The Meharry Questionnaire: Measuring Attitudes Towards AIDS-Related Issues

Abstract

The Meharry Questionnaire (MQ) is a 13-item psychometric instrument designed to quantify the attitudes and behavioral intentions of individuals concerning AIDS-related issues. Originally developed to assess the views of physicians, the scale was subsequently modified to ensure general public comprehension and applicability. Responses are captured using a 6-point Likert scale ranging from 0 (strongly disagree) to 5 (strongly agree).

The primary aim of the MQ was to identify attitudes among health care workers that might compromise the quality of patient care for those affected by AIDS or HIV. Furthermore, the questionnaire was utilized to explore how these attitudes varied across key demographic groups, including race, gender, educational level, and religious preference.

Keywords

AIDS attitudes, HIV/AIDS, healthcare worker attitudes, moral conservatism, social stigma, Likert scale, public health psychology, attitude measurement.

Authors

Frederick A. Ernst, Rupert A. Francis, Joyce Perkins, Quintessa Britton-Williams, Ajaipal S. Kang.

Purpose

The core purpose of the Meharry Questionnaire is the systematic measurement of attitudes and corresponding behaviors related to AIDS-related issues, particularly within the sensitive environment of health care facilities. The initial development team, including researchers from Meharry Medical College and the Centre for Addiction and Mental Health, sought to proactively identify potential biases among staff that could lead to substandard or compromised quality of care for patients.

A significant secondary objective involved leveraging the data set to isolate differences in attitudes based on specific demographic variables. This research revealed important sociological findings; for instance, early analyses indicated that Black respondents were significantly more likely than White respondents to report personal habit changes to prevent HIV infection. Additionally, the scale highlighted stronger condemnation of homosexuality within the Black community, a phenomenon attributed primarily to the relatively less tolerant attitudes expressed by Black females.

Construct

The Meharry Questionnaire measures a broad construct defined as Attitudes Toward AIDS-Related Issues. This construct encompasses various dimensions, including perceived risk, social judgment, moral condemnation, and policy beliefs related to the disease and affected populations.

Although the 13 items address diverse topics (from divine retribution to mandated testing), subsequent scoring analyses focused on deriving a highly specific construct: the Moral Conservatism Score. This score, calculated using responses to seven specific items (2, 4, 6, 9, 10, 11, and 13), isolates a cluster of socially judgmental and religiously conservative beliefs regarding the AIDS epidemic and the behaviors associated with high-risk groups. The observed mean score for this measure was 6.11 (SD = 0.18), with a theoretical range of –5 to 30.

Validity

At the time of the original reporting, formal, published validity studies establishing the psychometric properties of the Meharry Questionnaire were pending. However, the researchers provided internal data supporting the scale’s validity, particularly concerning the derived Moral Conservatism Score.

Evidence for construct validity was established through the strong relationship between the Moral Conservatism Score and established demographic variables. Specifically, the researchers found that moral conservatism was strongly and inversely related to the respondent’s educational level (p <.000001). Furthermore, scores on this measure were predictive of religious preference, although this relationship was complex, as more conservative religious groups (e.g., Church of God) often contained a disproportionate number of subjects with less formal education, potentially confounding the independent effect of religious belief.

Reliability

Reliability analyses were conducted to ensure the consistency of the Meharry Questionnaire. The measure of internal consistency, the Cronbach alpha coefficient, was calculated at .70, which is generally considered an acceptable level for attitude scales in social science research. The average inter-item correlation across the 13 items was .16.

Further reliability testing included measures of temporal stability and internal consistency correlation. The Split-half reliability coefficient was found to be .74. Test-retest correlation coefficients, assessing stability over time, varied widely across the individual items, ranging from a low of .24 to a high of .72. This variability suggests that while some attitudes measured by the scale are relatively stable, others are more volatile or context-dependent.

Factor Analysis

The source documentation does not detail a formal exploratory or confirmatory factor analysis conducted on the Meharry Questionnaire to identify underlying latent factors for all 13 items. The 13 items appear to have been analyzed independently in many initial studies, allowing for comparison across specific demographic characteristics.

However, the subsequent derivation and use of the Moral Conservatism Score (composed of Items 2, 4, 6, 9, 10, 11, and 13) indicates that the developers recognized a strong theoretical clustering of items reflecting punitive and socially conservative judgment regarding AIDS, suggesting an implicit factor structure related to moral judgment.

Instrument

Test Type: Attitude Questionnaire / Psychosocial Assessment Scale

Format: 13 statements requiring responses on a 6-point Likert scale (0=Strongly Disagree to 5=Strongly Agree).

Language Available: English (Original research language).

Population Group: Health care facility employees (initially); modified for general public comprehension.

Age Group: Adults (Implied, based on employment status).

Population Details: The primary data set was derived from two convenience samples of employees in mental health and retardation residential facilities throughout Tennessee. The 1989 sample included 2,006 respondents, and the 1994 follow-up included 857 respondents. The combined population was 38% Black, 55% White, and 68% female, representing a cross-section of socioeconomic strata and occupational categories.

Test Methodology: Self-report questionnaire. Completion time is approximately 5 to 10 minutes, including the provision of demographic information.

Keywords

Attitude measurement, healthcare staff, HIV stigma, moral judgment, Tennessee study, psychometrics, Cronbach alpha, split-half reliability.

Authors

Author ORCID Identifier: Not provided in source material.

Affiliation Email addresses: [email protected] (Frederick A. Ernst)

Correspondence Address: Frederick A. Ernst, Department of Psychology and Anthropology, University of Texas–Pan American, 1201 West University Drive, Edinburg, TX 78541-2999.

Permissions & Fee and Test Year

Test Year: Initial administration 1989; follow-up administration 1994.

Permissions/Fee: Information regarding permissions and usage fees is not specified in the source material.

Reference’s

• Ernst, F. A., Francis, R. A., Nevels, H., Collipp, D., & Lewis, A. (1991). Racial differences in affirmation of personal habit change to prevent HIV infection. Preventive Medicine, 20, 529–533.

• Ernst, F. A., Francis, R. A., Nevels, H., & Lemeh, C. A. (1991). Condemnation of homosexuality in the Black community: A gen- der-specific phenomenon? Archives of Sexual Behavior, 20, 579– 585.

Items of the The Meharry Questionnaire: The Measurement of Attitudes Toward AIDS-Related Issues

Please circle the number which reflects the amount of your agreement or disagreement with each statement.

1. AIDS will never be a threat to the rural areas of the U.S.A.

   0 1 2 3 4 5a

   Strongly Disagree Strongly Agree

2. AIDS is the result of God’s punishment (“Divine Retribution”).

3. Most of the AIDS patients in the 1990s will have to be treated by family doctors.

4. AIDS will help the society by decreasing the number of homosexuals (gay people).

5. I have made changes in my personal habits to prevent being infected by the AIDS virus.

6. Sterilized needles should be made available to needle-using drug abusers to prevent the spread of AIDS.

7. All pregnant women should be required to have their blood tested for the AIDS virus.

8. It is easier to catch the AIDS virus than the experts are leading us to believe.

9. The AIDS epidemic is a fulfillment of biblical prophecy.

10. AIDS will help the society by decreasing the number of drug abusers.

11. People with AIDS have gotten what they deserve.

12. In the 1990s, a large increase in health care manpower will be required because of AIDS.

13. Needle-using drug abusers who get AIDS are not worthy of extensive medical attention.

a This scale follows each of the statements.