Design and Validation of a Tool to Measure the Knowledge, Attitude, and Performance of Health Workers Regarding Population Growth Policies

Background: The decline in fertility rates, including in Iran, poses demographic challenges like an aging population and a reduced workforce. Iran's fertility rate has fallen below replacement levels. In ۲۰۲۱, legislation was passed to improve fertility and population quality. The law's success depends on the Ministry of Health personnel, as their knowledge and attitudes affect community reproductive behaviors. However, there are no standardized tools to evaluate these factors among Iranian healthcare professionals regarding the new population policies. Objectives: This study aims to create and validate a reliable tool to assess Iranian healthcare workers' knowledge, attitudes, and practices regarding population growth policies. Methods: This instrument development study was conducted in Mashhad during ۲۰۲۲–۲۰۲۳ to design and validate a questionnaire on healthcare providers’ awareness. The initial item pool was derived from the Ministry of Health’s checklist and refined through expert review and consultations with officials from the Health Vice-Chancellor of Mashhad University of Medical Sciences. Overlapping items were removed, and the finalized questions were compiled into the preliminary instrument. Content validity was evaluated using CVR and CVI by ۱۲ experts. Reliability was assessed among ۶۵ healthcare personnel, including physicians, midwives, nurses, and health workers, using Cronbach’s alpha and test–retest methods. Data analysis was performed with SPSS using descriptive and nonparametric statistics. Results: The results showed that ۱۲ items were not suitable in terms of content validity and were removed from the questionnaire, while the other questions remained in the questionnaire with some minor modifications in the writing. The final questionnaire comprised ۴۰ valid items encompassing the domains of knowledge, performance, attitudes towards population growth, and attitudes towards socio-legal and cultural contradictions. Reliability metrics indicated robust internal consistency, with Cronbach's alpha exceeding ۰.۸۵ across all domains, and demonstrated satisfactory test-retest reproducibility, with an Intraclass Correlation Coefficient (ICC) of ۰.۸۳ or greater. Conclusion: This validated questionnaire is a key tool for assessing health workers' knowledge, attitudes, and practices about population growth policies in Iran. It aids in targeted educational interventions and policy monitoring, supporting demographic goals amid declining fertility trends.

کلیدواژه ها:

Knowledge ، attitudes ، performance ، population policy