Development and validation of a skin health knowledge, attitudes, and behaviors questionnaire for the general population
A cross-sectional study
Bibliographic Data
| ID | 22075149 |
|---|---|
| Authors | Xinquan Wang (0000-0003-3136-8070, Central South University), Liping Jin (Hainan General Hospital), Yue Wang (0000-0001-8527-9175, Hainan General Hospital), Yuanzhi Wang (Department of Dermatology, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University)), Wenhao Fu (Department of Dermatology, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University)), FU Wenhao (Hainan General Hospital), Minxue Shen (0000-0003-0441-9303, Central South University), Wu Zhu (0000-0002-3645-7059, Hainan General Hospital) |
| Year | 2026 |
| Volume | 14 |
| Pages | 1856843-1856843 |
| Publication date | 2026-06-08 |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | Frontiers in Public Health (JOURNAL) |
| Journal identifiers | ISSN: 2296-2565 • E-ISSN: 2296-2565 |
| Publisher | Frontiers Media SA (PUBLISHER • CH) |
| DOI | 10.3389/fpubh.2026.1856843 |
| PMID | 42338535 |
| OpenAlex | W7163956430 |
| Language | EN |
| References cited | 35 |
Background Existing skin health assessments predominantly focus on single topics or diseases, making it difficult to cover the complete “Knowledge–Self-efficacy–Attitudes–Behaviors (KSAB)” continuum. Objective To develop and validate a skin health knowledge, attitudes, and behaviors questionnaire for the general population. Methods A cross-sectional online survey was conducted among the general population between October and November 2025. The questionnaire was developed based on a conceptual structure incorporating four dimensions: knowledge, self-efficacy, attitudes, and behaviors. Content validity was assessed by 13 experts, and the Item-level Content Validity Index (I CVI ) and modified Kappa (K * ) were calculated. Construct validity was examined using confirmatory factor analysis (CFA). Item-level evaluation was performed using item response theory (IRT), including the two-parameter logistic (2PL) model for dichotomous items and the graded response model (GRM) for ordered items. Results A total of 865 individuals were enrolled (men: women = 1.24:1). Content validity was good (I CVI = 0.846–1.000, K* = 0.845–1.000). The five-factor model from CFA showed a good fit (CFI = 0.969, TLI = 0.960, RMSEA = 0.070, SRMR = 0.095). IRT analysis indicated that K1–K5 had acceptable discrimination ( a = 0.59–2.40) and difficulty parameters ranging from −3.63 to −1.33. However, items K6, K7 and S1 were excluded due to insufficient threshold coverage. The proportion of women reporting frequent sunscreen use was higher than that of men. Self-efficacy levels showed a decreasing trend with age. Furthermore, individuals in service/manual labor occupations exhibited lower proportions on certain items. Conclusion This study developed and validated a KSAB questionnaire on skin health knowledge, attitudes, and behaviors, showing good validity and item-level performance. The findings support targeted health promotion for men, older adults, and service/manual workers
Cohen's kappa · Confirmatory factor analysis · Construct validity · Content validity · Item response theory · Logistic regression · Population · Psychometrics · Structural equation modeling · Health Education and Validation · Reliability and Agreement in Measurement · Skin Protection and Aging
eHeals
Is the CVI an acceptable indicator of content validity? Appraisal and recommendations
An Introduction to Item Response Theory for Patient-Reported Outcome Measurement
Item Response Theory and Clinical Measurement
Health literacy and public health
The content validity index
Skin Cancer Knowledge, Attitudes and Sun Protection Practices in the Hispanic Population
The relationship between socioeconomic position and health literacy among urban and rural adults in regional China
Cross-cultural validation of the Jenkins Sleep Scale in Spanish-speaking countries
| Highly cited | No |
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