Development and Psychometric Validation of Nu-KAP Questionnaire: Integrating IRT and Multigroup Factor Analysis in a Multidimensional Tool for the Assessment of Knowledge, Attitudes, and Practices of Arsenic

• Published in: Biological trace element research
• Main Authors: Kumar, V. Udaya, Nikhil, K., KT, Muhammed Favas, Shetty, Rakhesha, Pandey, Krishna, Kumar, Arun, Kumar, Nitesh, Murti, Krishna
• Format: Journal Article
• Language: English
• Published: United States 02.08.2025
• Subjects: Practices; Arsenic; Psychometric analysis; Toxicity; Epidemiology
• ISSN: 1559-0720; 1559-0720
• DOI: 10.1007/s12011-025-04767-y

The United Nations International Children's Emergency Fund (UNICEF) has repeatedly spotlighted the assessment of psychometric parameters, knowledge, attitudes, and practices (KAP) of arsenic among arsenic-endemic communities as one of the strategies to tackle arsenic toxicity. In response, as one of the first attempts, we had previously developed the Nu-KAP questionnaire, which exhibited robust structural reliability and construct validity. This study aims to further validate this tool by assessing difficulty, discrimination, and invariance of Nu-KAPQ using item response theory (IRT) and multigroup confirmatory factor analysis (MG-CFA). A cross-sectional survey was conducted among n = 979 subjects attending the outpatient department of Rajendra Memorial Research Institute of Medical Sciences, Patna. The discrimination and difficulty parameters ranged from - 0.60 to 3.1 and - 0.79 to 0.50, respectively. MG-CFA demonstrated excellent model fit (p < 0.05) amongst configural (X /df = 2.28), (X /df = 2.20), and scalar models (X /df = 2.1). The CFI and RMSEA values were within the threshold among the unconstrained configural, metric, and scalar models, indicating invariance across gender. The Nu-KAP questionnaire demonstrated moderate difficulty and consistent measurement among males and females. These results support the applicability of Nu-KAPQ as a multidimensional tool for assessing psychometric parameters addressing arsenic and associated health risks to foster positive attitudes and tackle arsenic toxicity.