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Measuring Advanced Practice in Health Visiting: Development and Psychometric Testing of the Health Visiting Advanced
John Unsworth1, Karen Whittaker2, Michael Fanner3
1School of Healthcare and Nursing Sciences, Northumbria University, Newcastle-upon-Tyne, UK.
Journal of Clinical Nursing
|February 25, 2026
Summary
A new scale validates advanced practice in UK health visiting, assessing domains like family care and leadership. This tool measures and improves health visitors' professional scope and informs policy development.
Area of Science:
- Nursing Science
- Public Health
- Healthcare Policy
Background:
- Health visiting, a specialist community public health nursing role, has long been debated as an advanced practice nursing role.
- Empirical evidence is scarce, despite health visitors exhibiting advanced practice attributes like prescribing and complex case management.
Purpose of the Study:
- To develop, refine, and test the Health Visiting Advanced Practice Scale.
- To assess the scope of advanced practice among UK health visitors.
Main Methods:
- A cross-sectional, methodological scale validation design.
- Three phases: item generation, content validity index assessment, and a cross-sectional survey for construct validity, reliability, and factor analysis.
- Adherence to STROBE guidelines for cross-sectional studies.
Main Results:
- An initial 44-item scale was refined to a 29-item, 5-factor scale.
- The scale covers family-centred care, leadership, prescribing, diagnostic reasoning, and professional practice.
- Demonstrated strong reliability and construct validity in exploratory factor analysis, with supportive, though mixed, fit indices in confirmatory factor analysis.
Conclusions:
- The Health Visiting Advanced Practice Scale is a rigorously validated tool for assessing advanced practice in UK health visitors.
- It captures key domains and bridges theoretical frameworks with practice, addressing a gap in evaluating this public health nursing specialty.
- Findings offer reliable insights for measuring and enhancing health visitors' advanced practice and informing professional policies.
Keywords:
advanced practice nursingcross‐sectional surveyhealth visitingpublic health nursingscale developmentMore Related Videos
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