Developing a Scale to Measure Public Health Nurses' Advocacy Practices in Group and Community Settings in Japan

This study aimed to develop a scale to assess public health nurses' (PHNs') advocacy practices in groups and communities in Japan and determine its reliability and validity.

This study is a cross-sectional investigation. The sample comprised PHNs across various municipalities in Japan.

Anonymous self-administered questionnaires were conducted, including the attributes of PHNs, a preliminary scale, and external criteria. Reliability was assessed by calculating the alpha coefficient. To ascertain construct validity, exploratory and confirmatory factor analyses were conducted.

A total of 432 questionnaires were analyzed. The scale comprised 27 items divided into five factors: "Raising awareness of the challenging situation faced by disadvantaged individuals," "Empowering disadvantaged individuals to improve their situation autonomously," "Establishing a foundation in local governments and community groups of disadvantaged individuals for advocacy initiatives," "Working toward policy changes," and "Collaborating with stakeholders and organizations to enhance the effectiveness of activities." The Cronbach's alpha coefficient for this scale was 0.945. Model fit indices included a comparative fit index of 0.907, a goodness-of-fit index of 0.840, an adjusted goodness-of-fit index of 0.806, and a root mean square approximation of 0.067.

The developed scale demonstrated satisfactory reliability and validity.