Data collection tool and technique

Data were collected using a questionnaire comprised of 38 items which was prepared in four languages, which are English, Bahasa Malaysia, Mandarin and Tamil. The researcher had adapted and developed the questionnaire based on past literatures, Reproductive Health of Adolescents Module and the physical and health education textbooks use in Malaysian primary schools. The instrument examines students’ knowledge on (a) puberty (e.g., Puberty is the transition period that happens when a child becoming sexually mature and able to reproduce), (b) HIV/AIDS and sexually transmitted diseases (e.g., AIDS can be spread by having sex with someone who has AIDS), (c) child sexual abuse prevention (e. g. You should inform your parents or the person you trust if a grown up touches your private parts.), and (d) reproductive systems and reproduction (e.g., Testes is the male reproductive organ that produces millions of sperms.). Each section entails items that measure students’ knowledge and understandings towards SRH topics that had been taught in school. The questionnaire was administered by the teachers who are teaching health education and clear instructions were given to the students in completing the questionnaire. The respondents are required to answer each item with “yes,” “no,” or “not sure,” each correct response receives 1 score, zero score will be given to wrong response or the response, “not sure.” The correct responses were combined to yield a total score ranging from 0 to 38.

The content of the questionnaire was validated by three experts from sexuality education, health education and educational psychology. The multi-rater κ_free was obtained by using the Online Kappa Calculator available at (http://justusrandolph.net/kappa/) which showed that there was a good agreement between the experts’ evaluation, κ_free= 0.77 (95% confidence interval [CI], 0.72–0.83). The psychometric properties of the instrument were examined by using Rasch Measurement Model.[14] The instrument demonstrated satisfactory unidimensionality, and the items exhibited a wide range of difficulty level (ranging from −2.53 to 3.25). The RMM outputs showed good item's reliability (item reliability = 0.97) with high item separation index (5.52). However, the person reliability (person reliability = 0.79) and the person separation index (1.94) were slightly below the recommended value. The reliability and internal consistency of the instrument also estimated through the Cronbach's Alpha and reported a value of 0.81. Overall, the results show that the developed instrument can be used with confidence to assess SRH knowledge among primary school students in Malaysia.