Assessing the reliability and validity of anti-tobacco attitudes/beliefs in the context of a campaign strategy.
OBJECTIVE
To identify multi-item attitude/belief scales associated with the theoretical foundations of an anti-tobacco counter-marketing campaign and assess their reliability and validity.


METHODS
The data analyzed are from two state-wide, random, cross-sectional telephone surveys [n(S1)=1,079, n(S2)=1,150]. Items forming attitude/belief scales are identified using factor analysis. Reliability is assessed with Chronbach's alpha. Relationships among scales are explored using Pearson correlation. Validity is assessed by testing associations derived from the Centers for Disease Control and Prevention's (CDC) logic model for tobacco control program development and evaluation linking media exposure to attitudes/beliefs, and attitudes/beliefs to smoking-related behaviors. Adjusted odds ratios are employed for these analyses.


RESULTS
Three factors emerged: traditional attitudes/beliefs about tobacco and tobacco use, tobacco industry manipulation and anti-tobacco empowerment. Reliability coefficients are in the range of 0.70 and vary little between age groups. The factors are correlated with one-another as hypothesized. Associations between media exposure and the attitude/belief scales and between these scales and behaviors are consistent with the CDC logic model.


CONCLUSIONS
Using reliable, valid multi-item scales is theoretically and methodologically more sound than employing single-item measures of attitudes/beliefs. Methodological, theoretical and practical implications are discussed.
Department of Epidemiology and Public Health, University of Miami School of Medicine, Miami, FL 33136, USA. karheart@med.miami.edu
Kristopher L
KL
Arheart
David F
DF
Sly
Edward J
EJ
Trapido
Richard D
RD
Rodriguez
Amy J
AJ
Ellestad
D000293:Adolescent; D000329:Advertising / Q000706:statistics & numerical data; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006266:Health Education / Q000379:methods* / Q000706:statistics & numerical data*; D007722:Health Knowledge, Attitudes, Practice; D006306:Health Surveys; D006801:Humans; D008297:Male; D016017:Odds Ratio; D016730:Program Development / Q000379:methods*; D015397:Program Evaluation; D015203:Reproducibility of Results; D014029:Tobacco Use Disorder / Q000517:prevention & control*; D014481:United States