Development and validation of Health Belief Model based instrument to assess secondary school student's adherence to COVID-19 self-protective practices in Jimma, Oromia, Ethiopia

Background The study aimed in developing and validating a Health Belief Model (HBM) based instrument used for cross-sectional studies among secondary school students in Jimma town, Oromia, Ethiopia. Methods A school-based cross-sectional study was conducted from May 25 to June 10, 2021. The sample size was 634, and students were randomly selected from public and private secondary schools. The 81 items were developed reviewing different literatures based on the constructs of HBM. The constructs were perceived severity, perceived vulnerability, perceived benefit, perceived barrier, self-efficacy, cues to action, perceived school support and self-protective practice. Data were collected using a self-administered questionnaire. The data were cleaned, entered into and analyzed using SPSS 23.0. A principal axis factoring with varimax rotation was carried out to extract items. Items with no loading factor or cross-loaded items were deleted. Items having factor loading coefficient of >= 0.4 were retained. An internal reliability was ensured at Cronbach's alpha >0.70. All items with corrected item-total correlation coefficient below 0.30 were deleted from reliability analysis. Results In this study, 576 respondents were participated making a response rate of 90.8%. A total of thirty items were extracted and loaded in to eleven factors with cumulative variance of 56.719%. Percieved social support, percieved benefit, percieved school responsibility, self-efficacy, and practice items were internally consistent. Percieved vurnerability was neither valid nor reliable construct. Similarly, from the extracted factors, attitude towards face mask use and percieved peer influence were not internally consistent. Lastly, percieved benefit, self-efficacy and percieved school responsibility significantly predicted student's adherence to COVID-19 self-protective practices. Conclusions The study found that perceived benefit, perceived school support, social support, self-efficacy, perceived school environment cleanness, perceived school responsibility, perceived school health education, attitude to use face mask, perceived severity, cues to action and perceived peer influence were valid. Finally, perceived benefit, self-efficacy and perceived school responsibility significantly predicted student's adherence to COVID-19 self-protective practices.