Abstract
BackgroundBack pain is an important public health problem and the leading cause of adult disability worldwide and is rising among schoolchildren populations. Despite numerous studies reporting on back care interventions in pediatric population; there is currently no existing theory-based instrument to assess impact and outcome of these programs. This paper reports on development and psychometric testing of a theory based back-care behavior instrument for use among elementary schoolchildren.MethodsThis was a three-phases study that included the following steps: a) a literature research to review existing instruments that assess healthy spine-related behavior in elementary schoolchildren; b) development of a new instrument namely the Back-care Behavior Assessment Questionnaire (BABAQ) based on the Social Cognitive Theory and existing instruments, and c) conducting a cross sectional study to test psychometric properties of the BABAQ by estimating the content validity ratio (CVR), the content validity index (CVI), performing confirmatory factor analysis (CFA), reliability analysis, and convergent validity as estimated by the Average Variance Extracted (AVE).ResultsFirst, a questionnaire (the BABAQ) was developed. It contained of 49 items tapping into 5 pre-defined constructs (skills, knowledge, self-efficacy, expectation beliefs, and behavior). Then, 610 fifth-grade female schoolchildren were entered into a cross sectional study and they completed the BABAQ. The CVR and the CVI of the questionnaire was found to be ≥0.54 and > 0.7, respectively. The CFA confirmed the five constructs and showed good fit for the data. The intraclass correlation (ICC) and the Cronbach’s alpha coefficients for the BABAQ were 0.84 (P < 0.001) and 0.93, respectively. The convergent validity as measured by the AVE also showed satisfactory results.ConclusionThe findings suggest that the Back-care Behavior Assessment Questionnaire (BABAQ) is a valid instrument for measuring healthy spine-related behaviors among schoolchildren.
Highlights
Back pain is an important public health problem and the leading cause of adult disability worldwide and is rising among schoolchildren populations
Structural validity The results obtained from confirmatory factor analysis for the Back-care Behavior Assessment Questionnaire (BABAQ) were as follows: Chi-Square = 3921.78, df = 1117 (χ2/df = 3.51, P = 0.53), Comparative Fit Index (CFI) = 0.97, root mean square error of approximation (RMSEA) = 0.091 (P < 0.001), and SRMR = 0.078
This study is a modest contribution to ongoing discussions on development and psychometric testing of the Back-Care Behavior Assessment Questionnaire (BABAQ) among 5th-grade girls in some Iranian elementary schools
Summary
Back pain is an important public health problem and the leading cause of adult disability worldwide and is rising among schoolchildren populations. An individual who develops back, leg, and arm pain might experience difficulty dressing, sitting, standing, walking, turning one’s head, holding arms up, as well as lifting things. They might sleep poorly, have headaches, feel tired and worried, and lose some enjoyments of life [6]. It is argued that measuring healthy spine-related behaviors during daily life activities among children, as a key outcome in evaluation of educational interventions for back-care, is of prime importance [10]
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