Preliminary Validation of the Italian Version of the Artificially Intelligent Device Use Acceptance (AIDUA-IT) Scale: Cross-Cultural Adaptation and Psychometric Evaluation

Abstract

<b>Background:</b> Artificial intelligence (AI) is increasingly integrated into healthcare and public services, making user acceptance a key prerequisite for safe and effective implementation. The Artificially Intelligent Device Use Acceptance (AIDUA) model provides a multidimensional framework for evaluating acceptance of intelligent systems, yet no validated Italian instrument is currently available. <b>Objectives:</b> This study aimed to translate, culturally adapt, and preliminarily validate the Italian version of the AIDUA scale (AIDUA-IT) following COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) and Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) recommendations. <b>Methods:</b> A two-phase cross-sectional design was used. Phase one included forward-backward translation, expert review (<i>n</i> = 7), and cognitive debriefing (<i>n</i> = 8). Phase two assessed structural validity, internal consistency, convergent and discriminant validity, and short-term test-retest reliability in a convenience sample of Italian-speaking adults (<i>N</i> = 140), with a subsample completing the test-retest assessment (<i>n</i> = 32). <b>Results:</b> The hypothesized eight-factor measurement model demonstrated excellent fit (Comparative Fit Index [CFI] = 0.984; Tucker-Lewis Index [TLI] = 0.981; Root Mean Square Error of Approximation [RMSEA] = 0.041; Standardized Root Mean Square Residual [SRMR] = 0.056), with strong standardized loadings (β range: 0.64-0.96) and good internal consistency (Cronbach's α and McDonald's ω range: 0.82-0.90). Convergent and discriminant validity were supported, and test-retest reliability was good to excellent across subscales (Intraclass Correlation Coefficient [ICC] range: 0.81-0.90). <b>Conclusions:</b> These findings provide initial evidence that the AIDUA-IT is a reliable and valid instrument for assessing acceptance of AI-enabled services in Italy. Further validation in larger and more diverse samples is recommended.

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