Development of the Public Law-Abiding Beliefs and Practices Scale (PLABPS) and the relationship between health-related and non-health-related behaviors

doi:10.21203/rs.3.rs-3131600/v1

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Development of the Public Law-Abiding Beliefs and Practices Scale (PLABPS) and the relationship between health-related and non-health-related behaviors

https://doi.org/10.21203/rs.3.rs-3131600/v1

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Background: Interactions between social and personal behavioral choices might explain why individuals behave differently with respect to public laws and regulations, some of which are known to influence individuals’ health. Evaluation of such interactions needs valid assessment tools.

Objectives: The primary objective of the present study was to develop and validate the Public Law-Abiding Beliefs and Practices Scale (PLABPS). The second objective was to examine whether there was a significant association between health-related and non-health-related behaviors (including COVID-19 preventive behaviors).

Methods: To develop the scale, several steps were taken including item suggestion, discussion by an expert panel, performing a pilot study on the initial scale, sequential item reduction to maximize internal consistency using exploratory and confirmatory factor analysis, and finalizing the scale items through expert review. Data were collected from 1108 community-dwelling individuals aged 18 years and older. Internal consistency and construct validity of the PLABPS were examined.

Results: A 10-item scale comprising two factors was extracted showing good psychometric properties. Confirmatory factor analysis results demonstrated good model fit indices (CMIN/DF: 2.340, SRMR = 0.053, RMSEA= 0.067, CFI= 0.960). The Cronbach alpha was 0.86 suggesting very good internal consistency. There was a significantly moderate association between PLABPS scores and COVID-19 preventive behaviors, indicating that individuals with greater law-abiding tendency were more likely to follow preventive COVID-19 behaviors.

Conclusion: The PLABPS is a reliable and valid brief instrument for assessing individuals’ adherence to general public laws. The scale may predict COVID-19 protective behaviors and other health-related behaviors. Given its potential use with regard to psychosocial issues, the PLABPS may contribute to worldwide research in social and behavioral science fields.

Public Law-Abiding Beliefs and Practices Scale

COVID-19 pandemic

psychometrics

validation study

It is widely recognized that individuals’ social milieu and relationships are fundamental determinants of their physical and mental health. The concept of social determinants of health seeks to understand how social ecology affects individuals’ health-related behaviors and health outcomes¹. One of the main features of social ecology that promotes or hinders specific behaviors from occurring are public laws and regulations. Laws not only affect individuals’ behavior through expected punishments or rewards, but they also play an important role in shaping and expressing social norms, that are unwritten values in society^2–4. It has been suggested that social determinants of health are strongly influenced by laws through forming social interactions⁵.

Although, there are different definitions in different jurisdictions and legal systems, public law is used broadly to refer to a set of legal rules, enforceable by the governments, that regulates the relationship between individuals and the state⁶. In contrast to private law by which the government horizontally supervises and facilitates relationships between individuals as well as non-governmental private parties, public laws vertically regulate the relationships between government and individuals, and the government imposes an obligation owed to it on individuals^7,8. Therefore, public law deals with issues that affect the general public or society as whole, rather than specific social sections or population subgroups. Overall, they express public policies responsible for creating and maintaining welfare and safety of citizens⁵.

Public laws may be classified as administrative (laws that govern government agencies), constitutional (laws that protect citizens' rights as afforded in the Constitution), criminal (laws that relate to crime), municipal (those that are ordinances, regulations and by-laws that govern a city or a country, representing local or national governments) and international laws (laws that oversee relations between nations)^{6, 9–11}. The present paper refers to public laws as those laws, mostly municipal, that are publicly observable and their violations are expected to be followed by or lead to a legal penalty or social punishment. Compliance with laws and regulations is of crucial importance for social functioning, safety and sustainability. Moreover, law violations can be a source of social instability¹².

Law-abiding behavior is defined as a stable behavior of an individual in following most important public municipal rules¹³. According to Tyler, law-abiding individuals are motivated to voluntarily obey the law, because they recognize law obedience behavior as both socially appropriate and ethical¹⁴. Law-abiding behaviors originate from recognition of an existing law (law awareness) and perception of the law as a social value and obeying it as a law¹⁵. Therefore individuals’ obedience to law requires belief in values contained in psychosocial and cultural context¹⁴. In addition to genetic and psychological factors, Jackson suggested other influencing determinants associated with compliance with laws including legitimacy, that is “an authority being recognized and believed by people as rightful” (p.1053) and existence of a shared moral purpose between the government and its citizens¹⁶.

Predicting and influencing public behaviors and practices necessitate developing appropriate tools to assess factors associated with individuals’ law-abiding behaviors at the society level. Obviously, individuals behave differently with regard to public laws and regulations, some of which may influence health. For example, one of the challenges health systems faced during the COVID-19 pandemic was non-compliance with COVID-19 related public health measures, especially among young adults¹⁷. While some individuals strictly adhere to the public laws, some individuals ignore them or do not take them seriously. As an important outcome, assessing law-abiding behaviors and understanding correlates of beliefs and practices with regard to them, may elucidate paths toward more safe and sustainable societies.

To best of the present authors’ knowledge, there is currently no scale that directly assesses individuals’ tendency to comply with the law. The lack of unified and widely accepted definition of public laws and diversity of laws across countries may be the reasons why (to date) no psychometric instrument has been developed that assesses individuals’ law-abiding behaviors. Therefore, the main objective of the present study was to develop and validate a brief tool for assessing individuals’ public law-abiding beliefs and practices. The study also had a secondary objective to evaluate the relationship between public law-abiding practices as a measure of non-health social behaviors and COVID-19 self-protective behaviors as a proxy measure of health behaviors.

Development of the scale

Identifying the public law domain. The first step of the study was to identify a set of items that encompassed the domain of public laws. A review of literature was conducted on law and its classification. Here, public law was defined as a set of legal rules, primarily municipal, enforceable by the governments, that regulates the relationship between individuals and the government which aim to provide and maintain welfare and safety of the population.

Item generation. Due to lack of pre-existing scales and scarcity of related literature, the inductive method was used for item generation. The initial items were generated based on the preliminary literature review, alongside discussion groups with experts and lay people. The target items were those public regulations that individuals frequently encounter in their daily life where following them is publicly deemed to be right doing and disobeying them can lead to a legal/social warning or penalty. Initially, a total of 22 items were generated and discussed by the expert committee including experts from various fields such as sociology, psychology and public health. Noting the diversity of laws across the world, the expert committee focused on public laws that are acceptable to the majority of civilized societies. The number of items reduced to 16 after conducting a screening process for redundancy and the general aim of the present study. All the items were rated on a five-point Likert-type scales from 1 (strongly disagree) to 5 (strongly agree). A pilot study was carried among 80 participants (53% male, mean age: 40 years [SD ± 16]) for initial evaluation of the scale. Finally, the expert committee agreed on 14 items covering public laws to be tested. In the next step, the new scale (named the Public Law-Abiding Beliefs and Practices Scale [PLABPS]) was evaluated among a sample of 1108 Iranian community-dwellers (of which 808 comprised the sample for exploratory factor analysis and 300 comprised the sample for the confirmatory factor analysis) (see Appendix 1 for all the PLABPS items).

Demographics. Basic demographic data comprising age, gender, marital status, and educational level were collected.

COVID-19 preventive behaviors. To evaluate COVID-19 preventive behaviors, participants were asked how often they followed five recommended safe COVID-19-related behaviors during peak months of the pandemic in the past 12 months. The item questions included: (i) “I have regularly sanitized my hands with water and soap or alcohol hand-rubs”, (ii) “I have regularly avoided touching my eyes, mouth and nose”, (iii) “I have regularly covered my nose with tissue or bent elbow while coughing or sneezing”, (iv) “I have regularly maintained at least one meter distance with other people”, and (v) “I have stayed at home when feeling sick”. Items are rated on a five-point scale from 1 (strongly disagree) to 5 (strongly agree). Items were summed to create a total COVID-19 preventive behaviors score that ranged from 5 to 25, with a higher score indicating safer COVID-19 behaviors. In the present study, the scale had adequate internal consistency and reliability (Cronbach’s alpha = 0.798; McDonald’s omega = 0.809).

PLABPS. The PLABPS comprises 10 items (see Appendix 1). Each item was in the form of a statement about compliance with a public municipal law that people commonly encounter in their daily life and individuals rate their degree of agreement from 1 (strongly disagree) to 5 (strongly agree). Items were summed to create a total PLABPS score that ranged from 10 to 50, with a higher score indicating greater compliance with public municipal law. The internal consistencies are reported in the Results section.

Validity of the PLABPS

To ensure validity of the new scale, different aspects including face and content validity, construct validity, convergent and divergent validity and known-groups validity were examined.

Face and content validity. Face validity and content validity of the items were evaluated by a panel of 15 experts with professional expertise in psychology, law, sociology, public health, and epidemiology. After removing items which were viewed as not totally relevant to the target domain, 16 items were retained for further evaluation. Item-level and scale-level content validity ratio (CVR) and content validity index (CVI) were used to examine the content validity of the scale. Item-level CVR was calculated using the formula: CVR = (NE − N/2) / (N/2), where NE is the number of experts who described the item as essential and N is the total number of experts. Scale-level CVR was measured by calculating the average of items’ CVR. The item-level content validity index (CVI) was computed as the number of experts who gave 3 or 4 points (out of 5) for clarity and relevancy of the item divided by the total number of experts. Scale level CVI for relevancy was computed as the proportion of items considered relevant (items scoring 3 or 4) by all the experts divided by the total number of the items¹⁸.

Construct validity. The construct validity of the scale was evaluated using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA).

Known-groups validity. Because there are no similar scales to compare the new scale with a gold standard test, known-groups validity was used to evaluate how much the new scale can discriminate between two groups known to differ on the scale of the interest. To assess known-groups validity of the scale, item points of PLABPS were summed and total scores were calculated. Educational level was dichotomized into (i) college degree or (ii) high school or lower education. It was assumed that those with a university degree would be more law-abiding than those without one¹⁹. Total PLABPS scores were compared between two groups.

Convergent validity. To assess convergent validity, participants were asked a one-item question “I follow public laws as much as I can”. Responses were rated from 1 (strongly disagree) to 5 (strongly agree).

Divergent validity. To evaluate divergent (discriminant) validity, participants were asked an irrelevant item question “I have easy access to healthcare facilities”. Responses were rated from 1 (strongly disagree) to 5 (strongly agree).

Participants and procedure

The target population was the Iranian general population living in Shiraz, Southern Iran. The inclusion criteria were being Iranian and aged 18 years and older and being able to understand spoken Persian. For exploratory factor analysis (EFA), a convenience sample of 808 participants were recruited from public places (including bus stations, public parks, banks, clinics) in 17 community neighborhoods of Shiraz from November to December 2022. For confirmatory factor analysis, a convenience sample of 300 participants were also recruited from public places in six community neighborhoods of Shiraz during May 2023. These analyses were carried out to test the internal structure of the PLABPS and to determine how well the data fitted the parameters. The survey was voluntary, self-administered and anonymous and took about five minutes to complete.

Statistical analysis

Individual characteristics of the participants were described using frequencies (percentages) for categorical variables, and means (and standard deviations) for numerical variables. An EFA using principal axis functioning with varimax rotation method was used to understand which items grouped into a single factor. The Kaiser-Meyer-Olkin (KMO) value measure of sampling adequacy indicated the appropriateness of factor analysis based on the study sample. Bartlett’s test of sphericity was used to confirm adequate correlation between variables in the PLABPS. The appropriate number of factors was determined using Eigen values and scree plot and was confirmed with parallel analysis. To determine best fitting model, CFA was performed using AMOS 23.0 software. Cronbach's Alpha coefficient was computed to calculate internal consistency. Also, McDonald’s omega coefficient was calculated as a measure of composite reliability. McDonald’s omega coefficient was calculated for the PLABPS and its subscales using Hayes' Omega Macro²⁰. Reliability coefficients of 0.7 or more were considered as acceptable. To estimate the correlation between law-abiding tendency and safe COVID-19 behaviors, total scores of both scales were calculated by summing up points obtained from each scale items. Correlation coefficient was computed using Spearman rank test. The statistical analyses were performed using SPSS version 26 software (SPSS Inc., Chicago). The study was approved by Research Ethics Committee of Shiraz University of Medical Sciences. (Ref: IR.sums.med.rec.1401.042). Written informed consent was obtained from all participants.

The mean age of the participants in the EFA sample (n = 808) was 40.4 years (SD ± 14.6). Approximately half of the participants were male (51.4%), more than half of them were married (58.7%), and 40.5% had a college degree. The mean age of participants in the CFA sample (n = 300) was 37.2 years (SD ± 12). More than half of the participants were female (57%), approximately half were married (52%), and three-fifths had a college degree (59%).

According to the item-level CVRs, Item 13 (“Spitting in public places is not allowed, I follow the rules”) was deleted due to low CVR value (CVR = 0.2). CVR of the remaining items were good. Also, Item 16 (“In places [like around hospitals] where blowing unnecessary horns by vehicles is not allowed, I follow the rules”) was deleted due to low clarity score on item-CVI (Table 1). EFA results showed a KMO measure of 0.916, which indicates that the data were appropriate for this analysis. Bartlett's test of sphericity yielded a significant result (p < 0.001), indicating that correlations exist among the scale dimensions. Results of the first step of EFA showed a structure with three factors.

Table 1

Decisions on Retaining or excluding primary items suggested for PLABPS after face validity evaluation phase.
Item questions	Decision	Reason for exclusion
Q1: In public places where smoking is legally prohibited, I follow the rules.	Excluded	< 3 items loaded on a single factor in EFA
Q2: Using mobile phone while driving is legally prohibited, I follow the rules.	Retained	-
Q3: In places (like protected areas of natural or cultural values) where entrance is legally prohibited, I follow the rules.	Excluded	Low factor loading in EFA
Q4: On roads where there is a driving speed limit, I follow the rules.	Retained	-
Q5: In situations where wearing a seat belt is mandatory for car passengers, I follow the rules.	Excluded	Low factor loading in EFA
Q6: In places where parking is not allowed, I follow the rules.	Retained	-
Q7: In public places (like public museums) where eating and drinking are banned, I follow the rules.	Retained	-
Q8: On pedestrian crossings where there are signals telling individuals when they can cross the road, I follow the rules	Excluded	Low factor loading in EFA
Q9: If damaging public property is legally prohibited, I follow the rules.	Retained	-
Q10: If physical quarreling or fighting is legally banned, I follow the rules.	Retained	-
Q11: In places (like hospitals and libraries) where speaking loudly is not allowed, I follow the rules.	Retained	-
Q12: When people are standing in a queue, jumping the queue is not allowed, I follow the rules.	Retained	-
Q13: Spitting in public places is not allowed, I follow the rules.	Excluded	Low item-CVR
Q14: Throwing litter in public places is not allowed, I follow the rules.	Retained	-
Q15: Making too much noise that could disturb neighbors is not allowed, I follow the rules.	Retained
Q16: Blowing unnecessary horns in the streets is not allowed, I follow the rules.	Excluded	Low item-CVI
EFA: exploratory factor analysis, CVR: content validity ratio, CVI: content validity index

In the next stage, Item 1 (“In public places where smoking is legally prohibited, I follow the rules”) was removed from the scale because there were fewer than three loaded items for a single factor. Parallel analysis supported retaining two factors. Factor analysis was continued with 13 items, where the value of the loading for three other items (Items 3, 5 and 8) was < 0.4 and so they were removed from the scale. Finally, the EFA results demonstrated a structure consisting two factors with eigenvalues greater than 1.0 and a cumulative variance of 63.34% (Table 2). Results of CFA confirmed two factor model with good psychometric properties. The identified factors were named traffic laws (TLs) comprising three items and general laws (GLs) comprising seven items (Fig. 1). Psychometric properties of the two-factor PLABPS are shown in Table 3. Model fit estimates showed good to excellent results (CFI: 0.96, CMIN/DF: 2.340, SRMR: 0.053, RMSEA: 0.067, PCLOSE: 0.080). Internal consistency, composite reliability and Average Variance Extracted of the PLABPS subscales are shown in Table 4.

Table 2

Results of exploratory factor analysis of the 10 items PLABPS.
Dimension variables	Corrected item-total correlation	Factor loading	Eigen value	Variance explained	Cumulative variance explained
Factor 1: General laws (GL)			4.724	47%	47%
GL1: In public places (like public museums) where eating and drinking are banned, I follow the rules.	0.608	0.640
GL2: If damaging public property is legally prohibited, I follow the rules.	0.681	0.816
GL3: If physical quarreling or fighting is legally banned, I follow the rules.	0.638	0.779
GL4: In places (like hospitals and libraries) where speaking loudly is not allowed, I follow the rules.	0.568	0.803
GL5: When people are standing in a queue, jumping the queue is not allowed, I follow the rules.	0.576	0.866
GL6: Throwing litter in public places is not allowed, I follow the rules.	0.593	0.796
GL7: Making too much noise that could disturb neighbors is not allowed, I follow the rules.	0.608	0.640
Factor 2: Traffic laws (TL)			1.610	16%	63%
TL1: Using mobile phone while driving is legally prohibited, I follow the rules.	0.463	0.879
TL2: On roads where there is a driving speed limit, I follow the rules.	0.550	0.860
TL3: In places where parking is not allowed, I follow the rules.	0.528	0.762

Table 3

Scale level psychometric properties of 10-items PLABPS.
Psychometric index	value	Acceptable cutoff
Goodness of fit index (GFI)	0.947	> 0.90
Comparative fit index(CFI)	0.960	> 0.95
Minimum Discrepancy Function by Degrees of Freedom divided (CMIN/DF)	2.340	Between 1 and 3
Standardized Root Mean Square Residual (SRMR)	0.053	< 0.08
Root-mean-square error of approximation (RMSEA)	0.067	< 0.08
Composite reliability (CR)	0.858	> 0.7
Average variance extracted (AVE)	0.541	> 0.5
Content validity ratio (CVR)	0.934	> 0.5
Content validity index (CVI)	0.993	> 0.8
Internal consistency (Cronbach’s α)	0.862	> 0.7

Table 4

Internal consistency (Cronbach’s Alpha), composite reliability (McDonald's omega), and Average Variance Extracted of PLABPS subscales.
PLABPS subscale	No. of items	Cronbach’s Alpha	McDonald's omega	Average Variance Extracted
Traffic laws	3	0.779	0.784	0.548
General laws	7	0.883	0.884	0.538

According to the Spearman rank correlation coefficient, there was a positive correlation between participants’ PLABPS scores and safe COVID-19 behavior scores (r = 0.564; p < .001), indicating that individuals with higher law-abiding scores were more likely to follow safe COVID-19 behaviors. The result of the known-groups validity evaluation showed the scale could differentiate well between those with a college degree and those with high school or lower education (p < .001). Also, there was a high correlation between the one-item question “I follow public laws as much as I can” with the total PLABPS score (r = 0.644, p < .001), indicating good convergent validity. Additionally, the total PLABPS score had a negligible correlation²¹ with the irrelevant item (I have easy access to healthcare facilities), indicating appropriate divergent validity (r = 0.148, p = 0.05).

The present study’s aim was to develop a psychometrically robust, valid and reliable instrument to assess public law-abiding beliefs and practices among individuals. Based on the present limited literature on the concept of being law-abiding as well as feedback from the expert panel members and lay people in the development phase, a scale for assessing the law-abiding beliefs and practices was successfully developed (i.e., Public Law-Abiding Beliefs and Practices Scale [PLABPS]).

In the content validity evaluation phase, two items (Item 13 and Item 16) were discarded. Item 13 did not achieve adequate CVR by the expert panel, probably due to the fact that in most countries there is no enforceable rule or social punishment to warn or punish individuals who spit in public places. Also, Item 16 was deleted due to low clarity and relevancy of the item. Additionally, EFA did not support the inclusion of Items 1, 3, 5 and 8. Item 1 (smoking in public places) tended to be loaded on a single factor and was therefore removed. Removing these aforementioned items significantly improved the model fit measures. Sequential item reduction using exploratory factor analysis showed that items on traffic laws tend to be loaded on a separate factor and parallel analysis confirmed that the scale best fitted into two factors. The final scale included 10 items which appear to be widely accepted public regulations in most civilized countries.

Regarding some items, individuals might not have ever experienced specific situations (for example, some individuals might never have driven a car). Since the overall goal of the scale was to assess law-abiding tendency, individuals could assess the items according to their opinions and beliefs toward that specific item based on their previous observations in their daily life, even though they may have not had any personal experience with that situation.

The present authors believe that scale items are generalizable to most parts of the world, since most items are based on moral and ethical bases. The resultant model showed a robust structure with good reliability and validity indices. Furthermore, the results of convergent, divergent, and known-groups validity evaluations showed that the scale corresponded well with the main expected goal of the study and was able to differentiate individuals with different levels of law-abiding tendency. Therefore, the PLABPS has the potential for future use to explore psychosocial factors associated with adherence to social regulations. Additionally, the PLABPS may serve as a research tool that can be used across different nations, cultures, and communities.

Obviously, governmental laws and social norms can be different at the country and sub-country levels, and this might be the reason why there has not been (until now) a general international scale to assess how much a country’s people follow public rules and regulations. However, as there is increasingly more international relations among different countries, more similarities can be found with public regulations and social norms across the world.

The present study also found a significant association between individuals’ public law-abiding tendency and their self-reported safe COVID-19 practices. The COVID-19 pandemic was a good example of how people’s behavior with respect to public health-related regulations could affect the society as whole. Additionally, some of the public laws, directly or indirectly, can affect people health²². For example, cigarette smoking in public places can negatively impact other people’s health through passive inhalation of smoke. Therefore, obeying smoking bans in public places would be beneficial to all society²³. Ideally, the legitimacy of legal authorities and acceptability of laws to people will result in good compliance with all the rules. Encouraging a law-abiding lifestyle, including both non-health and health-related laws, may prepare society for emergency situations such as natural disasters and pandemics²⁴.

Strengths

The PLABPS is a brief scale with 10 items, so it takes little time for individuals to complete. The scale allows researchers from disciplines such as psychology, sociology, criminology, and urban sciences to compare law-abiding behaviors of various community subgroups and their deviations from the average of the general population, so that the correlates of such behaviors can be clarified in each subgroup. In addition, it may provide a useful benchmark for researchers of political sciences and law decision-makers to identify which specific laws are more likely to be accepted and followed by individuals. The association between PLABPS scores and health behaviors need to be confirmed in future studies, and may be useful in developing strategies to promote positive health-related behaviors.

Limitations

There were some limitations to the present study that should be noted. The present study was conducted in one city of one country, and participants were recruited through convenience sampling. These sampling issues may compromise generalizability. Assessing public law-abiding behaviors is conceptually challenging and diversity of public laws throughout the world makes it difficult to cover all aspects of the issue. However, the present study developed a brief scale that consisted of items which are supposed to be legal in most parts of the world. The present study comprised a single population with a moderate size sample of general population. Therefore, it was unable to compare specific population subgroups who have a greater tendency to disobey the law, such as substance addicts, prisoners and individuals with antisocial personality disorder. To the best of the present authors’ knowledge, there is no gold standard test for evaluating law-abiding behaviors. Therefore, the criterion validity of the PLABPS could not be tested. Nevertheless, assessment of known-groups validity confirmed that the scale could discriminate between groups that are known to differ in their law-abiding tendency (i.e., those with or without a university degree). Further cross-country and within-country studies are needed to validate the PLABPS in diverse cultural contexts.

The PLABPS is a psychometrically robust and practical measure to evaluate law-abiding beliefs and behaviors among the general public. Development and validation of appropriate measurement tools are critical for expanding research on social and behavioral sciences. Looking for correlates of public law-abiding beliefs may contribute to development of strategies for promotion of positive collective behaviors within societies, especially in critical circumstances such as natural disasters, epidemics, and pandemics.

PLABPS: Public Laws-Abiding Beliefs and Practices Scale

CVR: Content validity ratio

CVI: Content validity index

S-CVR: Scale-level content validity ratio

S-CVI: Scale-level content validity index

ICC: Intra-class correlation

EFA: Exploratory factor analysis

CFA: Confirmatory factor analysis

KMO: Kaiser-Meyer-Olkin

Ethics approval and consent to participate: The protocol was approved by the Shiraz University’s Ethics Committee (IR.SUMS.MED.REC.1401.042). All methods were carried out in accordance with the Declaration of Helsinki. The informed consent was obtained from all participants.

Consent for publication: Not applicable

Availability of data and materials: The datasets generated and/or analyzed during the present study are not publicly available due to due to institutional regulations and privacy restrictions but are available from the corresponding author upon reasonable request.

Competing interests: The authors declare that they have no conflict of interest.

Funding: The project was funded by Vice Chancellor for Research of Shiraz University of Medical Sciences (Ref No: 25361). There has been no financial support for this work that could have influenced its outcome or presentation.

Authors' contributions: RS designed the study, arranged expert panel sessions and prepared primary draft. AKJ contributed in data gathering, data analysis and writing the manuscript. FIM contributed in data gathering, data analysis. MDG contributed in reviewing and writing drafts and critically appraising the manuscript. All the authors read and approved the final manuscript.

Acknowledgements: The authors would like to thank the experts who participated in the item assessment panel.

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No competing interests reported.

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Development of the Public Law-Abiding Beliefs and Practices Scale (PLABPS) and the relationship between health-related and non-health-related behaviors

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Abstract

Figures

Introduction

Methods

Development of the scale

Measures

Validity of the PLABPS

Participants and procedure

Statistical analysis

Results

Discussion

Strengths

Limitations

Conclusion

Abbreviations

Declarations

References

Additional Declarations

Supplementary Files

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