Construct validation: coping with HIV/AIDS in Primary Health Care

To validate the construct and measure the trustworthiness of a questionnaire aimed at assessing HIV/AIDS coping actions developed by health professionals in Primary Health Care.

Method:

A methodological study carried out with 397 primary health care professionals in two municipalities in the Northeast region of Brazil. The construct validity was developed by the exploratory and confirmatory factor analysis, and the reliability analyzed by the reliability and reproducibility.

Results:

The validation determined six factors retention that composed the six domains of the questionnaire. Internal consistency was 0.91 and quality of the confirmatory analysis adjustment was 0.998 for Goodness of Fit Index. The domains presented Kappa values between 0.833 and 0.997.

Conclusions:

The final questionnaire was composed of 18 items and presented feasibility of application, and potential to evaluate actions for HIV/AIDS control in Primary Health Care.

Descriptors:
Acquired Immunodeficiency Syndrome; HIV; Primary Health Care; Validation Studies; Health Evaluation

Item	Questions
1	After confirmation of pregnancy by women who sought health services, is the prenatal visit performed as quickly as possible?
2	Does the unit have physical space available for educational activities?
3	Is the rapid or serological test offered to partners of people diagnosed with HIV/AIDS?
4	Does delivery of the condom (male condom) happen outside the physical space of the health unit?
5	Are people diagnosed with HIV/AIDS followed-up by the health unit?
6	Are there information and awareness campaigns for HIV/AIDS prevention in social facilities under the scope of the health unit?
7	When pregnancy test result is positive, are exams recommended by the Ministry of Health requested at the first visit?
8	Is the rapid or serological HIV test required for women who have complaints suggestive of gynecological infection?
9	Is the amount of condoms (male condoms) that the unit receives per month enough to meet demand?
10	Is an active search conducted for people whose HIV diagnosis was positive and did not return to receive the result?
11	At the first prenatal visit, is the HIV/AIDS serology requested?
12	Is the HIV rapid or serological test offered to users of this unit?
13	Is pre-test counseling and rapid post-test for HIV/AIDS performed?

Variables	Factors (Domains)
Variables	I	II	III	IV	V	VI	h²
Are collective educational actions aimed at the population related to prevention of Sexually Transmitted Infections (STIs)?	0.81	0.13	0.28	0.00	0.02	0.08	0.81
Are educational actions carried out for the information and prevention of Sexually Transmitted Infections - STIs in the physical space of the health unit?	0.87	0.20	0.12	0.02	-0.08	0.05	0.87
Is health education carried out on healthy living habits in social facilities under the area covered by the unit?	0.82	0.01	0.10	0.05	0.38	0.01	0.82
Are HIV/AIDS educational actions developed without hindrance?	0.86	0.11	-0.11	0.25	0.27	0.12	0.86
Are people diagnosed with HIV/AIDS referred by the unit?	-0.03	0.87	-0.10	0.16	0.23	0.14	0.87
Is the active search conducted to partners when the diagnosis of HIV/AIDS was positive?	0.32	0.80	0.00	-0.02	-0.12	0.12	0.80
Is SINAN notified on Sexually Transmitted Infections - STIs and injuries?	0.09	0.81	0.39	-0.11	0.13	-0.19	0.81
Do people suggestive of HIV infection seeking the basic unit have the opportunity to perform the diagnostic test in the health network?	0.14	0.83	-0.15	0.07	0.10	-0.12	0.83
Is the delivery of condoms (male condom) conducted with guidance for its use?	0.07	0.00	0.86	0.07	-0.09	0.07	0.86
Are there information and awareness campaigns on risk behaviors for HIV infection in the health area?	0.26	-0.13	0.84	0.03	0.16	0.04	0.84
Does the unit provide teaching materials for educational actions?	0.00	-0.01	0.80	0.14	0.38	0.34	0.80
Do they have access to manuals and notebooks of the Ministry of Health regarding the management of Sexually Transmitted Infections - STIs?	-0.04	0.03	0.03	0.86	-0.05	0.05	0.86
Are they aware of manuals contents provided by the Ministry of Health regarding the measures used to control HIV/AIDS in Primary Care?	0.35	0.10	-0.01	0.80	-0.03	-0.04	0.80
Have they participated in training/specialization on issues related to HIV/AIDS control in the last five years?	-0.01	-0.06	0.39	0.83	0.34	0.02	0.83
Is the result of the 1st and 2nd HIV serology requested in prenatal care delivered to the pregnant woman?	0.13	0.08	0.16	0.05	0.84	-0.06	0.84
Are pregnant women identified with HIV/AIDS who were referred to medium and high complexity services followed up by the health unit?	0.04	0.38	-0.16	-0.12	0.88	-0.01	0.88
Does the health facility provide material for rapid HIV/AIDS testing?	0.20	-0.15	-0.07	-0.11	0.09	0.86	0.86
Have they received training to conduct HIV rapid tests?	0.07	0.16	0.22	0.15	-0.20	0.80	0.80
Eigenvalue	3.64	2.10	1.53	1.42	1.25	1.09
% Total Variance Explained	80.26	81.66	88.50	77.92	76.99	86.10
α Cronbach	0.91	0.86	0.81	0.84	0.81	0.88

Factors (Domains)	Variables (items)	K^* * Kappa coefficient.	Classification
Health Education	Are collective educational actions aimed at the population related to prevention of Sexually Transmitted Infections (STIs)?	0.987	Excellent
	Are educational actions carried out for the information and prevention of Sexually Transmitted Infections - STIs in the physical space of the health unit?	0.890	Excellent
	Is health education carried out on healthy living habits in social facilities under the area covered by the unit?	0.964	Excellent
	Are HIV/AIDS educational actions developed without hindrance?	0.837	Excellent
Diagnóstico Precoce e Continuidade da Atenção	Are people diagnosed with HIV/AIDS referred by the unit?	0.893	Excellent
	Is the active search conducted to partners when the diagnosis of HIV/AIDS was positive?	0.961	Excellent
	Is SINAN notified on Sexually Transmitted Infections - STIs and injuries?	0.847	Excellent
	Do people suggestive of HIV infection seeking the basic unit have the opportunity to perform the diagnostic test in the health network?	0.991	Excellent
Prevention of Sexually Transmitted Infections	Is the delivery of condoms (male condom) conducted with guidance for its use?	0.895	Excellent
	Are there information and awareness campaigns on risk behaviors for HIV infection in the health area?	0.994	Excellent
	Does the unit provide teaching materials for educational actions?	0.891	Excellent
Permanent Education in Health	Do they have access to manuals and notebooks of the Ministry of Health regarding the management of Sexually Transmitted Infections - STIs?	0.947	Excellent
	Are they aware of manuals contents provided by the Ministry of Health regarding the measures used to control HIV/AIDS in Primary Care?	0.899	Excellent
	Have they participated in training/specialization on issues related to HIV/AIDS control in the last five years?	0.874	Excellent
Prevention of Vertical Transmission of HIV	Is the result of the 1st and 2nd HIV serology requested in prenatal care delivered to the pregnant woman?	0.833	Excellent
Prevention of Vertical Transmission of HIV	Are pregnant women identified with HIV/AIDS who were referred to medium and high complexity services followed up by the health unit?	0.939	Excellent
HIV/AIDS Testing	Does the health facility provide material for rapid HIV/AIDS testing?	0.997	Excellent
HIV/AIDS Testing	Have they received training to conduct HIV rapid tests?	0.855	Excellent

Associação Brasileira de Enfermagem SGA Norte Quadra 603 Conj. "B" - Av. L2 Norte 70830-102 Brasília, DF, Brasil, Tel.: (55 61) 3226-0653, Fax: (55 61) 3225-4473 - Brasília - DF - Brazil
E-mail: reben@abennacional.org.br

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[1] Corresponding Author: Richardson Augusto Rosendo da Silva E-mail: rirosendo@hotmail.com