.8. "Turkiye Klinikleri" may give links through the "SITE" to other websites and/or "CONTEXT"s and/or folders that are outside of their control and owned and run by third parties. These links are provided for ease of reference only and do not hold qualification for support the respective web SITE or the admin or declaration or guarantee for the information inside. "Turkiye Klinikleri" does not hold any responsibility over the web-sites connected through the links on the "SITE", folders and context, the services or products on the websites provided through these links or their context.

4.9. "Turkiye Klinikleri" may use the information provided to them by the "USERS" through the "SITE" in line with the terms of the "PRIVACY POLICY" and "USER CONTRACT". It may process the information or classify and save them on a database. "Turkiye Klinikleri" may also use the USER's or visitor's identity, address, e-mail address, phone number, IP number, which sections of the "SITE" they visited, domain type, browser type, date and time information to provide statistical evaluation and customized services.

5. PROPRIETARY RIGHTS

5.1. The information accessed through this "SITE" or provided by the users legally and all the elements (including but not limited to design, text, image, html code and other codes) of the "SITE" (all of them will be called as studies tied to "Turkiye Klinikleri"s copyrights) belongs to "Turkiye Klinikleri". Users do not have the right to resell, process, share, distribute, display or give someone permission to access or to use the "Turkiye Klinikleri" services, "Turkiye Klinikleri" information and the products under copyright protection by "Turkiye Klinikleri". Within hereby "Terms of Use" unless explicitly permitted by "Turkiye Klinikleri" nobody can reproduce, process, distribute or produce or prepare any study from those under "Turkiye Klinikleri" copyright protection.

5.2. Within hereby "Terms of Use", "Turkiye Klinikleri" reserves the rights for "Turkiye Klinikleri" services, "Turkiye Klinikleri" information, the products associated with "Turkiye Klinikleri" copyrights, "Turkiye Klinikleri" trademarks, "Turkiye Klinikleri" trade looks or its all rights for other entity and information it has through this website unless it is explicitly authorized by "Turkiye Klinikleri".

6. CHANGES IN THE TERMS OF USE

"Turkiye Klinikleri" in its sole discretion may change the hereby "Terms of Use" anytime announcing within the "SITE". The changed terms of the hereby "Terms of Use" will become valid when they are announced. Hereby "Terms of Use" cannot be changed by unilateral declarations of users.

7. FORCE MAJEURE

"Turkiye Klinikleri" is not responsible for executing late or never of this hereby "Terms of Use", privacy policy and "USER Contract" in any situation legally taken into account as force majeure. Being late or failure of performance or non-defaulting of this and similar cases like this will not be the case from the viewpoint of "Turkiye Klinikleri", and "Turkiye Klinikleri" will not have any damage liability for these situations. "Force majeure" term will be regarded as outside of the concerned party's reasonable control and any situation that "Turkiye Klinikleri" cannot prevent even though it shows due diligence. Also, force majeure situations include but not limited to natural disasters, rebellion, war, strike, communication problems, infrastructure and internet failure, power cut and bad weather conditions.

8. LAW AND AUTHORISATION TO FOLLOW

Turkish Law will be applied in practicing, interpreting the hereby "Terms of Use" and managing the emerging legal relationships within this "Terms of Use" in case of finding element of foreignness, except for the rules of Turkish conflict of laws. Ankara Courts and Enforcement Offices are entitled in any controversy happened or may happen due to hereby contract.

9. CLOSING AND AGREEMENT

Hereby "Terms of Use" come into force when announced in the "SITE" by "Turkiye Klinikleri". The users are regarded to agree to hereby contract terms by using the "SITE". "Turkiye Klinikleri" may change the contract terms and the changes will be come into force by specifying the version number and the date of change on time it is published in the "SITE".

 

30.03.2014

Privacy Policy

We recommend you to read the terms of use below before you visit our website. In case you agree these terms, following our rules will be to your favor. Please read our Terms of Use thoroughly.

www.turkiyeklinikleri.com website belongs to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. and is designed in order to inform physicians in the field of health

www.turkiyeklinikleri.com cannot reach to user’s identity, address, service providers or other information. The users may send this information to the website through forms if they would like to. However, www.turkiyeklinikleri.com may collect your hardware and software information. The information consists of your IP address, browser type, operating system, domain name, access time, and related websites. www.turkiyeklinikleri.com cannot sell the provided user information (your name, e-mail address, home and work address, phone number) to the third parties, publish it publicly, or keep it in the website. Gathered information has a directing feature to be a source for the website’s visitor profile, reporting and promotion of the services.

www.turkiyeklinikleri.com uses the taken information:

-To enhance, improve and maintain the quality of the website

-To generate visitor’s profile and statistical data

-To determine the tendency of the visitors on using our website

-To send print publications/correspondences

-To send press releases or notifications through e-mail

-To generate a list for an event or competition

By using www.turkiyeklinikleri.com you are considered to agree that;

-Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. cannot be hold responsible for any user’s illegal and immoral behavior,

-Terms of use may change from time to time,

-It is not responsible for other websites’ contents it cannot control or the harms they may cause although it uses the connection they provided.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. may block the website to users in the following events:

-Information with wrong, incomplete, deceiving or immoral expressions is recorded to the website,

-Proclamation, advertisement, announcement, libelous expressions are used against natural person or legal identity,

-During various attacks to the website,

-Disruption of the website because of a virus.

Written, visual and audible materials of the website, including the code and the software are under protection by legal legislation.

Without the written consent of Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. the information on the website cannot be downloaded, changed, reproduced, copied, republished, posted or distributed.

All rights of the software and the design of the website belong to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. will be pleased to hear your comments about our terms of use. Please share the subjects you think may enrich our website or if there is any problem regarding our website.

info@turkiyeklinikleri.com