Development and psychometric validation of the Hair Health and Care Questionnaire (HHCQ): a KAP-based instrument for...

Hair plays multiple biological, psychosocial, and cultural roles, impacting psychological well-being and contributing to a rapidly expanding hair care market. This study aimed to validate a questionnaire assessing hair health and care (HHCQ) among young adults.

A total of 200 participants completed the questionnaire (mean age = 20.75 years). Item screening and content validation reduced the initial 46 items to 32. No items were removed following face validation, which relied on a qualitative pilot study. Exploratory factor analysis yielded two factors for knowledge (knowledge about routine hair hygiene and care, and knowledge about hair products and procedures) and one factor for attitudes (attitudes toward hair care). The knowledge and attitude factors accounted for 50.3% and 50.6% of the explained variance, respectively. Confirmatory factor analysis revealed that the model was acceptable (CFI = 0.955, TLI = 0.991, RMSEA = 0.077, and SRMR = 0.060). Test-retest reliability showed excellent Intraclass Correlation Coefficients, and Cronbach's alpha coefficients were acceptable. Practice items were treated as a formative index, obviating the need for factor or internal consistency analyses. While the 32-item HHCQ showed basic evidence of validation and reliability, it should be culturally adapted to different settings with additional validation. The questionnaire can be used to guide public health campaigns, policymaking, and clinical practice.