Evaluation of the reliability and validity of a vaccine hesitancy scale on knowledge, attitude, trust and vaccination environment (KATE-S) in Chinese parents

Objective To verify the reliability and validity of a vaccine hesitancy scale about knowledge, attitude, trust and vaccination environment (KATE-S) among the Chinese parents. Methods A questionnaire survey was conducted by convenience sampling in China using the KATE-S to assess knowledge of vaccines, attitudes towards vaccines, trust in acquired information and vaccination environment and vaccination status of vaccine introduced in immunization program among children. Result A total of 199 valid questionnaires were collected from the parents. Among those, 83 (41.7%) parents accepted all vaccines without hesitancy, 111 (55.8%) parents accepted all but had hesitancy intention, and 5 (2.5%) had hesitancy behaviour of refusing or delaying vaccination. The overall test–retest reliability, split-half reliability and Cronbach's coefficient values were 0.924, 0.885 and 0.823, respectively. The scale-level content validity index (S-CVI) of universal agreement was 0.867, and the average S-CVI was 0.978. Exploratory factor analysis extracted seven common factors from the scale, and the cumulative contribution rate was 56.8%. The correlation coefficients between the items and their dimensions ranged from 0.405 to 0.760, with a calibration success rate of 100% for convergent and discriminant validity. After adjusting for the basic characteristics, the knowledge level of hesitancy intention group and hesitancy behavior group were both lower than accept all group (OR = 0.78, 95% CI: 0.65–0.94; OR = 0.26, 95 %CI: 0.07–0.94). Conclusion The KATE-S has good reliability and validity in Chinese parents and would be considered to expand the sample size and survey areas to obtain more representative results.