Validation of the condom use self-efficacy scale in Ethiopia

Background: The measurement of condom use self-efficacy requires contextually suitable, valid and reliable instruments due to variability of the scale across nations with different cultural and ethnic backgrounds. This study aims to construct a condom use self-efficacy scale suitable to Ethiopia (CUSES-E), based on the original scale developed by Brafford and Beck. Methods: A cross-sectional study was conducted on a random sample of 492 students at Hawassa University. A self-administered questionnaire containing 28 items from the original scale was used to collect the data. Principal Component Analysis (PCA) with Varimax rotation was used to extract factor structures. Cronbach's alpha and item-total correlations were used to determine the internal consistency of the scale. The convergent and discriminant validity of the scale was verified using a correlation matrix. Results: The PCA extracted three factors containing a total of 9-items. The extracted factors were labeled Assertiveness, Fear for partner rejection and Intoxicant Control, with internal consistency coefficients (Cronbach's alpha) of 0.86, 0.86 and 0.92, respectively. Altogether, the factors explained 77.8% of variance in the items. An evaluation of CUSES-E showed a significantly higher self-efficacy score among students who ever used condoms; P < 0.001. The correlation matrix revealed that all of the convergent correlations were higher than the discriminant ones, providing evidence in support of both types of validity. In the split sample validation, the communalities, factor loadings and factor structure were the same on the analysis on each half and the full data set, suggesting that the new scale is generalizable and replicable. Conclusion: This study of CUSES using an Ethiopian population found a different dimension to emerge, suggesting that the scale should be validated to local contexts before application. The CUSES-E is valid, reliable and replicable. Therefore, health cadres and researchers in Ethiopia can apply this scale to promote condom utilization to Ethiopian school youths. However, future research to develop a suitable scale (highly valid and reliable) in concordance with the local vernacular using a prior qualitative study is needed.