Development and psychometric of a scale for evaluating primary school teachers' knowledge, attitude and practice on ADHD

Abstract

Introduction Attention Deficit Hyperactivity Disorder (ADHD) is a prevalent neurodevelopmental condition affecting school-aged children worldwide. Effective management of ADHD in educational settings requires teachers to possess adequate knowledge, appropriate attitudes, and practical skills. However, in Iran, there is a lack of culturally adapted and psychometrically validated instruments to assess these dimensions comprehensively among primary school teachers. This study aimed to develop and evaluate the psychometric properties of a new instrument measuring primary school teachers' knowledge, attitudes, and practices (KAP) regarding ADHD in Isfahan, Iran. Methods A cross-sectional study was conducted between September and December 2022 with 137 primary school teachers selected through convenience sampling. The initial questionnaire was developed based on a literature review and expert input, resulting in 43 items. Content validity was assessed by 15 specialists using Content Validity Ratio (CVR) and Content Validity Index (CVI). Face validity was evaluated qualitatively and quantitatively using impact scores. Exploratory Factor Analysis (EFA) was performed to assess construct validity, and reliability was examined through internal consistency (Cronbach's alpha, McDonald's omega) and test-retest stability using the Intraclass Correlation Coefficient (ICC). Results After validation steps, 34 items remained in the final instrument, categorized into three factors: Knowledge (12 items), Attitude (12 items), and Practice (10 items). EFA confirmed a three-factor structure explaining 59.84 of the total variance (KMO = 0.876; Bartlett's test, p < 0.001). All subscales demonstrated strong internal consistency (Cronbach's alpha and McDonald's omega > 0.80) and acceptable test-retest reliability (ICC >= 0.70). Conclusion The developed instrument demonstrates robust psychometric properties and offers a comprehensive tool for assessing primary school teachers' KAP toward ADHD in the country of Iran. It can serve as a foundation for needs assessment, teacher training, and educational intervention design.