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Development of an instrument based on the theory of planned behavior variables to measure factors influencing Iranian adults’ intention to quit waterpipe tobacco smoking

Authors Mirzaei N, Dehdari T, Taghdisi MH, Zare N

Received 10 June 2019

Accepted for publication 3 September 2019

Published 24 September 2019 Volume 2019:12 Pages 901—912


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Professor Igor Elman

Nasim Mirzaei,1 Tahereh Dehdari,1 Mohammad Hossein Taghdisi,1 Najaf Zare2

1Department of Health Education and Health Promotion, School of Public Health, Iran University of Medical Sciences, Tehran, Iran; 2Department of Biostatistics, School of Medicine, Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

Correspondence: Tahereh Dehdari
Iran University of Medical Sciences, Shahid Hemmat Highway, Tehran 1449614535, Iran
Tel +98 218 860 4625

Background: Theory of planned behavior (TPB) is one of the most widely used theoretical frameworks to explain addictive behaviors, such as tobacco smoking. The aim of this study is to develop and validate an instrument based on TPB variables to measure factors influencing Iranian rural adults’ intention to quit waterpipe tobacco smoking.
Methods: This study was performed on a sample of rural adult waterpipe consumers living in two villages in Shiraz, Southern Iran. In the beginning, the initial items of instrument were extracted from the literature review and interviews with 20 waterpipe consumers. After that, face validity and qualitative content validity of the items were appraised. To measure quantitative content validity index (CVI) and the content validity ratio (CVR), a panel of experts reviewed the items. In addition, the exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were applied to characterize the construct validity of the instrument. Finally, Cronbach’s alpha coefficient and intraclass correlation coefficient (ICC) were computed.
Results: CVI and CVR of items were within the ranges of 0.89–0.95 and 0.85–0.96, respectively. EFA indicated the Kaiser-Meyer-Olkin (=0.71) and Bartlett’s test of sphericity was significant (=912.36, df=105, p<0.0001). Principal component analysis revealed that 15 items could be grouped into four subscales that accounted for 64.97% of the variance. Based on CFA, two items were deleted. CFA results showed that the remained data were fit to the model. The Cronbach’s alpha and ICC of subscales were, respectively, in the ranges of 0.72–0.87 and 0.64–0.82. Finally, a 13-item instrument with four subscales was confirmed.
Conclusions: The findings reveal that the developed TPB instrument is a reliable and valid scale to identify the determinants of the intention to quit waterpipe smoking among Iranian rural adults.

Keywords: waterpipe tobacco smoking, theory-based, Iran, confirmatory factor analysis, exploratory factor analysis

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