Alternate Forms of HIV Prevention Attitude Scales for Teenagers

Abstract

The Alternate Forms of HIV Prevention Attitude Scales for Teenagers were developed by Mohammad R. Torabi and William L. Yarber to address the critical need for valid and reliable instruments capable of measuring adolescent attitudes toward HIV prevention. The scales are grounded in a multidimensional attitude framework, incorporating cognitive, affective, and conative components. A comprehensive pool of 50 Likert-type items was reviewed by a jury of experts and refined before initial administration to 210 high school students. Extensive item analyses resulted in the creation of two comparable, 15-item alternate forms (Form A and Form B). These forms were then administered simultaneously to a representative sample of 600 teenagers in a Midwestern high school. The resulting data provided strong psychometric evidence supporting the scales’ internal consistency, comparability, and suitability for use in educational evaluation settings, particularly those utilizing a pretest/posttest design.

Keywords

HIV prevention, attitude measurement, adolescents, teenagers, Likert scale, psychometrics, alternate forms, reliability, validity, pretest/posttest design.

Authors

Mohammad R. Torabi, William L. Yarber

Purpose

The primary purpose of this research was to construct parallel and equivalent attitude scale forms to measure adolescents’ attitudes toward HIV and the prevention of HIV infection. The development was necessitated by the recognized obstacle that a lack of valid measurement devices posed to effective evaluation of HIV/AIDS education programs.

By creating alternate forms, the authors aimed to provide researchers and educators with instruments suitable for repeated testing scenarios, such as the common pretest/posttest design used in educational evaluation. The use of alternate forms, rather than a single form, helps mitigate potential testing effects, such as familiarity with items or practice effects, thereby enhancing the integrity of longitudinal attitude assessment.

Construct

The scale is designed to measure attitudes, which are conceptualized as multidimensional constructs following the established model developed by Ajzen and Fishbein (1980). This model posits that attitudes are composed of three distinct, yet related, components:

• Cognitive Component: Refers to beliefs and knowledge regarding HIV prevention.
• Affective Component: Relates to feelings and emotional reactions toward HIV or individuals affected by HIV.
• Conative Component: Measures the intention to act or behavioral readiness concerning preventative behaviors (e.g., condom use, drug avoidance).

The items generated for the scale were guided by a table of specifications to ensure comprehensive coverage of these three components across conceptual areas related to HIV and its prevention, ensuring that the final instrument captures the complexity of adolescent attitudes.

Validity

Evidence for the validity of the scales was established through multiple rigorous procedures. Content validity was initially ensured during the item generation phase by utilizing a detailed table of specifications and subsequently by review from a jury of experts who provided feedback on clarity and relevance.

Further evidence of validity and comparability between the two forms was derived from factor analysis procedures. The results indicated that Form A and Form B possessed reasonably comparable factor structures, suggesting that they measure the same underlying construct equivalently. The authors noted that while criterion-related validity (assessing correlations with actual sexual or injecting drug behaviors) would have been ideal, it was not feasible due to significant ethical and practical resistance to surveying minors on these sensitive topics. Furthermore, the authors caution that the validity evidence was obtained primarily from a sample of predominantly White, in-school students, potentially limiting the appropriateness of the forms for minority or out-of-school youth populations.

Reliability

The psychometric properties of the alternate forms indicated strong reliability. The key reliability statistics reported by Torabi and Yarber (1992) include:

• Alternate Forms Reliability: The correlation coefficient between Form A and Form B was 0.82, demonstrating the high equivalence and interchangeability of the two forms.
• Internal Consistency (Alpha Reliability): Coefficient alpha for Form A was 0.78, and for Form B was 0.77. These values indicate good internal consistency within each 15-item scale.
• Split-Half Reliability: Estimates using the split-half method were 0.76 for Form A and 0.69 for Form B.

These findings collectively provide strong evidence that the scales are reliable and consistent measures of attitudes toward HIV prevention among the target population.

Factor Analysis

Factor analysis was a crucial technique used in the scale development process to confirm the structural integrity and comparability of the two alternate forms. The procedure was implemented after administering the 15-item forms to the large sample of 600 teenagers.

The results of the factor analysis confirmed that both Form A and Form B exhibited statistically comparable factor structures. This comparability is vital for instruments intended as alternate measures, as it assures researchers that both forms are tapping into the same latent psychological dimensions related to HIV attitudes. The successful identification of comparable factor structures reinforced the initial evidence of content validity.

Instrument

Test Type: Psychological Attitude Scale (Self-report)

Format: 5-point Likert-type items (Strongly Agree, Agree, Undecided, Disagree, Strongly Disagree). Each form contains 15 items.

Language Available: English (US)

Population Group: Teenagers / Adolescents (High School Students)

Age Group: Typically 14–18 years old (High School age)

Population Details: The validation sample consisted of 600 Midwestern high school students, predominantly White and in-school. Caution is advised when using the scale with minority or out-of-school youth.

Test Methodology: The scale is designed for pencil-and-paper administration. The estimated time required to complete one form is approximately 10 minutes. The instrument is optimally suited for pretest/posttest designs in educational evaluation.

Keywords

HIV/AIDS education evaluation, attitude components, cognitive, affective, conative, split-half reliability, internal consistency, psychometric properties, Indiana University.

Authors

Author ORCID Identifier: Not provided in source.

Affiliation Email addresses: [email protected] (William L. Yarber)

Correspondence Address: William L. Yarber, Department of Applied Health Science, Indiana University, HPER Building, Bloomington, IN 47405.

Permissions & Fee and Test Year

The scale was developed and published in 1992. Information regarding current fees and permissions for use should be obtained directly from the corresponding author, William L. Yarber.

Reference’s

Ajzen, I., & Fishbein, M. (1980). Understanding attitudes and predicting social behavior. Englewood Cliffs, NJ: Prentice Hall.

Coyle, S., Boruch, R. F., & Turner, C. F. (1989). Evaluating AIDS prevention programs. Washington, DC: National Academy Press.

Kothandapani, V., (1971). A psychological approach to the prediction of contraceptive behavior. Chapel Hill Carolina Population Center, University of North Carolina.

Ostrom, T. M. (1969). The relationship between the affective, behavioral, and cognitive components of attitude. Journal of Experimental Psychology, 5, 12–30.

Timminga, E. B. (1990). The construction of parallel tests from IRT-based item banks. Journal of Educational Statistics, 15(2), 129–145.

Torabi, M. R., & Seffrin, J. R. (1986). A three component cancer attitude scale. Journal of School Health, 56, 170–174.

Torabi, M. R., & Veenker, C. H. (1986). An alcohol attitude scale for teenagers. Journal of School Health, 56, 96–100.

Torabi, M. R., & Yarber, W. L. (1992). Alternate forms of the HIV prevention attitude scales for teenagers. AIDS Education and Prevention, 4, 172–182.

Yarber, W. L., Torabi, M. R., & Veenker, C. H. (1989). Development of a three component sexually transmitted diseases attitude scale for young adults. Journal of Sex Education and Therapy, 15, 36–49.

Items of the Alternate Forms of HIV Prevention Attitude Scales for Teenagers

The minimum possible score for each form is 15 points, and the maximum is 75 points. Higher scores indicate more positive attitudes toward HIV and HIV prevention.

Scoring for Form A: For Items 7, 8, 11, 13, 15, strongly agree = 5 points, agree = 4, undecided = 3; disagree = 2, strongly disagree = 1. For the remaining items, strongly agree = 1, agree = 2, undecided = 3, disagree = 4, strongly disagree = 5.

Scoring for Form B: For Items 1, 3, 8, 9, 10, 11, 12, 13, 14, 15, strongly agree = 5, agree = 4, undecided = 3, disagree = 2, strongly disagree = 1. For the remaining items, strongly agree = 1, agree = 2, undecided = 3, disagree = 4, strongly disagree = 5.

Form A

Directions: Please read each statement carefully. Record your immediate reaction to the statement by blackening the proper oval on the answer sheet. There is no right or wrong answer for each statement, so mark your own response. Use the below key:

• A = Strongly agree
• B = Agree
• C = Undecided
• D = Disagree
• E = Strongly disagree

Example: Doing something to prevent getting HIV is the responsibility of each person.

1. I would feel very uncomfortable being around someone with HIV.
2. I feel that HIV is a punishment for immoral behavior.
3. If I were having sex, it would be insulting if my partner insisted we use a condom.
4. I dislike the idea of limiting sex to just one partner to avoid HIV infection.
5. I would dislike asking a possible sex partner to get the HIV antibody test.
6. It would be dangerous to permit a student with HIV to attend school.
7. It is easy to use the prevention methods that reduce one’s chance of getting HIV.
8. It is important to talk to a sex partner about HIV prevention before having sex.
9. I believe that sharing IV drug needles has nothing to do with HIV.
10. HIV education in schools is a waste of time.
11. I would be supportive of a person with HIV.
12. Even if a sex partner insisted, I would not use a condom.
13. I intend to talk about HIV prevention with a partner if we were to have sex.
14. I intend not to use drugs so I can avoid HIV.
15. I will use condoms when having sex if I’m not sure if my partner has HIV.

Form B

Directions: Please read each statement carefully. Record your immediate reaction to the statement by blackening the proper oval on the answer sheet. There is no right or wrong answer for each statement, so mark your own response. Use the below key:

• A = Strongly agree
• B = Agree
• C = Undecided
• D = Disagree
• E = Strongly disagree

Example: Doing something to prevent getting HIV is the responsibility of each person.

1. I am certain that I could be supportive of a friend with HIV.
2. I feel that people with HIV got what they deserve.
3. I am comfortable with the idea of using condoms for sex.
4. I would dislike the idea of limiting sex to just one partner to avoid HIV infection.
5. It would be embarrassing to get the HIV antibody test.
6. It is meant for some people to get HIV.
7. Using condoms to avoid HIV is too much trouble.
8. I believe that AIDS is a preventable disease.
9. The chance of getting HIV makes using IV drugs stupid.
10. People can influence their friends to practice safe behavior.
11. I would shake hands with a person having HIV.
12. I will avoid sex if there is a slight chance that the partner might have HIV.
13. If I were to have sex I would insist that a condom be used.
14. If I used IV drugs, I would not share the needles.
15. I intend to share HIV facts with my friends.