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Correspondence to Author:  Izzaty Dalawi^{1 , Mohamad Rodi Isa2*, Nazim Aimran3}

1. National Public Health Laboratory, Lot 1853, Kampung Melayu, 47000 Sungai Buloh, Selangor, Malaysia. 2. Department of Public Health Medicine, Faculty of Medicine, Universiti Teknologi MARA, Jalan Hospital, 47000 Sungai Buloh, Selangor, Malaysia. 3. School of Mathematical Sciences, College of Computing, Informatics and Media, Universiti Teknologi MARA, Shah Alam 40450, Selangor, Malaysia.

DOI: 10.52338/tajoph.2025.4466

Abstract:

Introduction: Coronavirus Disease 2019 (COVID-19) is an emerging respiratory illness caused by a novel coronavirus known as Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). To effectively assess understanding, attitudes, practices, and health literacy regarding COVID-19, a valid and reliable questionnaire needs to be developed. Therefore, this study aims to develop and validate the Understanding, Attitude, Practice and Health Literacy Questionnaire on COVID-19 (MUAPH C-19) in Malay Language.
Materials and Methods: A cross-sectional study was conducted across three hospitals in Klang Valley from June 20, 2022, to June 30, 2022. The study’s target population consisted of Malaysian citizens aged 18 years and older who attended the three hospitals. A systematic random sampling method was employed to select participants. The original MUAPHQ C-19 questionnaire consists of four domains: understanding (12 items), attitude (15 items), practice (11 items), and Health Literacy (12 items). The validity of the questionnaire was assessed using exploratory factor analysis (EFA) and the reliability was assessed using Cronbach’s alpha and interclass correlation.
Results: A total of 100 respondents participated in the study. The Kaiser-Meyer-Olkin (KMO) Measure of Sampling Adequacy ranged from 0.691 to 0.899, and Bartlett’s Test of Sphericity was significant across all domains, indicating sufficient sample adequacy for the EFA. An eigenvalue greater than 1.0 revealed two components in the understanding domain (41.308% to 68.250%), three components in the attitude domain (22.802% to 58.973%), four components in the practice domain (19.852% to 73.500%), and a single component in the health literacy domain (64.194%). In the reliability assessment, Cronbach’s alpha ranged from 0.677 to 0.914, while the intraclass correlation ranged from 0.562 to 0.759 across all domains, demonstrating a good and reliable scale. Finally, 10 items have been deleted, and 10 sub-domains have emerged across four domains.
Conclusion: This study successfully developed a valid and reliable tool of the 42-item MUAPHQ C-19 for measuring understanding, attitudes, practice and health literacy related to COVID-19 among the general public in Malaysia. Future studies utilizing the MUAPHQ C-19 can be conducted nationwide to monitor public literacy and behaviours regarding COVID-19 and to assess the effectiveness of prevention and control programs implemented.

Keywords: Exploratory Factor Analysis, COVID-19, Understanding, Attitude, Practice, Health Literacy, Malay.

Citation:

Mohamad Rodi Isa. The Development and Validation of the Understanding, Attitude, Practice and Health Literacy Questionnaire on COVID-19 (MUAPH C-19) in Malay Language: An Exploratory Factor Analysis. The American Journal of Public Health. 2025.