DEVELOPMENT AND CONTENT VALIDITY OF THE HANDWASHING INDEX (HWI)

Handwashing is the simplest way to stop the spread of infections and maintain health. To the best of our knowledge, there is no validated scale to measure this habit. Given the need to raise awareness and its importance, a study was undertaken to develop, test, and validate the HWI. The Physical Activity Questionnaire for Adolescents (PAQ-A) was adapted and substantially modified to draft the first version of the index (HWQ). The COnsensus-based Standards for the Selection of Health Measurement Instrument (COSMIN) guided our approach. The HWQ The questionnaire consisted of six questions with a five-point scale response for each item, ranging from the lowest [1] to the highest activity [5] as scoring criteria. We followed a four-stage procedure in validating the instrument: Stage I: items were created from the review of the relevant literature (PAQ-A, COSMIN); Stage II: the study targeted and recruited 57 health professionals from different backgrounds and vetted them as decliners, non-regulars, and regular hand washers through a scoring process.

This crucial phase ensured that the respondents had hands-on experience in handwashing in addition to their expertise. In Stage III, 10 respondents from the regular hand washers were randomly selected as expert judges. They were divided into two (2) groups (Group one and Group two) of four and six members, respectively. Further comprehensibility and comprehensiveness of the HWQ were established through a review by the four members of Group 1, and revisions were made to create HWQ-I. At stage IV, the HWQ-I was administered to the six members of the second group for ratings and content validity index calculations. The final draft of the HWI includes 4 items. Item CVI ranges between 0.8 and 1.The average scale CVI was 0.9.

The HWI demonstrated excellent content validity, showing its relevance for monitoring handwashing, and individuals can track their compliance, promoting a healthy life. We propose further studies to test the psychometric properties of the scale.