An explorative approach of the InovSafeCare model for education in infection prevention and control: a cross-sectional study among undergraduate nursing students in sub-Saharan Africa
BACKGROUND: Adherence to healthcare-associated infection prevention and control best practices is essential to reducing morbidity and mortality in sub-Saharan Africa, where structural and educational challenges may affect adherence. Strengthening nursing education requires contextually appropriate frameworks and valid tools to evaluate them. OBJECTIVE: To evaluate the psychometric properties of the culturally adapted InovSafeCare Questionnaire and examine the structural relationships proposed by the InovSafeCare Model among undergraduate nursing students in sub-Saharan Africa. METHODS: A multiple-method approach was employed, involving the translation, cultural adaptation, and psychometric evaluation of the InovSafeCare Questionnaire. Data were collected from 486 undergraduate nursing students across four higher education institutions in two sub-Saharan African countries. Principal component analysis and reliability testing examined the questionnaire structure, followed by path analysis to evaluate the relationships among the model constructs. RESULTS: /df = 5.59; CFI = 0.88; GFI = 0.95; RMSEA = 0.097). No direct relationships were found between educational constructs and self-reported adherence. Instead, these associations operated through psychological and contextual mediators, including motivation, expectations, skepticism, environmental complexity, and overload and fatigue. The model explained 18.9% of the variance in adherence. CONCLUSIONS: The culturally adapted InovSafeCare Questionnaire demonstrated acceptable psychometric properties, and structural analysis provided preliminary support for the model's applicability in the sub-Saharan African sample. Further research should replicate the measurement and structural model across settings before considering its use to inform contextually adapted educational interventions.
Authors
- Filipa Ventura (ORCID: https://orcid.org/0000-0001-5722-5612)
- Gisela Teixeira (ORCID: https://orcid.org/0000-0003-2228-8263)
- Ewelina Chawłowska (ORCID: https://orcid.org/0000-0002-1966-9498)
- Pedro Lucas (ORCID: https://orcid.org/0000-0002-2560-7306)
- João Graveto (ORCID: https://orcid.org/0000-0001-6974-9421)
- Paulo Santos‐Costa (ORCID: https://orcid.org/0000-0003-0761-6548)
- Rivo Solotiana Rakotomalala (ORCID: https://orcid.org/0000-0002-2472-6725)
- Carla Nascimento (ORCID: https://orcid.org/0000-0002-4880-0141)
- Guy E. Raoelison
- Paulo Kidayi (ORCID: https://orcid.org/0000-0003-2868-3424)
- Lova Narindra Randriamanantsoa
- Harilalaina Willy Franck Randriamarotia
- Krystyna Jaracz (ORCID: https://orcid.org/0000-0002-0595-6891)
- Livuka Nsemwa
- Grażyna Bączyk (ORCID: https://orcid.org/0000-0001-8919-5729)
- Rose Laisser (ORCID: https://orcid.org/0000-0002-2636-0843)
- Christina Mtuya
- Edyta Cudak (ORCID: https://orcid.org/0000-0002-1217-1099)
- Márcia Pestana‐Santos (ORCID: https://orcid.org/0000-0002-4093-0291)
- Marlena Szewczyczak (ORCID: https://orcid.org/0000-0001-8345-0282)
- Maria do Rosário Pinto (ORCID: https://orcid.org/0000-0001-6786-6069)
- Pedro Parreira (ORCID: https://orcid.org/0000-0002-3880-6590)
- Jane Rogathi
- Stephanie Norotiana Andriamiharisoa (ORCID: https://orcid.org/0000-0003-2295-6313)
- João Agrelos (ORCID: https://orcid.org/0009-0007-4908-4187)
- Eyeshope J. Dausen
- Vololomboahanginirina Ella Françoise Andriamampiandra (ORCID: https://orcid.org/0009-0001-0282-9352)
- Hobiherinjato Jhonse Tovohandraina (ORCID: https://orcid.org/0009-0007-8181-4573)
- Zo Lalaina Ony Andriamalala
- Liliane Ravelonarivo
- Narindrarimanana Avisoa Randriamihangy (ORCID: https://orcid.org/0000-0001-5639-3235)
Institutions
- Poznan University of Medical Sciences (PL)
- University of Antananarivo (MG)
- Catholic University of Health and Allied Sciences (TZ)
- Moshi Co-operative University (TZ)
- Université de Mahajanga (MG)
- Lisbon School of Design (PT)
- Direção Geral do Território (PT)
- KCMC University (TZ)
- Escola Superior de Enfermagem de Coimbra (PT)
- University of Coimbra (PT)
Publication Details
- Journal
- Global Health Action
- Published
- 2026-09-15
- DOI
- https://doi.org/10.1080/16549716.2026.2728504
- Primary Topic
- Infection Control in Healthcare
- Type
- article
- Field-Weighted Citation Impact
- 0.00
Funders
- European Commission