Validity and Reliability of an Information-Motivation-Skill-Behavior Questionnaire: A Gender-Sensitive HIV Survey

Background: Despite the essence of HIV-related surveys, their precision in measurement of intended constructs has been an area of controversy. Considering the increasing trend of sexual transmission of HIV among women, standard gender-sensitive tools can yield pivotal information for researchers and policy-makers in Iran. Aim: To evaluate the reliability and validity of a questionnaire (IMSB) based on the Information-Motivation-Behavior model of HIV-related behavior prediction. Methods: The IMSB survey constituted of five main domains: HIV-related knowledge, attitudes toward people living with HIV, motivation to practice safe-sex, skills to practice safe-sex, and HIV-related behaviors. Completed questionnaires (n = 189) from pilot phases of three projects were accessed. We assessed face and content validity through expert consultation and respondent feed-backs for the primary pool of items. Discriminant validity was measured utilizing non-parametric tests. Cronbach’s alpha was calculated for each domain to assess internal consistency, and paired t-tests were used to measure stability over time. Results: The primary pool of items was reduced in the process of validation. The discriminant validity was appraised to be favorable since the survey can differentiate between age groups, women with different levels of education and marital status. The survey was reliable in 4 domains; but a Cronbach’s alpha of 0.6 was reported for the fifth domain (HIV-related behaviors). Younger women had higher knowledge and motivation scores; single women were more motivated to practice safe-sex and divorced/widowed women had lower motivation and skills scores. Conclusion: This questionnaire can be used as a valid and reliable tool to measure the IMB constructs. The lower reliability of the “behavior” domain is probably rooted in societal norms and cultural definitions. The integration of motivation and skill domains can provide valuable information for clinicians/interventionists to address vulnerabilities experienced by their female clients.