Development and psychometric validation of a community microbiology literacy scale in the context of infectious...

Microbiology literacy has become increasingly important for public health and societal resilience, particularly in the context of emerging infectious diseases, antimicrobial resistance, and misinformation. However, standardized instruments for assessing Microbiology literacy at the community level remain limited. This study aimed to develop a valid and reliable tool to assess Microbiology literacy in the general population and to examine its multidimensional structure. This methodological, cross-sectional study developed the Community Microbiology Literacy Scale (CMLS). An initial item pool was generated based on international Microbiology books and World Health Organization (WHO) guidelines, followed by expert evaluation and content validity assessment using the Davis technique. Data were collected from 835 adults aged ≥18 years. Exploratory factor analysis (EFA) was conducted using data from 498 participants without imposing an a priori dimensional structure. A conceptually coherent four-factor structure emerged from the data, and the factors were named according to the content of their constituent items. This structure was subsequently tested by confirmatory factor analysis (CFA) in an independent subsample of 337 participants. The EFA identified a four-factor structure comprising Basic Microbiology Knowledge, Infection Control Awareness, Antibiotic and Antimicrobial Resistance Awareness, and Vaccine Awareness, explaining 60.66% of the total variance. CFA confirmed acceptable model fit. The scale demonstrated high internal consistency [Cronbach's alpha (α) = 0.925], with subscale Cronbach's α values ranging from 0.793 to 0.896. Higher Microbiology literacy scores were associated with older age, higher educational attainment, being a healthcare professional, prior Biology or Microbiology education, and awareness of the term "Microbiology" (P < .05). No significant differences were observed according to place of residence. The CMLS is a valid, reliable, and multidimensional instrument for assessing community-level Microbiology literacy and may support targeted educational and public health interventions.