Acceptability of the tuberculosis service: scale development

Health workers require reliable, easily administered and scored measures to evaluate acceptability of a health service. A 13-item attitude scale was developed to determine acceptability of the tuberculosis (TB) service. The objectives of this study were to: ascertain reliability (internal consistency) of the scale and confirm, through factor analysis, that acceptability of the TB service was based on cognitive and affective reactions. The sample comprised 487 black adult interviewees (67 TB patients on ambulatory therapy and 420 non-TB community members) from two urban townships in the Transvaal, South Africa. The reliability coefficient revealed a high level of internal consistency for the scale (r = 0.84). A principal components analysis, with orthogonal and oblique rotations, was conducted. Two factors accounted for 45.4% of the variance. The highest loadings on Factor I involved an empathic dimension (friendly, helpful, encouraging and communicative). Factor II tended to focus on the organizational elements of the system, such as availability, consistency of information, length of waiting time and maintenance of contact. It was concluded that this scale was a reliable, easily administered and scored measure of acceptability, with underlying affective and cognitive components.