Despite the unequivocal value of vaccination in reducing the global burden of infectious diseases, the anti‐vaccination movement thrives. The vast majority of the existing validated tools explore attitudes regarding vaccination in children. The aim of our study was to develop and validate a scale assessing attitudes towards adult immunisation. This national cross‐sectional study included adult healthcare users who visited 23 Greek Primary Healthcare Units. The development of the scale was the result of literature review, semi‐structured interviews and pilot testing of its preliminary versions. The initial version contained 15 items measuring respondents’ attitudes on a 6‐point Likert scale. The sample was randomly split into two halves. Exploratory factor analysis, performed in the first sample, was used for the creation of multi‐item scales; confirmatory factor analysis was used in the second sample to assess goodness of fit. Moreover, concurrent validity, internal consistency reliability, test–retest reliability and ceiling and floor effects were explored. The total sample consisted of 1,571 individuals. Overall ‘Cronbach's alpha’ (0.821) indicated good internal consistency. The initial exploratory factor analysis resulted in a three‐factor model. The subsequent confirmatory factor analysis indicated that an 11‐item version of the scale provided the best fit of the model to the data (RMSEA = 0.050, SRMR = 0.053, TLI = 0.937, CFI = 0.955, AIC = 24,999.949). All subscales (‘value of adult vaccination’, ‘safety concerns’ and ‘perceived barriers’) demonstrated strong concurrent associations with participants’ attitudes and behaviour regarding vaccination (p < .001). No ceiling or floor effects were noted for any of the subscales (0.13%, 2.61% and 0.51%; 0.13%, 0.57% and 0.45% respectively). The 11‐item ATAVAC scale proved to be a reliable and valid tool, suitable for assessing attitudes towards adult vaccination.

中文翻译：

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了解人们对成人疫苗接种的看法和感受以及希腊的相关障碍：成人疫苗接种态度 (ATAVAC) 量表的制定和验证

尽管疫苗接种在减少全球传染病负担方面具有明确的价值，但反疫苗接种运动蓬勃发展。绝大多数现有的经过验证的工具都探讨了对儿童疫苗接种的态度。我们研究的目的是制定和验证评估成人免疫接种态度的量表。这项全国横断面研究包括访问了 23 个希腊初级医疗保健单位的成年医疗保健用户。量表的发展是文献综述、半结构化访谈和初步版本试点测试的结果。最初的版本包含 15 个项目，以 6 点李克特量表衡量受访者的态度。样本被随机分成两半。在第一个样本中进行的探索性因素分析用于创建多项目量表；在第二个样本中使用验证性因子分析来评估拟合优度。此外，还探讨了并发效度、内部一致性信度、重测信度以及上限和下限效应。总样本包括 1,571 个人。总体'Cronbach's alpha' (0.821) 表明良好的内部一致性。最初的探索性因素分析产生了一个三因素模型。随后的验证性因素分析表明，该量表的 11 项版本提供了模型与数据的最佳拟合（RMSEA = 0.050，SRMR = 0.053，TLI = 0.937，CFI = 0.955，AIC = 24,999.949）。所有分量表（“成人疫苗接种的价值”、“安全问题”和“感知障碍”）都与参与者对疫苗接种的态度和行为密切相关（p  < .001）。没有注意到任何子量表的天花板或地板效应（分别为 0.13%、2.61% 和 0.51%；分别为 0.13%、0.57% 和 0.45%）。11 项 ATAVAC 量表被证明是一种可靠且有效的工具，适用于评估对成人疫苗接种的态度。