Contextual adaptation and validation of the international Pro-VC-Be tool for measuring healthcare worker vaccine confidence in Nigeria

Abstract

BACKGROUND: Vaccine hesitancy among healthcare workers (HCWs) is a global concern, needing reliable tools to measure HCW vaccine confidence. We adapted and validated the 10-item 'iPro-VC-Be' tool for the Nigerian context. RESEARCH DESIGN AND METHODS: We conducted a 3-step process. First, contextual adaptation using expert round-table discussions and cognitive interviews with HCWs in Oyo and Jigawa States (12/2023-05/2024). Second, translation and back-translation to Hausa, Igbo and Yoruba, including HCW group discussions (05/2024). Finally, testing validity in all languages, using a test-retest approach (06/2024-09/2024). RESULTS: Sixty-four participants contributed to adaptation, 25 researchers and 39 HCWs supported translations, 435 HCWs completed the first survey, and 263 completed the re-test. Of the 10 iPro-VC-Be items, 3 were unchanged, 6 had language edits, and 1 was replaced. The Cronbach's alpha indicated good internal reliability, and overall the intraclass correlation coefficient indicated moderate re-test reliability. Confirmatory factor analysis supported goodness of fit across multiple indices, but one negatively framed item performed poorly. Items assessing confidence in vaccines and trust in government were significantly associated with HCW vaccine uptake. CONCLUSION: The adapted iPro-VC-Be was valid, however, we recommend using a shorter 6-item version for Nigeria that does not include items linked to immunization resources.