Deepening Our Understanding of COVID-19 Vaccine Decision-Making amongst Healthcare Workers in Southwest Virginia, USA Using Exploratory and Confirmatory Factor Analysis

The Knee Injury and Osteoarthritis Outcome Score (KOOS) is well known and commonly used to assess young, active patients with ACL injuries. However, this application of the outcome measure has been called into question. There is currently no evidence supporting the structural validity of the KOOS for this patient population. Structural validity refers to whether a questionnaire meant to provide scores on different subscales behaves as intended in the populations of interest. Structural validity should be assessed for all questionnaire measures with multiple items or subscales. Does the KOOS demonstrate adequate structural validity in young, active patients with ACL tears, when evaluated using (1) exploratory and (2) confirmatory factor analyses? Between January 2014 and March 2017, 1033 patients were screened for eligibility in the Stability 1 randomized controlled trial from nine centers in Canada and Europe. Patients were eligible if they had an ACL deficient knee, were between 14 and 25 years old, and were thought to be at higher risk of reinjury based on the presence of two or more of the following factors: participation in pivoting sports, presence of a Grade 2 pivot shift or greater, generalized ligamentous laxity (Beighton score of 4 or greater), or genu recurvatum greater than 10°. Based on this criteria, 367 patients were ineligible and another 48 declined to participate. In total, 618 patients were randomized into the trial. Of the trial participants, 98% (605 of 618) of patients had complete baseline KOOS questionnaire data available for this analysis. Based on study inclusion criteria, the baseline KOOS data from the Stability 1 trial represents an appropriate sample to investigate the structural validity of the KOOS, specifically for the young, active ACL deficient population.A cross sectional retrospective secondary data analysis of the Stability 1 baseline KOOS data was completed to assess the structural validity of the KOOS using exploratory and confirmatory factor analyses. Exploratory factor analysis investigates how all questionnaire items group together based on their conceptual similarity in a specific sample. Confirmatory factor analysis is similar but used often in a second stage to test and confirm a proposed structure of the subscales. These methods were used to assess the established five-factor structure of the KOOS (symptoms [seven items], pain [nine items], activities of daily living [17 items], sport and recreation [five items], and quality of life [four items]) in young active patients with ACL tears. Incremental posthoc modifications, such as correlating questionnaire items or moving items to different subscales, were made to the model structure until adequate fit was achieved. Model fit was assessed using chi-square, root mean square error of approximation (RMSEA) and an associated 90% confidence interval, comparative fit index (CFI), Tucker-Lewis index (TLI), as well as standardized root mean square residual (SRMR). Adequate fit was defined as a CFI and TLI > 0.9, and RMSEA and SRMR < 0.08. Structural validity of the KOOS was not confirmed when evaluated using (1) exploratory or (2) confirmatory factor analyses. The exploratory factor analysis, where the 42 KOOS items were allowed to group naturally, did not reflect adequate fit for a five-factor model (TLI = 0.828). Similarly, the confirmatory factor analysis used to investigate the KOOS structure as it was originally developed, revealed inadequate fit in our sample (RMSEA = 0.088 [90% CI 0.086 to 0.091]). Our analysis suggested a modified four-factor structure may be more appropriate in young, active ACL deficient patients; however, the final version presented here is not appropriate for clinical use because of the number and nature of post-hoc modifications required to reach adequate fit indices. The established five-factor structure of the KOOS did not hold true in our sample of young, active patients undergoing ACL reconstruction, indicating poor structural validity. We question the utility and interpretability of KOOS subscale scores for young, active patients with ACL tears with the current form of the KOOS. A modified version of the KOOS, adjusted for this patient population, is needed to better reflect and interpret the outcomes and recovery trajectory in this high-functioning group. A separate analysis with a defined a priori development plan would be needed to create a valid alternative.

Why physically active people report lower anxiety than those who are inactive is not well understood. This study examined whether physical self-concept and self-esteem would mediate associations of self-reported physical activity with anxiety disorder symptoms in young women, a population with elevated risk for developing an anxiety disorder. College women (N = 1036, mean ± SD = 19.7 ± 2.9 yr) completed a physical activity recall, the Psychiatric Diagnostic Screening Questionnaire, and the Physical Self-Description Questionnaire. Structural equation modeling was used to test hypotheses. Physical activity had inverse, indirect associations with symptoms of social phobia, generalized anxiety disorder, and obsessive-compulsive disorder that were expressed through its positive association with specific and global physical self-concept and self-esteem. The results were independent of similar relations with symptoms of major depressive disorder as well as the estimates of body fatness and use of psychotropic medications. These correlational findings provide initial evidence to warrant experimental efficacy trials of whether physical activity will reduce the risk of anxiety disorders in young women by positive influences on physical self-concept and self-esteem.

Introduction Despite being one of the most effective methods of preventing the spread of communicable diseases1, vaccination has been subjected to criticism. Several scales have been formulated that were used to document attitudes towards vaccination. However, they either focus on parental attitudes towards children’s vaccinations or are targeted towards an individual’s attitude towards a specific vaccine. A scale that could document an individual’s attitude about vaccinations in general was developed by Martin and Petrie2. Aim The study aimed to translate and validate an Urdu version of the Vaccine Attitude Examination (VAX) scale in a selected Pakistani sample. Methods A cross sectional study was conducted for a month (Sept. 2021) in an outpatient department of a healthcare facility in Karachi, Pakistan. All adult men and women, as well as their caregivers (≥ 18 years), who visited the clinic, spoke Urdu as their first language, and were eligible for COVID-19 vaccine were invited. Convenience sampling method was selected, and sample size calculation was based on an item response ratio of 1:20. An Urdu version of the VAX scale was developed. Data were analysed using IBM SPSS version 23. The reliability was assessed using Cronbach’s alpha (α) and intraclass correlation coefficient (ICC) was calculated. The model fitness was evaluated through IBM AMOS version 25. It done carried out using confirmatory factor analysis (CFA) and reporting of fit indices, namely goodness of fit index (GFI), adjusted goodness of fit index (AGFI), Tucker Lewis index (TLI), comparative fit index (CFI), and root mean square error of approximation (RMSEA). The scale was considered as reliable if Cronbach’s (α) was &amp;gt;0.7. Model fitness was considered acceptable if most fit indices were in acceptable ranges3, i.e., GFI, TLI, CFI &amp;gt; 0.9 and RMSEA &amp;lt; 0.6, as well as p value &amp;lt; 0.05. This study was granted ethical clearance by the Institutional Review Board of Tabba Heart Institute, Karachi, Pakistan (Reference# THI/IRB/FQ/22-09-21/017). Results A total of 211 responses were analysed. The reliability of the scale, i.e., Cronbach’s alpha value was 0.821, and remained the same, i.e., &amp;gt; 0.8 during item deletion. CFA using a 4-factor model revealed the following values for fit indices; GFI = 0.944, TLI = 0.953, CFI = 0.966, and RMSEA = 0.051 (p value = 0.008). Discussion/Conclusion Although a very small scale study, the findings suggest that the Urdu version of VAX scale is reliable and a valid instrument for use in an Urdu speaking population. The scale showed good internal consistency and acceptable model fitness. The use of convenience sampling and being conducted at a single site may affect the generalisability of the results. However, this was the first time the VAX Urdu version was made available for an Urdu speaking population. It is hoped that the attitudes toward vaccines that are measured by the Urdu VAX will provide valuable information as public health officials and others work to improve vaccine uptake. Availability of the Urdu version will enable clinicians to assess the Urdu speaking persons’ attitude towards general vaccination including COVID-19 vaccination.

BackgroundThe conceptualization of negative symptoms has been refined in the past decades. Two-factor model comprising Motivation and Pleasure (MAP) and Emotional Expressivity (EE), five-factor model representing five domains of negative symptoms and second-order five-factor model incorporating the two-factor and five-factor models (Anhedonia, Asociality and Avolition regressed on MAP; Blunted Affect and Alogia regressed on EE) have been suggested as latent structure of negative symptoms. In most studies, the item “Lack of Normal Distress” in the Brief Negative Symptom Scale (BNSS) did not fit well in factor models. Nevertheless, the reported correlation and item-total correlation of Distress with other negative symptom domains and BNSS items were not negligible. Emotion deficit was also discussed as a part of negative symptoms conceptualization. As a single item may not be sufficient to represent an underlying construct that is potentially abstract and complex, the Schedule for the Deficit Syndrome (SDS) which comprises “Diminished Emotional Range” that is conceptually relevant to the BNSS Distress was employed. The study aimed to reexamine the conceptualization of negative symptoms by examining the model fit of several models when BNSS Distress and SDS Emotion (EMO) were included in the models using confirmatory factor analyses (CFA).MethodsTwo-hundred and seventy-four schizophrenia outpatients aged 21–65 were assessed on the BNSS and SDS. In the two-factor models, Restricted Affect, Diminished Emotional Range and Poverty of Speech in SDS and all items in BNSS Blunted Affect and Alogia subscales were regressed on EE, Curbing of Interests, Diminished Sense of Purpose and Diminished Social Drive in SDS and all items in BNSS Anhedonia, Asociality and Avolition subscales were regressed on MAP, without EMO, or with EMO regressed on either EE or MAP. Five-factor models and second-order five-factor models were examined, with or without EMO. Lastly, a six-factor model with EMO manifested by the sixth factor and second-order six-factor models in which EMO was regressed on either EE or MAP were tested. Root mean square error of approximation (RMSEA) <0.08, comparative fit index (CFI) >0.95, the Tucker-Lewis Index (TLI) >0.95, and weighted root-mean-square residual (WRMR) <1.0 indicate good model fit. CFAs were conducted using Mplus version 7.4.ResultsThe two-factor models did not yield adequate fit indices. Five-factor model and second-order five-factor model without EMO had good model fit; five-factor model: RMSEA=0.056 (0.044–0.068), CFI=0.996, TFI=0.995, WRMR=0.718; second-order five-factor model: RMSEA=0.049 (0.036–0.061), CFI=0.997, TFI=0.996, WRMR=0.758. When EMO was included as indicator in one of the factors in the five-factor models, only the model in which EMO was regressed on Alogia yielded adequate fit. Similarly, in the second-order five-factor models, adequate fit indices were observed only when EMO was regressed on Alogia and Blunted Affect. The six-factor model fitted the data well, RMSEA=0.053 (0.042–0.064), CFI=0.996, TFI=0.995, WRMR=0.711. Second-order six-factor model with EMO regressed on EE yielded better model fit than MAP, RMSEA=0.050 (0.039–0.061), CFI=0.996, TFI=0.995, WRMR=0.849.DiscussionIn line with previous studies, five-factor and second-order five-factor models without EMO fitted the data well. When EMO was included, a six-factor model and a second-order six-factor model in which the sixth factor was regressed on EE showed good model fit. Emotion, motivation and behavior are intertwined. Our results showed that diminished emotion may also be one of the components of negative symptoms, which had higher association with EE than MAP.

In differentiated learning, the teacher needs to be aware of the learning styles of students in the classroom to accommodate specific learning preferences, e.g., the Felder–Silverman learning style model. The corresponding instrument, i.e., the Felder–Silverman Index of Learning Style (ILS), was designed to assess learning styles, specifically for engineering students. The ILS has been tested at the middle school level to identify the learning styles; however, validity/reliability had not been established in earlier studies with large samples. The focus of this study was to identify the validity and reliability of an ILS instrument for middle school students (N=450) by investigating the factor structure through factor analysis. This includes internal consistency reliability and constructing validity report of the ILS. An exploratory and confirmatory factor analysis was undertaken to investigate the factor structure to establish validity. As a result of the study, the reliability of the instrument was established. Five-factors emerged through exploratory factor analysis (EFA), which were subjected to confirmatory factor analysis (CFA). The outcome provided five-factors (i.e., Comparative Fit Index (CFI), Tucker–Lewis Index (TLI), Root Mean Square Error of Approximation (RMSEA), Standardized Root Mean Residual (SRMR), and Goodness of Fit (GFI)), out of which four factors were related to the four dimensions of the Felder–Silverman model, and the fifth factor was related to the association of sensing/intuitive and sequential/global dimensions of the model, which is in agreement with the theoretical construct of ILS. As a result of CFA, ILS entailing 24 items indicates a good fit with five-factor structure. CFI=0.922;TLI=0.927; RMSEA=0.026; SRMR=0.585;GFI=0.911;X2=277;df=42;p=0.60. This study suggests that the ILS for the secondary-grade students needs to be revised with fewer items to improve the reliability, as supported by empirical evidence through the EFA and CFA.

The Sport Emotion Questionnaire (SEQ) is a reliable and valid multidimensional instrument for assessing athletes' pre-competition emotional states. This study aimed to test the Chinese-translated version (SEQ-C) by examining pre-training emotional states of table tennis athletes, using validity and reliability analyses. This study employed a cross-sectional survey design using a cluster-based sampling strategy. A total of 670 athletes aged 15-18 years from the Jining Youth Table Tennis Training Base in Jining City, Shandong Province, China, participated in the study; 656 valid responses were retained after data screening. The original English version of the SEQ was translated into Chinese and validated through expert review and pilot testing. Data were collected in September 2024 using a self-administered questionnaire administered via a mixed-mode approach (online and offline), yielding a response rate of 97.9%. Data analysis included a common method bias test, exploratory factor analysis (EFA), and confirmatory factor analysis (CFA). Model fit was evaluated using the standardized root mean square residual (SRMR), root mean square error of approximation (RMSEA), Tucker-Lewis index (TLI), and comparative fit index (CFI). Construct validity was assessed using composite reliability (CR), average variance extracted (AVE), and inter-factor correlations. The study adhered to ethical research standards and was approved by the Human Research Ethics Committee of Universiti Sains Malaysia. All observed items demonstrated strong factor loadings, confirming that the assumed model, consisting of 22 items grouped into five latent variables, was consistent with the original model. The CFA result indicated a good model fit, as reflected by fit indices: RMSEA = 0.042 (90% CI: 0.037, 0.048), SRMR = 0.026, CFI = 0.971, TLI = 0.966. The final measurement model retained all 22 items, each deemed acceptable for the target sample. The findings suggest that the SEQ-C is a valid and reliable instrument for assessing the pre-training emotional states of table tennis athletes in Shandong Province, China. Researchers, sport psychologists, and coaches can adopt the SEQ-C framework to effectively capture the unique emotional experiences of Chinese-speaking athletes, thereby providing valuable insights for emotional regulation strategies and psychological interventions within sports settings.

Self-report measures of periodontal disease have utility for screening, but have not capitalized on a latent variable approach based on psychometric theory to validate such measures. This study aimed to develop a psychometrically valid self-report measure of periodontal disease using latent variable factor analysis and other evidence-based psychometric analyses. Likert-type items reflecting periodontal disease were administered to a sample of adults (n=828) in the United States via an online survey. Items were adapted from prior self-report measures or were newly developed based on psychometric item development theory and theoretical knowledge of periodontal disease. Psychometric analyses included exploratory and confirmatory factor analysis, parallel analysis, and a calculation of internal consistency. Exploratory factor analysis (EFA) was indicative of the goodness-of-fit with two factors (root mean square error of approximation (RMSEA)=0.08; comparative fit index (CFI)=0.97; Tucker Lewis index (TLI)=0.96; standardized root mean squared residual=0.06); five of the 22 original survey questions were eliminated based on the results of this EFA. Parallel analysis supported a two-factor model to represent the similarities across items-one factor reflecting physiologic components and another reflecting functional components of periodontal disease. Confirmatory Factor Analysis also indicated adequate model fit (RMSEA=0.07; CFI=0.98; TLI=0.98; and weighted root mean square residual=1.20). Psychometric analyses of a new 17-item periodontal disease self-report measure provided initial evidence of construct/factor validity. This approach to developing self-report periodontal disease measures may facilitate useful and cost-effective estimates of periodontal disease and provide a testable scale. Future work should include clinical validation.

Identifying the factor structure of the Mother-to-Infant Bonding Scale for post-partum women and examining its consistency during pregnancy.

The Double-Edged Sword Effects of Career Calling on Occupational Embeddedness: Mediating Roles of Work–Family Conflict and Career Adaptability

Objectives: This paper is to culturally adapt and confirm the validity and reliability of a job motivation scale among health workers in hospitals in Vietnam. Methods: We used data from two studies of health workers’ job motivation which were conducted at two public hospitals in Vietnam. These studies were conducted in 2016 in 2018. Exploratory factor analysis (EFA) was used to identify the motivation factors and confirmatory factor analysis (CFA) was then used to certify the elementary factors produced by EFA using Comparative Fit Index (CFI), Tucker Lewis Index (TLI), Root Mean Square Error of Approximation (RMSEA) and the Standardized Root Mean Square Residual (SRMR). Results: The results demonstrate that two factors of job motivation, namely ‘Satisfaction and Commitment’ and ‘Conscientiousness’ were identified by EFA with Cronbach’'s Alpha of 0.88 and 0.89 respectively. The whole scale of job motivation was reliable, with Cronbach’'s Alpha of 0.87. The result was confirmed by CFA where the motivation item corresponds as CFI (0.91), TLI (0.88) and RMSEA (0.087), SRMR (0.06) are good fit indices. Conclusions: Job motivation scale should be widely applied for measuring the health workers’ motivation in other hospitals in Vietnam. The necessary solutions should be implemented to improve health workers’ job motivation.

AimsThe aim of this study was to examine the factor structure of attitudes towards psychiatry among medical students by using the ‘Attitude towards psychiatry-30’ (ATP-30) scale, which is one of the most widely used psychometric tools in assessing medical students’ attitudes regarding psychiatry. We also aimed to explore the possible existence of meaningful subscales in the ATP-30 scale.MethodSecondary data from a survey of 743 final-year medical students from nine medical schools in Sri Lanka were subjected to factor analysis. Models based on empirical evidence were tested with Confirmatory Factor Analysis (CFA) for model fit using Comparative Fit Index (CFI), Tucker Lewis Index (TLI), root mean square error of approximation (RMSEA) and Chi square. To explore the underlying latent structure of the scale, Exploratory Factor Analysis (EFA) with oblique (i.e. Promax) rotation was employed. Horn's parallel analysis and goodness-of-fit statistics for a series of EFA models tested with different numbers of factors were used in determining the number of factors to retain. Items conceptually external to the emerging factors or with factor loadings less than 0.4 were discarded. Gender invariance of the final model was tested by configural, metric and scalar invariance. Internal consistency of subscales was assessed using McDonald's omega (ω).ResultThree models based on literature (one-, five-, and eight- factor) were disproved by CFA. EFA revealed a six-factor solution, encompassing 18 out of the 30 items, to be the most theoretically meaningful factor structure. This six-factor model was affirmed by a CFA (CFI = 0.94, TLI = 0.92, RMSEA = 0.036). These factors were, namely, ‘the image of psychiatrists’, ‘psychiatric patients and mental illness’, ‘efficacy of treatment’, ‘psychiatric teaching’, ‘career choice’, and ‘psychiatry as an evidence-based discipline’. This six-factor solution was invariant across gender. ‘The image of psychiatrists’ appeared to be the most salient factor, and formed the most consistent subscale (ω = 0.71). The internal consistencies of the other subscales were modest (ω = 0.55–0.67). The overall 18-item scale showed good internal consistency (ω = 0.78).ConclusionOur findings provide evidence of a multi-dimensional structure in medical students’ attitudes towards psychiatry, endorsing six meaningful subscales of the ATP-30. Future researchers and educators can utilize these subscales in identifying specific attitudinal domains which are more closely associated with students’ future choice of a career in psychiatry, and also in identifying specific areas where attitudes are more stigmatized, so that appropriate interventions can be incorporated into the undergraduate psychiatric curriculum.

BackgroundExisting occupational stress questionnaires are mostly based on Western work environments and were generally developed earlier, with insufficient cultural adaptation and incomplete coverage of emerging stressors in Chinese work environments. Their applicability has also been constrained by cultural differences and by the lack of validation in non-Western populations. This study aimed to develop and evaluate an instrument to measure the level of occupational stress among workers and the risk of occupational stress in the workplace.MethodThe study was carried out in two stages: questionnaire development and item screening with subsequent questionnaire evaluation. The Occupational Stress Check and Assessment Questionnaire (OSCAQ) was developed based on three classical models: the NIOSH Model of Job Stress, the Job Demand-Control-Support (JDCS) Model, and the Effort-Reward Imbalance (ERI) Model. The initial questionnaire was developed through a comprehensive literature review, reference to existing scales, expert consultation, and a preliminary survey conducted among the target population. During July 2023 to November 2024, a valid sample of 13,019 respondents was collected in Beijing, China, through an online platform. Item analysis and exploratory factor analysis (EFA) were conducted on a sample of 6,453 workers to screen questionnaire items and investigate the factorial structure. Validity testing was conducted on a sample of 6,566 workers using confirmatory factor analysis (CFA) to assess the construct validity, convergent validity, and discriminant validity. Cronbach’s α coefficients and Spearman-Brown coefficients were used to determine the questionnaire’s internal consistency reliability.ResultsThrough item analysis and EFA, a total of 10 items were removed from the OSCAQ, resulting in a final questionnaire consisting of 75 items. The retained items were categorized into three subscales: work stressors, social support factors, and stress reactions. The work stressors and social support factors were jointly analysed, explaining 66.99% of the total variance, while the stress reactions were analysed separately, accounting for 64.43% of the total variance. A good model fit was indicated by CFA, as evidenced by root mean square error of approximation (RMSEA) = 0.063, comparative fit index (CFI) = 0.908, tucker-lewis index (TLI) = 0.905, and standardized root mean square residual (SRMR) = 0.067. Convergent validity was demonstrated, with all latent constructs exceeding the combined reliability (CR) threshold (> 0.70), and most average variance extracted (AVE) values above 0.50, except for the work stressors subscale (AVE = 0.443). Discriminant validity was supported, as the square root of AVE for each dimension was greater than its correlations with other dimensions. The questionnaire demonstrated good internal consistency, with Cronbach’s α coefficients ranging from 0.911 to 0.952 across subscales and from 0.770 to 0.927 across dimensions, and Spearman-Brown coefficients ranging from 0.850 to 0.895 and 0.671 to 0.919, respectively.ConclusionThe OSCAQ was demonstrated to possess satisfactory reliability and validity, and can be considered a suitable instrument for assessing the status of occupational stress.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12889-025-24713-w.

BackgroundThe Maslach Burnout Inventory (MBI) is an instrument commonly used to evaluate burnout syndrome. The goal of the present study was to assess the internal reliability and the performance of the items and the subscales of the MBI-HSS (the version for professionals working in human services) by validating its factorial structure in Spanish urgency healthcare personnel.MethodsCross-sectional study including 259 healthcare emergency professionals (physicians and nurses) in the Spanish health region of Lleida and the Pyrenees. Burnout was measured using the Spanish validated version of the MBI-HSS. Internal reliability was estimated using Cronbach’s alpha coefficient. The sampling adequacy was assessed using the Kaiser-Meyer-Olkin measure along with the Bartlett’s test of sphericity. A principal axis exploratory factor analysis with an oblique transformation of the solution and a confirmatory factor analysis with maximum likelihood estimation were performed. Goodness-of-fit was assessed by means of the chi-square ratio by the degrees of freedom, the standardized root mean square residual (SRMR), the root mean square error of approximation (RMSEA), the Tucker-Lewis Index (TLI) and the comparative fit index (CFI).ResultsThe three subscales showed good internal reliability with Cronbach’s alpha coefficients exceeding the critical value of 0.7. Exploratory factor analysis revealed five factors with eigenvalues greater than 1. Nevertheless, confirmatory factor analysis showed a relatively satisfactory fit of the three-factor structure (χ2/df = 2.6, SRMR = 0.07, RMSEA = 0.08, TLI = 0.87, CFI = 0.89), which was improved when several items were removed (χ2/df = 1.7, SRMR = 0.04, RMSEA = 0.05, TLI = 0.97, CFI = 0.98).ConclusionsAlthough it is necessary exploring new samples to get to more consistent conclusions, the MBI-HSS is a reliable and factorially valid instrument to evaluate burnout syndrome in health professionals from the Spanish emergency services.

ObjectivesThe Australian Ageing Semantic Differential (AASD) survey was developed to quantify medical student attitudes towards older people. The purpose of this study is to examine psychometric properties of the survey...

ObjectivesThis study aimed to develop and validate the family sports ecosystem questionnaire (FSEQ), a novel instrument measuring the family sports ecosystem construct for junior high school students, defined as a dynamic network comprising family sports environment, family physical education, and individual sports consciousness.DesignA methodological cross-sectional study was conducted, employing a multi-phase questionnaire development and validation design: (1) initial item compilation based on theory and literature, (2) content/face validity assessment via expert consultation (three rounds, n = 23 experts), (3) preliminary survey, and (4) psychometric evaluation using split-sample methodology (n = 1344 students, randomly split into n = 672 for exploratory factor analysis (EFA)/item analysis and n = 672 for confirmatory factor analysis (CFA)).MethodsThe initial items were determined in the form of expert scoring and interviews. Internal consistency assessed via Cronbach's alpha and corrected item total correlation. The construct validity of the questionnaire was verified by EFA and CFA. Model fit indices assessed (e.g. χ²/df, root mean square error of approximation (RMSEA), comparative fit index (CFI), and Tucker–Lewis index (TLI)). The convergent validity of the questionnaire was evaluated by factor load, average variance extracted (AVE), and composite reliability (CR). The Fornell–Larcker criterion was used to evaluate discriminant validity.ResultsThe final FSEQ comprised 33 items across nine factors nested within three dimensions: family sports environment (ball/leisure facilities, swimming/winter facilities, and home electronic devices), family physical education (parental support, role modeling, and sports knowledge instruction), and individual sports consciousness (cognitive identification, emotional attitude, and will/intention). Content validity: Achieved consensus after expert revisions. Reliability: Excellent internal consistency (overall Cronbach's α = 0.943; sub-dimensions α = 0.740 to 0.942). Structural validity: EFA explained 69.543% variance; CFA demonstrated excellent fit (χ²/df = 1.538, RMSEA = 0.028, CFI = 0.979, and TLI = 0.975). Convergent validity: All factor loadings > 0.6, AVE > 0.5, and CR > 0.7. Discriminant validity: Satisfied Fornell–Larcker criterion for all latent variables.ConclusionThe present study established a comprehensive family sports ecosystem and subsequently developed the “FSEQ” for the first time.