Development and psychometric validation of the sun exposure and protection questionnaire (SEPQ) in young adults: a university-based validation study

Abstract Sun exposure increases the risk of skin cancer and accelerates photoaging. Most of the validated sun safety questionnaire focused on behaviors. This university-based study aimed to develop and validate a questionnaire measuring knowledge, attitudes, and practices related to sun safety among young adults. The validation included item generation and screening; content, face, and construct validity; and reliability. Items were generated based on a four-domain framework following a literature review and expert group discussions. Content validity was checked via expert assessment, and face validity via a pilot study. The construct validity was tested via factor analyses and item discrimination and difficulty. Cronbach’s alpha and intraclass correlation coefficients were used to assess internal consistency and reliability. The sample consisted of 350 participants. Exploratory factor analysis yielded a one-factor model for each of the knowledge and attitude sections, with an acceptable model fit and internal consistency for the knowledge (0.814) and attitude factors (0.897). Test‒retest reliability was ‘good’ for the knowledge (0.719) and practice (0.860) sections and ‘moderate’ for the attitude Sect. (0.692). The final SEPQ consists of 46 items: 18 knowledge, 10 attitudes, and 18 practice items. This 46-item SEPQ is a tool that can be used to assess sun safety awareness and practices among young adults. It can also be adapted and further validated for use in designing health interventions, educational curricula, and clinical counselling.