Development and Validation of the Knowledge of Human Papillomavirus Scale in Japan

Background/Objectives: In Japan, the human papillomavirus (HPV) vaccine introduction process is unique, and no HPV knowledge scale with established reliability and validity currently exists. This study aimed to develop a new HPV knowledge scale and evaluate its reliability and validity for practical use. Methods: With permission from the original authors of the HPV Knowledge Scale (Jo Waller et al.), we created a Japanese version incorporating the original two subscales and adding new items. The translation process involved multiple researchers, back-translation by a professional agency, and expert review to ensure linguistic and contextual accuracy. The study was approved by the Clinical Research Ethics Review Board of the researchers' affiliated universities and conducted between April and August 2024. Results: Reliability and validity were assessed using data from 793 parents of junior high school students, including both boys and girls. Confirmatory factor analysis showed a good model fit (Goodness-of-Fit Index [GFI] = 0.934, Adjusted GFI [AGFI] = 0.907, Comparative Fit Index [CFI] = 0.928, Root Mean Square Error of Approximation [RMSEA] = 0.063). Cronbach's alpha ranged from 0.688 to 0.845 and item-total correlations ranged from 0.393 to 0.584. Test-retest reliability, assessed with Spearman's rank correlation, was r = 0.791 (p < 0.001). The final scale, named the Japan HPV Knowledge Scale (J-HPV-KS), includes 17 items across five factors. Conclusions: The J-HPV-KS covers HPV-related diseases, transmission routes, natural history, and vaccines. It demonstrated sufficient reliability and validity for use in Japan and is a useful tool for assessing HPV-related knowledge among Japanese parents and guardians.