Development of a COVID-19 Disease Risk Perception Scale


COVID-19, Reliability and validity, Risk perception, Scale, SARS-CoV-2


How to Cite

Ozlu, T., Topbas, M., Sahin, K., Saglam Aykut, D., & Beyhun, N. E. (2023). Development of a COVID-19 Disease Risk Perception Scale. Iranian Red Crescent Medical Journal, 25(5).


Background: The COVID-19 pandemic has affected several areas of society, such as social life, the economy, education, and the provision of health services. The need to evaluate individuals’ risk perception has assumed particular importance in this situation in which people find themselves.

Objectives: This study aimed to develop a “COVID-19 Disease Risk Perception Scale” for determining COVID-19 risk perceptions in the adult patient group during the COVID-19 pandemic.

Methods: The proposed scale form was established once the content validity of the item pool created by the research team had been evaluated by experts. Exploratory and confirmatory factor analysis for construct validity, item-total correlation, Cronbach alpha coefficients, and the test-retest method were employed to determine criterion-dependent validity and reliability in a group of 564 individuals aged 18-73.

Results: Following exploratory factor analysis, a nine-factor structure explaining 61.733% of variance was established. Confirmatory factor analysis results were found within the values defined in the literature. The Cronbach alpha coefficient of the scale was 0.906, with an intraclass correlation coefficient of 0.881 (P<0.001).

Conclusion: The developed scale is a valid and reliable inventory capable of using in the examination and evaluation of risk perception of COVID-19 disease in the adult age group.


WHO. Pneumonia of unknown cause – China. Available from:

WHO. COVID-19 Public Health Emergency of International Concern (PHEIC) Global research and innovation forum. Available from:

Sergeant A, van Reekum EA, Sanger N, Dufort A, Rosic T, Sanger S, et al. Impact of COVID-19 and other pandemics and epidemics on people with pre-existing mental disorders: a systematic review protocol and suggestions for clinical care. BMJ Open. 2020;10(9):e040229. doi: 10.1136/bmjopen-2020-040229. [PubMed: 32873685].

Burns WJ, Slovic P. Risk perception and behaviors: anticipating and responding to crises. Risk Anal. 2012;32(4):579–82. doi: 10.1111/j.1539-6924.2012.01791.x. [PubMed: 22500649].

Arslankara VB, Ertuğrul US. Development of virtual world risk perception scale (VWRPS). BUJFE. 2018;7(1):111-31. doi: 10.14686/buefad.356898.

Ferrer R, Klein WM. Risk perceptions and health behavior. Curr Opin Psychol. 2015;5:85-9. doi: 10.1016/j.copsyc.2015.03.012. [PubMed: 26258160].

de Bruin WB, Bennett D. Relationships between initial COVID-19 risk perceptions and protective health behaviors: A national survey. Am J Prev Med. 2020;59(2):157-67. doi: 10.1016/j.amepre.2020.05.001. [PubMed: 32576418].

Lifshitz R, Nimrod G, Bachner YG. Measuring risk perception in later life: The perceived risk scale. J Am Psychiatr Nurses Assoc. 2016;22(6):469–74. doi: 10.1177/1078390316659910.

Dryhurst S, Schneider CR, Kerr J, Freeman AL, Recchia G, Van Der Bles AM, et al. Risk perceptions of COVID-19 around the world. J Risk Res. 2020;23(7-8):994-1006. doi: 10.1080/13669877.2020.1758193.

Dohmen T, Falk A, Huffman D, Sunde U, Schupp J, Wagner GG. Individual risk attitudes: Measurement, determinants, and behavioral consequences. J Eur Econ Assoc. 2011;9(3):522-50. doi: 10.1111/j.1542-4774.2011.01015.x.

Bennett D, Chiang CF, Malani A. Learning during a crisis: The SARS epidemic in Taiwan. J Dev Econ. 2015;112:1-18. doi: 10.1016/j.jdeveco.2014.09.006.

Bruine de Bruin W, Carman KG. Measuring subjective probabilities: The effect of response mode on the use of focal responses, validity, and respondents” evaluations. Risk Anal. 2018;38(10):2128-43. doi: 10.1111/risa.13138. [PubMed: 30114338].

Boateng GO, Neilands TB, Frongillo EA, Melgar-Quiñonez HR, Young SL. Best practices for developing and validating scales for health, social, and behavioral research: a primer. Front Public Health. 2018;6:1–18. doi: 10.3389/fpubh.2018.00149. [PubMed: 29942800].

Slavec A, Drnovšek M. A perspective on scale development in entrepreneurship research. EBR. 2012;14(1):39-62. doi: 10.15458/2335-4216.1203.

Geckil T, Tikici M. A study on developing the organizational democracy scale. Amme İdaresi Dergisi. 2015;48(4):41-78.

Çokluk O, Sekercioğlu G, Büyüköztürk S. Multivariate Statistics SPSS and Listrel Applications for Social Sciences. Ankara: Pegem Akademi; 2018.

Evci N, Aylar F. Use of confirmatory factor analysis in scale development studies. J Soc Sci. 2017;4(10):389-412.

Aksu G, Eser MT, ve Güzeller CO. Exploratory and confirmatory factor analysis and structural equation model applications. Ankara: Detay Publication; 2017.

Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav. 1983;24(4):385-96. doi: 10.2307/2136404.

Eskin M; Harlak H; Demirkıran F; Dereboy Ç. The Adaptation of the perceived stress scale ınto Turkish: a reliability and validity analysis. New Symposium J. 2013;51(3):132–40.

Baltaş Z, Atakuman Y, Duman Y. Standardization of the perceived stress scale, perceived stress in middle managers. In: Stress and Anxiety Research Society 19 the International Conference, İstanbul, Turkey; 1998.

Lee SA. Coronavirus anxiety scale: A brief mental health screener for COVID-19 related anxiety. Death Stud. 2020;44(7):393-401. doi: 10.1080/07481187.2020.1748481. [PubMed: 32299304].

Biçer İ, Çakmak C, Demir H, Kurt ME. Coronavirus anxiety scale short form: Turkish validity and reliability study. ACJMS. 2020;25:216-25. doi: 10.21673/anadoluklin.731092.

Arpaci I, Karataş K, Baloğlu M. The development and initial tests for the psychometric properties of the COVID-19 Phobia Scale (C19P-S). Pers Individ Dif. 2020;164:110108. doi: 10.1016/j.paid.2020.110108. [PubMed: 32394993].

Sullivan GM, Artino AR Jr. Analyzing and interpreting data from likert-type scales. J Grad Med Educ. 2013;5(4);541-2. doi: 10.4300/JGME-5-4-18.

Ozdemir Z. Development of a likert type attitude scale in health sciences. J Hacettepe Fac. 2018;5(1):60-8.

Koo TK, Li MY. A guideline of selecting and reporting ıntraclass correlation coefficients for reliability research. J Chiropr Med. 2016;15(2):155-63. doi: 10.1016/j.jcm.2016.02.012. [PubMed: 27330520].

Ayre C, Scally AJ. Critical values for Lawshe’s content validity ratio. Meas Eval Couns Dev. 2014;47(1):79–86. doı: 10.1177/0748175613513808.

Kılıç S. Cronbach’s alpha reliability coefficient. J Mood Disord. 2016;6(1):47. doı: 10.5455/jmood.20160307122823.

Paulsen A, Odgaard A, Overgaard S. Translation, cross-cultural adaptation and validation of the Danish version of the Oxford hip score. Bone Jt Res. 2012;1(9):225-33. doi: 10.1302/2046-3758.19.2000076. [PubMed: 23610695].

Shen Z, Zhong Z, Xie J, Ding S, Li S, Li C. Development and psychometric assessment of the public health emergency risk perception scale: Under the outbreak of COVID-19. Int J Nurs Sci. 2021;8(1):87-94. doi: 10.1016/j.ijnss.2020.12.012. [PubMed: 33520340].

Dash G, Paul J. CB-SEM vs PLS-SEM methods for research in social sciences and technology forecasting. Technol Forecast Soc Change. 2021;173:21092. doi: 10.1016/j.techfore.2021.121092.

Yaşlıoğlu MM. Factor analysis and validity in social sciences: application of exploratory and confirmatory factor analyses. IUJSB. 2017;46:74-85.

Alpar R. Applied statistics and validity-reliability with examples from sports, health and education sciences. Ankara: Detay Yayıncılık; 2020.

Civelek ME. Essentials of structural equation modeling. Zea E-Books. The Zea E-Books at DigitalCommons@University of Nebraska – Lincoln; 2018.

Özcan K, Balyer A. Adaptation of leadership orientation scale ınto Turkish. MUJFE. 2013;9(1):136-50.

Kline RB. Principles and practice of structural equation modeling. 3rd ed. New York: The Guilford Press; 2011.

Walker TJ, Tullar JM, Diamond PM, Kohl HW, Amick BC. Validity and reliability of the 8-ıtem work limitations questionnaire. J Occup Rehabil. 2017;27(4):576–83. doi: 10.1007/s10926-016-9687-5.

Tunç A, Atıcı FZ. Struggling Pandemics in the world and in turkey: a study in the context of risk and crisis management. Troyacademy. 2020;5(2):329–62. doi: 10.31454/usb.808685.

İnandı T, Sakarya S, Ünal B, Ergin I. Risk assessment approach for decision makers specific to the COVID-19 Outbreak. Sağlık ve Toplum. 2020;3:27–38.

Tükel R. Mental Health During the COVID-19 Pandemic. Turkish medical association covıd-19 pandemic sixth month evaluation report. Türk Tabipleri Birliği COVID-19 Pandemisi Altıncı Ay Değerlendirme Raporu; 2020.

Metintaş S. Managing the COVID-19 pandemic (COVID-19 pandemi̇si̇ni̇n yöneti̇mi̇); 2020.

Ekiz T, Ilıman E, Dönmez E. Comparison of health anxiety level and control perception of COVID-19. Int J Health Manag. 2020;6(1):39-54

Al Otair HA, Temsah MH, Al-Eyadhy A, Alsubaie S, Azfar MF, Abdeldayem AA et. al. Anxiety and work avoidance among intensive care workers during an Influenza A/H1N1 outbreak. J Community Med Health Educ. 2017;7. doi: 10.4172/2161-0711.1000515

Özer K. Investigation of perceptions related to the COVID-19 epidemic in healthcare professionals in the context of stress level. SMRTJ.2020;6(36):1725–33.

Hair JF, Black WC, Babin BJ, Anderson RE. Multivariate data analysis. Prentice Hall; 2009.

Yong AG, Pearce S. A Beginner’s guide to factor analysis: focusing on exploratory factor analysis. TQMP. 2013;9(2):79-94. doi: 10.20982/tqmp.09.2.p079.