Development and Validation of a Social Influence Scale for Antiviral Therapy Behavior of Patients with Chronic Hepatitis B.

PURPOSE: Hepatitis B virus (HBV) infection remains a global health problem with widespread prevalence, yet treatment rates remain persistently low worldwide. Although the impact of social influence on health behaviors has been well confirmed and proven to play a prominent role, a standardized scale to measure its specific influence on treatment behavior among chronic hepatitis B (CHB) patients is still lacking. Therefore, this study aimed to develop a social influence scale to assess its role in patients' treatment decision-making. PATIENTS AND METHODS: The scale was developed through four steps. First, a preliminary scale was developed based on the literature review and internal discussion. Second, two rounds of Delphi expert consultation were conducted for item content validation. Third, a cross-sectional survey involving 611 participants was conducted from March to October 2023 in Fuqing, China, to test the reliability and validity of the preliminary scale. Finally, the scale was assessed by item analysis, internal consistency tests, and exploratory and confirmatory factor analysis. RESULTS: The final scale consisted of five dimensions and 16 items that explained 90.5% of the total variance. Confirmative factor analysis model showed that the 5-factor model fits the data well (χ2/df=4.266, CFI=0.979, GFI=0.925, and RMSEA=0.073). The Cronbach alpha coefficient of the total scale and the five factors was 0.818 and 0.896-0.970. For convergent validity, AVE was 0.795-0.895, and CR was 0.918-0.971. The dimensions comprised descriptive norm, injunctive norm, social support, discrimination, and prototype. CONCLUSION: The scale is valid and reliable to evaluate the impact of social influence on treatment behaviors among CHB patients.