A confirmatory factor analysis of the knowledge, attitude and practice questionnaire towards prevention of respiratory tract infections during Hajj and Umrah

BACKGROUND: Respiratory tract infections are one of the common infection associated with Hajj pilgrimage that is of great public health and global concern. This study is aimed at determining the factor structure of the knowledge, attitude, and practice questionnaire for the prevention of respiratory tract infections during Hajj by confirmatory factor analysis (CFA). METHODS: A multistage cluster sampling method was conducted on Malaysian Umrah pilgrims during the weekly Umrah orientation course. A total of 200 Umrah pilgrims participated in the study. The knowledge, attitude and practice (KAP) questionnaire was distributed to pilgrims at the beginning of the orientation and retrieved immediately at the end of the orientation. Data analysis was done using R version 3.5.0 after data entry into SPSS 24. The robust maximum likelihood was used for the estimation due to the multivariate normality assumption violation. A two-factor model was tested for measurement model validity and construct validity for each of the attitude and practice domains. RESULTS: CFA of a 25-item in total, the two-factor model yielded adequate goodness-of-fit values. The measurement model also showed good convergent and discriminant validity after model re-specification. A two-factor model was tested for measurement model validity and construct validity for each of the attitude and practice domains. The result also showed a statistically significant value (p < 0.001) with χ(2) (df) values of 76.8 (43) and 121 (76) for attitude and practice domains, respectively. CONCLUSION: The KAP questionnaire was proven to have a valid measurement model and reliable constructs. It was deemed suitable for use to measure the KAP of Hajj and Umrah pilgrims towards the prevention for all respiratory tract infections.