title: Development and validation of questionnaire measuring attitudes towards sexual health among university students.
abstract: OBJECTIVE
  To develop a questionnaire on attitudes towards sexual health and validate it on a sample of medical and non-medical students and adult women.
  
  
  METHODS
  For the purpose os constructing a Likert-type scale, four medical studentsgenerated 130 statements reflecting clearly positive or negative attitudes towards sexual health. The scale had five scoring points (1 - strongly disagree, 2 - disagree, 3 - undecided, 4 - agree, and 5 - strongly agree). We revised the items to ensure that all were clearly positive or clearly negative in their form, as well as straightforward in their meaning, leaving 100 items in the raw questionnaire, which was then applied to the convenience sample (total n=336) of female medical students (n=93), male medical students (n=75), female non-medical students (n=93) and adult working women with at least high-school education (n=75). After the administration of the questionnaire, we performed content examination, discriminant validation of the statements, and principal-components analysis.
  
  
  RESULTS
  After discriminant validation of the statements and principal-components analysis limited to three factors, the final scale contained 50 items (20 positive and 30 negative), distributed in three subscales: "Personal sexual health care," "Principles of sexual behavior," and "Safe sex behavior." The Cronbach alpha of the whole scale was 0.910, indicating good internal consistency. When the scores of the final scale were analyzed for the study sample, all participants had positive attitude towards sexual health, with a mean score (+/-standard deviation) of 4.1+/-0.4 out of maximum 5. The same was true for all threee subscales. Female groups, regardless of their student status or age, did not differ in their attitude scores on the whole scale, as well as on any of the subscales. Male medical students had lower scores on the whole scale and all subscales than the female groups.
  
  
  CONCLUSIONS
  It is posible to construct a reliable instrument to assess attitudes towards three important aspects of sexual health: personal sexual health care, sexual behavior, and safe sex behavior. Future studies with this instrument, on different populations and in different cultural and socio-economic settings, are needed to make generalized conclusions on sexual health attitudes and behavior.
authors.affiliation: Zagreb Universitiy School of Medicine, Salata 3, 10000 Zagreb, Croatia. dhren@mef.hr
authors.forename: Nina
authors.initials: N
authors.lastname: Nemcić
authors.forename: Sandra
authors.initials: S
authors.lastname: Novak
authors.forename: Lana
authors.initials: L
authors.lastname: Marić
authors.forename: Ivana
authors.initials: I
authors.lastname: Novosel
authors.forename: Ozren
authors.initials: O
authors.lastname: Kronja
authors.forename: Darko
authors.initials: D
authors.lastname: Hren
authors.forename: Ana
authors.initials: A
authors.lastname: Marusić
authors.forename: Matko
authors.initials: M
authors.lastname: Marusić
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001294:Attitude to Health; D017523:Croatia; D005260:Female; D006801:Humans; D008297:Male; D011594:Psychometrics; D012725:Sexual Behavior / Q000523:psychology*; D013337:Students, Medical / Q000523:psychology*; D011795:Surveys and Questionnaires