Development and Validation of a Questionnaire to Assess Perceptions and Acceptance of Micronutrient-Fortified Bouillon Cubes in Northern Ghana

Background Micronutrient deficiencies remain a major public health issue in West Africa, contributing to anaemia, impaired cognitive development, and increased infection risk. Bouillon cubes are widely consumed in the region and offer a culturally appropriate vehicle for micronutrient delivery. However, no validated instrument exists to assess the psychosocial and behavioural factors influencing household acceptance of fortified bouillon cubes. This study aimed to develop and validate a questionnaire to assess perceptions and acceptance of micronutrient-fortified bouillon cubes among non-index household members (NIHMs) in northern Ghana. Methods A 29-item questionnaire was developed based on the Theory of Planned Behaviour and the Health Belief Model. Development involved literature review, expert consultation, and pretesting with 18 adults. The instrument included 26 five-point Likert-scale items and 3 categorical items. One NIHM (aged ≥ 15 years) was randomly selected per household using the Kish method. The questionnaire was administered to 731 NIHMs within 1–2 months of intervention initiation as part of a double-blind randomised controlled trial comparing multiple micronutrient-fortified bouillon cubes to iodine-only cubes in Kumbungu and Tolon districts. The dataset was split for exploratory (n = 292) and confirmatory (n = 439) factor analyses. Psychometric properties were evaluated using Cronbach’s alpha, composite reliability (CR), and average variance extracted (AVE). Results Participants had a mean age of 40.8 ± 17.4 years; 58.8% were female. Exploratory factor analysis identified two latent constructs comprising Perception (8 items) and Acceptance (10 items) explaining 56% of total variance. Confirmatory factor analysis showed good model fit (chi-square/df = 1.91, root mean square error of approximation [RMSEA] = 0.04, comparative fit index [CFI] = 0.98, Tucker–Lewis’s index [TLI] = 0.98, and standardised root mean square residual [SRMR] = 0.06). Internal consistency was acceptable (Cronbach’s alpha: 0.71 for Perception, 0.72 for Acceptance; CR: 0.86 and 0.82, respectively). AVE was 0.52 for Perception and 0.46 for Acceptance. Discriminant validity was supported. Conclusion This validated 18-item questionnaire demonstrates strong psychometric properties and provides a standardised tool for assessing household-level perception and acceptance of fortified foods. It is suitable for use in programme design, evaluation, and behavioural monitoring in settings where bouillon is commonly consumed.