---
title: "Psychometric validation of the HAT‑IV scale measuring trust in U.S. public health actors for vacci"
id: "pubmed-42641256"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42641256"
content_type: "clinical_feed_article"
specialty: "Pharmacology"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42641256/"
doi: "10.1016/j.vaccine.2026.129026"
published_at: "2026-10-03T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Psychometric validation of the HAT‑IV scale measuring trust in U.S. public health actors for vacci
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42641256
- **Specialty:** [Pharmacology](https://medichelpline.com/clinical-feed/pharmacology.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42641256/)
- **DOI:** [10.1016/j.vaccine.2026.129026](https://doi.org/10.1016%2Fj.vaccine.2026.129026)
- **Published At:** 2026-10-03T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- This study generated psychometric validity evidence for a novel 4‑item scale measuring **trust** in U.S. public health actors for vaccine information, named the Public Health Actor Trust for Information about Vaccines (HAT‑IV) scale. - Data came from 7,394 respondents in nationally representative KFF public opinion surveys collected at five time points between 2020 and 2025. - Items asked respondents their level of trust in the FDA, CDC, their local public health department, and their own doctor to provide reliable vaccine information. - Classical test theory showed high internal consistency (Cronbach's alpha = **0.84**), and parallel analysis indicated a single underlying dimension representing trust in public health actors for vaccine information. - Item Response Theory (graded response model) indicated items provided adequate information across a wide latent trust range: discrimination (a) parameters between **1.55 and 4.04** and threshold (b) parameters between **-2.62 and 0.69**. - Differential test functioning analyses found no substantively meaningful DTF at the scale level by political partisanship or survey time point. - Higher HAT‑IV scores were positively associated with vaccine uptake and pro‑vaccine attitudes, including confidence in COVID, influenza, and MMR vaccines (all reported p < .001). - The authors conclude the HAT‑IV is a short, robust measure suitable for U.S. population survey research to study relationships between trust in public health actors and vaccine outcomes. - The abstract reports no competing interests. The paper is published in Vaccine (2026) and is available as a free article; additional methodological details or limitations beyond the abstract are not reported in the source provided.
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Epub 2026 Aug 25. # Psychometric validity evidence for a measure of trust in U.S. public health actors for vaccine information [Amanda M Gutierrez](https://pubmed.ncbi.nlm.nih.gov/?term=Gutierrez+AM&cauthor_id=42641256)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42641256/#full-view-affiliation-1 "PhD Program in Health Policy, Harvard University, Cambridge, MA 02138, United States. Electronic address: amandagutierrez@fas.harvard.edu."), [My H Do](https://pubmed.ncbi.nlm.nih.gov/?term=Do+MH&cauthor_id=42641256)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42641256/#full-view-affiliation-2 "Graduate School of Education, Harvard University, Cambridge, MA 02138, United States."), [Matthew Motta](https://pubmed.ncbi.nlm.nih.gov/?term=Motta+M&cauthor_id=42641256)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42641256/#full-view-affiliation-3 "Department of Health Law, Policy, & Management, Boston University School of Public Health, Boston, MA 02118, United States.") Affiliations Expand ### Affiliations * 1 PhD Program in Health Policy, Harvard University, Cambridge, MA 02138, United States. Electronic address: amandagutierrez@fas.harvard.edu. * 2 Graduate School of Education, Harvard University, Cambridge, MA 02138, United States. * 3 Department of Health Law, Policy, & Management, Boston University School of Public Health, Boston, MA 02118, United States. * PMID: **42641256** * DOI: [ 10.1016/j.vaccine.2026.129026 ](https://doi.org/10.1016/j.vaccine.2026.129026) Free article Item in Clipboard # Psychometric validity evidence for a measure of trust in U.S. public health actors for vaccine information Amanda M Gutierrez et al. Vaccine. 2026. Free article Show details Display options Display options Format Abstract PubMed PMID Vaccine Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Vaccine%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Vaccine%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42641256/) . 2026 Oct 3:91:129026. doi: 10.1016/j.vaccine.2026.129026. Epub 2026 Aug 25. ### Authors [Amanda M Gutierrez](https://pubmed.ncbi.nlm.nih.gov/?term=Gutierrez+AM&cauthor_id=42641256)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42641256/#short-view-affiliation-1 "PhD Program in Health Policy, Harvard University, Cambridge, MA 02138, United States. Electronic address: amandagutierrez@fas.harvard.edu."), [My H Do](https://pubmed.ncbi.nlm.nih.gov/?term=Do+MH&cauthor_id=42641256)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42641256/#short-view-affiliation-2 "Graduate School of Education, Harvard University, Cambridge, MA 02138, United States."), [Matthew Motta](https://pubmed.ncbi.nlm.nih.gov/?term=Motta+M&cauthor_id=42641256)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42641256/#short-view-affiliation-3 "Department of Health Law, Policy, & Management, Boston University School of Public Health, Boston, MA 02118, United States.") ### Affiliations * 1 PhD Program in Health Policy, Harvard University, Cambridge, MA 02138, United States. Electronic address: amandagutierrez@fas.harvard.edu. * 2 Graduate School of Education, Harvard University, Cambridge, MA 02138, United States. * 3 Department of Health Law, Policy, & Management, Boston University School of Public Health, Boston, MA 02118, United States. * PMID: **42641256** * DOI: [ 10.1016/j.vaccine.2026.129026 ](https://doi.org/10.1016/j.vaccine.2026.129026) Item in Clipboard Full text links Cite Display options Display options Format Abstract PubMed PMID Linked Discoveries ## Abstract **Purpose:** Generate psychometric validity evidence for a novel 4-item measure of trust in public health actors for vaccine information for use in U.S.-population survey research. **Methods:** We analyzed data from 7394 respondents in U.S.-nationally representative KFF public opinion surveys over five time points (2020-2025) regarding their level of trust in FDA, CDC, their local public health department, and their own doctor to provide reliable vaccine information. We used classical test theory to estimate internal consistency reliability and parallel analysis to evaluate dimensionality of the proposed measure. We fit an Item Response Theory graded response model to discern item and scale properties, and estimated differential test functioning (DTF) by political identity and time point. We estimated associations between scale scores and vaccine-related outcomes, and compared scale scores between groups of differing partisanship and vaccination status. **Results:** The 4-item scale had high internal consistency (Cronbach's alpha = 0.84) and a single underlying dimension ("trust in public health actors for vaccine information"). IRT suggested items provided sufficient information (a parameters: 1.55-4.04) across a wide range of latent trust levels (b parameters: -2.62-0.69). We did not find substantively meaningful DTF by political partisanship or survey time point at the scale level. Higher scale scores were positively associated with vaccine uptake and pro-vaccine attitudes, including COVID, flu, and MMR vaccine confidence (all p < .001). **Conclusion:** This public Health Actor Trust for Information about Vaccines (HAT-IV) scale had strong psychometric properties and associations with vaccine-related attitudinal and behavioral outcomes across U.S political and public health contexts. Scale functioning was robust across political identity and time point differences. HAT-IV provides a short, informative way to measure individuals' trust in U.S. public health actors for vaccine information in survey research. This scale can be administered to study relationships between trust, key public health actors, and vaccine outcomes in the U.S. **Keywords:** Differential test functioning; Item response theory; Psychometrics; Public health communication; Trust; Vaccine attitudes. Copyright © 2026 The Authors. Published by Elsevier Ltd.. All rights reserved. [PubMed Disclaimer](https://pubmed.ncbi.nlm.nih.gov/disclaimer/) ## Conflict of interest statement Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. ## Similar articles * [ Psychometric testing of two measures of vaccination attitudes among U.S. Latine respondents. ](https://pubmed.ncbi.nlm.nih.gov/41349445/) Budd EL, De Anda S, Chaovalit P, Vu AH, Leve LD, DeGarmo DS.Budd EL, et al.Vaccine. 2026 Jan 25;71:128044. doi: 10.1016/j.vaccine.2025.128044. Epub 2025 Dec 4.Vaccine. 2026.PMID: 41349445 * [ Measuring trust in public health authorities in the United States: An item response theory analysis. ](https://pubmed.ncbi.nlm.nih.gov/42561010/) Kloft S, Guimaraes R, Hyun JH, López-Cevallos D.Kloft S, et al.PLoS One. 2026 Aug 6;21(8):e0355498. doi: 10.1371/journal.pone.0355498. eCollection 2026.PLoS One. 2026.PMID: 42561010Free PMC article. * [ Properties and performance of a questionnaire assessing COVID-19 vaccine knowledge and attitudes in Brazilian pregnant women. ](https://pubmed.ncbi.nlm.nih.gov/41286800/) Maudonnet B, Silveira C, Cecatti JG, Costa ML, Tedesco RP, Matias JP, Tosetto M, Arthur AL, De Sousa ME, Limaye RJ, Schue JL, Miller E, Singh P, Fesshaye B, Karron RA, Gottlieb SL, Brizuela V, Abejirinde IO, Belayneh G, Souza RT.Maudonnet B, et al.BMC Public Health. 2025 Nov 24;25(1):4121. doi: 10.1186/s12889-025-25102-z.BMC Public Health. 2025.PMID: 41286800Free PMC article. * [ Is It Possible to Develop a Patient-reported Experience Measure With Lower Ceiling Effect? ](https://pubmed.ncbi.nlm.nih.gov/39466401/) Brinkman N, Looman R, Jayakumar P, Ring D, Choi S.Brinkman N, et al.Clin Orthop Relat Res. 2025 Apr 1;483(4):693-703. doi: 10.1097/CORR.0000000000003262. Epub 2024 Oct 25.Clin Orthop Relat Res. 2025.PMID: 39466401Free PMC article. * [ Folic acid supplementation and malaria susceptibility and severity among people taking antifolate antimalarial drugs in endemic areas. ](https://pubmed.ncbi.nlm.nih.gov/36321557/) Crider K, Williams J, Qi YP, Gutman J, Yeung L, Mai C, Finkelstain J, Mehta S, Pons-Duran C, Menéndez C, Moraleda C, Rogers L, Daniels K, Green P.Crider K, et al.Cochrane Database Syst Rev. 2022 Feb 1;2(2022):CD014217. doi: 10.1002/14651858.CD014217.Cochrane Database Syst Rev. 2022.Update in: [Cochrane Database Syst Rev. 2026 Feb 18;2:CD014217. doi: 10.1002/14651858.CD014217.pub2.](https://pubmed.ncbi.nlm.nih.gov/41705996/)PMID: 36321557Free PMC article.Updated. 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