Date of Award


Document Type

Campus Access Dissertation

Degree Name

Doctor of Philosophy (PhD)



First Advisor

Jacqueline Fawcett

Second Advisor

Philip S. Brenner

Third Advisor

Lisa Heelan-Fancher


Health policy is a concept of interest to nurses working to improve the health of individuals, communities, and populations, and is an integral component of the nursing profession’s interaction with the health care system and society. The aim of this study was to develop and psychometrically test a theoretically based instrument to measure nurses’ health policy participation. According to the WSPPIR theory, the concept of health policy participation is: A spectrum of involvement in policy efforts to solve problems that pertain to wellness and illness at all levels of society. The WSPPIR theory and instrument were derived from the study conceptual framework–the Conceptual Model of Nursing and Health Policy, the Culture of Health Action Framework, and the Adams Influence Model. During this four-phase study, the WSPPIR theory was tested and modified based on empirical results. Content validity was estimated in phase 1 with a review of the literature and by evaluation from 3 advisory panelists regarding instrument item face validity. Phase 2 content validity was estimated using a content validity index for individual instrument items and for the entire instrument based on 7 experts’ ratings. Five cognitive interviews were conducted in phase 3 to further the scale validity. In phase 4 exploratory factor analysis was used to identify empirically adequate items for each theory dimension and to demonstrate construct validity. Internal consistency reliability was estimated for each dimension, and were adequate. The full instrument alpha is 0.78. Over the course of the study, 180 instrument items were reduced to 38, with an overall decrease of 79%. The resulting WSPPIR instrument exhibits adequate estimates of reliability and validity as a measure of nurses' health policy participation, and should be useful in measuring individual nurses' health policy participation as well as benchmarking health policy participation across the profession of nursing. The value of a psychometrically tested instrument based on a nursing conceptual model and theory should inform future education, research, and practice–providing insights into gaps in knowledge and skills needed increasing nurses' health policy participation.


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