Content Validation of a Professionalism in Public Health Scale (PPHS) for Pakistani Public Health Professionals: An Expert Panel Study

Abstract

Objective: To assess the content validity of the Professionalism in Public Health Scale (PPHS), developed for Pakistani public health professionals, through a structured expert-panel review.

Methodology: A cross-sectional expert-panel study was conducted from Sept 2025 – Dec 2025 at the National University of Medical Sciences (NUMS), Rawalpindi. Ten experts with experience in public health practice, education, and research independently reviewed an initial pool of 45 items. Each item was rated for relevance (4-point scale), necessity (3-point scale), and clarity (4-point scale), with space for narrative suggestions. Quantitative content validity indices were calculated (item-level CVI and scale-level CVI/Ave), along with Content Validity Ratio (CVR) to assess item essentiality. Written qualitative feedback was analysed in parallel and used to guide item refinement and removal decisions.

Results: PPHS demonstrated strong scale-level content validity (S-CVI/Ave = 0.88), with consistently high domain-level indices (S-CVI/Ave = 0.83–0.91). Based on combined quantitative thresholds and narrative feedback, nine items were removed and several were revised for clarity and construct alignment, yielding a final 36-item scale (80% retention). Key expert suggestions centred on improving wording and specificity, addressing response-scale suitability, and correcting double-barrelled statements.

Conclusion: This expert review provides evidence of excellent content validity for the 36-item PPHS and supports progressing to field testing and further psychometric evaluation in Pakistani public health settings.