Development and Psychometric Validation of Nu-KAP Questionnaire: Integrating IRT and Multigroup Factor Analysis in a Multidimensional Tool for the Assessment of Knowledge, Attitudes, and Practices of Arsenic.

The United Nations International Children's Emergency Fund (UNICEF) has repeatedly spotlighted the assessment of psychometric parameters, knowledge, attitudes, and practices (KAP) of arsenic among arsenic-endemic communities as one of the strategies to tackle arsenic toxicity. In response, as one of the first attempts, we had previously developed the Nu-KAP questionnaire, which exhibited robust structural reliability and construct validity. This study aims to further validate this tool by assessing difficulty, discrimination, and invariance of Nu-KAPQ using item response theory (IRT) and multigroup confirmatory factor analysis (MG-CFA). A cross-sectional survey was conducted among n = 979 subjects attending the outpatient department of Rajendra Memorial Research Institute of Medical Sciences, Patna. The discrimination and difficulty parameters ranged from - 0.60 to 3.1 and - 0.79 to 0.50, respectively. MG-CFA demonstrated excellent model fit (p < 0.05) amongst configural (X/df = 2.28), (X/df = 2.20), and scalar models (X/df = 2.1). The CFI and RMSEA values were within the threshold among the unconstrained configural, metric, and scalar models, indicating invariance across gender. The Nu-KAP questionnaire demonstrated moderate difficulty and consistent measurement among males and females. These results support the applicability of Nu-KAPQ as a multidimensional tool for assessing psychometric parameters addressing arsenic and associated health risks to foster positive attitudes and tackle arsenic toxicity.