An Idea Health Journal
Vol 6 No 02 (2026)

Psychometric Evaluation of the Stakeholder Support Questionnaire for Integrated Primary Care: Evidence of a Multidimensional and Hierarchical Construct in Indonesia

Wiwin Wiarsih (Universitas Indonesia)
Utami Rachmawati (Universitas Indonesia)
Muhamad Jauhar (Universitas Muhammadiyah Kudus)
Megah Andriany (Universitas Diponegoro)
Endang Triyanto (Universitas Jenderal Soedirman)
Lita Heni Kusumawardani (Universitas Jenderal Soedirman)
Maula Mar'atus Solikhah (Universitas Diponegoro)
Umi Hani (Universitas Diponegoro)
Kinantika Nur Dewanti (Universitas Jenderal Soedirman)
M.Agung Akbar (Universitas Indonesia)



Article Info

Publish Date
03 May 2026

Abstract

Background: Integrated primary care (IPC) is recognized as essential for strengthening health systems. However, Indonesia currently lacks a validated instrument to assess stakeholder support, which is a critical determinant of successful IPC implementation. This study evaluated the content validity, internal structure, and reliability of the newly developed Stakeholder Support Questionnaire for Integrated Primary Care (SSQ-IPC), grounded in Freeman’s Stakeholder Theory. Methods: A cross-sectional psychometric validation was conducted with 570 primary healthcare nurses recruited through stratified random sampling across Indonesia. The initial 18-item instrument, encompassing four constructs, underwent content validation by a panel of seven experts. Data analysis included calculating the Content Validity Index (CVI), conducting exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and second-order CFA. Model fit was assessed using multiple fit indices, while construct validity and reliability were evaluated through factor loadings, Average Variance Extracted (AVE), Cronbach’s alpha, and McDonald’s omega. Results: EFA supported a four-factor structure. First-order CFA indicated acceptable model fit (CFI = 0.933, TLI = 0.921, SRMR = 0.037), with all factor loadings statistically significant (p<.001) and strong indicator reliability. Convergent validity was established with AVE values ranging from 0.650 to 0.869, and internal consistency was high across constructs (α= 0.877–0.978; ω = 0.884–0.973). Second-order CFA supported a hierarchical model, with all four constructs significantly loading onto a higher-order factor. Conclusion: The SSQ-IPC demonstrates strong evidence of validity and reliability, supporting its multidimensional and hierarchical structure. This instrument provides a robust tool for research and practice, facilitating.

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Journal Info

Abbrev

IHJ

Publisher

Subject

Dentistry Health Professions Medicine & Pharmacology Nursing Public Health

Description

a publication of scientific work in the field of health in a broad sense such as public health, nursing, midwifery, medicine, pharmacy, health psychology, nutrition, health technology, health analysis, health information systems, medical records, hospital management and so ...