Development and Validation of a Knowledge, Attitude, and Practice Questionnaire for Environmental Cardiovascular Awareness Among Allied Health Science Students

Introduction: Air pollution is a major environmental concern with significant implications for cardiovascular health.As future healthcare professionals, allied health science students play an important role in patient education and preventive healthcare.Assessing their awareness of air pollution and its potential cardiovascular effects is therefore essential.This study aimed to develop and validate a novel psychometric instrument to assess knowledge, attitudes, and practices (KAP) regarding air pollution and its cardiovascular health effects among first-year allied health science students.Methods: A cross-sectional online survey was conducted among 199 first-year allied health science students at a university-affiliated medical center.A novel questionnaire was developed through expert discussions and subsequently subjected to rigorous evaluation.Content validity was assessed, and exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were performed to evaluate the instrument's construct validity and model fit.Internal consistency was also assessed.CFA was conducted using the weighted least squares mean and variance adjusted (WLSMV)/diagonally weighted least squares (DWLS) estimator.Results: The validation process yielded a 26-item questionnaire comprising three domains: knowledge (10 items), attitudes (eight items), and practices (eight items).The Kaiser-Meyer-Olkin (KMO) measure of sampling adequacy was 0.93, and Bartlett's test of sphericity was statistically significant (p < 0.001).The three-factor CFA measurement model demonstrated excellent overall fit (χ²(296) = 298.501,WLSMV-scaled test statistic; p = 0.448; Comparative Fit Index (CFI) = 0.999; Tucker-Lewis Index (TLI) = 0.998; Root Mean Square Error of Approximation (RMSEA) = 0.007; Standardized Root Mean Square Residual (SRMR) = 0.052).Internal consistency was high across all three domains, with Cronbach's α values of 0.895 for knowledge, 0.923 for attitudes, and 0.929 for practices.Conclusions: The newly developed 26-item environmental cardiovascular awareness tool demonstrated promising reliability and validity, supporting its potential use in assessing KAP regarding air pollution and its cardiovascular health effects among allied health science students.