Evaluation of Environmental Health Literacy in High School Students Regarding Environmental Management Aspects for Malaria Vector Control Instrument Development and Validation

Abstract

Introduction: This study aims to develop and validate an instrument to evaluate EHL related to environmental management practices for malaria vector control among high school students. Methods: This study used a cross-sectional design with samples of high school students selected through Multistage Random Sampling in five schools. The sample size was determined based on the ratio of ten respondents per item. A total of 387 questionnaires were returned with a response rate of 77.4%. After eliminating 36 multivariate outliers, 351 questionnaires were further analyzed. Results: The initial instrument consisted of 39 items evaluated by seven expert panelists (I-CVI: 0.86–1.00; S-CVI/AVE: 0.92). Five items with I-CVI < 0.78 were removed, and three items were revised based on face validity. EFA with varimax rotation identified five factors explaining 53.57% of the total variance. The CFA results showed a good fit model (CMIN/df: 1.824; RMSEA: 0.049; RMR: 0.03; TLI: 0.931; CFI: 0.937). The final instrument included 28 items in four main domains: knowledge (factual and conceptual), information skills, attitudes, and environmental management practices.

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