Construct Validity Research Articles

The Italian version of the Majeed pelvic score: translation, cross-cultural adaptation and validation

Abstract Purpose The assessment of functional outcomes after pelvic ring fracture remains a controversial topic. The Majeed pelvic score (MPS) is the most commonly used pelvic-specific questionnaire in the literature. The aim of this study is translation, cross-cultural adaptation and validation of the Italian version of MPS. Methods The study was articulated in two phases. Phase 1 consisted in translation and cross-cultural adaptation of MPS, from English into Italian. The psychometric properties were tested on 52 Italian patients (Phase 2). Construct validity was assessed by correlation with Short-Form 12 (SF-12). 33 patients repeated the questionnaire after 14 days to assess its reproducibility. All data were subsequently analyzed (descriptive statistics, multitrait analysis, reliability and construct validity assessment). Results The questionnaire was clear and easily understood (no missing data). A ceiling effect was detected for all items of the scale. Multitrait analysis showed good results for each outcome measure, except for the item “walking distance” that showed poor item discriminant validity. A significant correlation between the MPS and the physical component summary (PCS) of the SF-12 was found, while there was a weak correlation with the mental component summary (MCS). The questionnaire showed high internal consistency (Cronbach’s alpha: 0.91–0.99) and very good test–retest reliability (intraclass correlation coefficients: 0.92–0.96). Conclusions The Italian version of the MPS has demonstrated to be reliable and valid in the evaluation of patients with pelvic ring fractures. There is still however a need for an instrument capable of evaluating the mental component in these types of injuries.

Psychometric properties of a COVID-19 health literacy scale in a sample of German school principals applying Rasch analysis

Abstract Background During the COVID-19 pandemic, health literacy was found to be an asset to manage health-related information. The HLS-COVID-Q22 has been developed to measure COVID-19 health literacy. External validation needs to be assessed in different populations to verify the questionnaire’s functioning. The present study aimed to evaluate the psychometric properties of the HLS-COVID-Q22 in a sample of German school principals. Methods The sample consisted of 2187 German school principals who completed the HLS-COVID-Q22 online from April to March 2021. The data was analyzed using Rasch analysis, applying the Partial Credit Model for polytomous data. Dimensionality, item fit statistics and rating scale functioning was tested. Values for item difficulty and person ability as well as reliability indices were computed. Results Unidimensionality could be confirmed. The rating scale categories worked as intended, participants used every rating step category. Generally, item fit was verified. One item showed potential misfit but could remain in the questionnaire as excluding the item did not reduce reliability. A person separation index of 3.41 and person reliability of 0.92 showed excellent differentiation between COVID-19 health literacy levels. Furthermore, the values for item separation of 20.08 and item reliability of 1.0 indicate good construct validity. Conclusions The German version of the HLS-COVID-Q22 appears to be a reliable measurement tool for the target population. Evidence for construct, statistical and fit validity was collected. Future studies need to test additional types of validity like convergent and divergent validity to further evaluate the questionnaire. Moreover, the psychometric properties of the translated versions of the HLS-COVID-Q22 should be compared using Rasch analysis.

Design and psychometrics of a tool for measuring social cognitive factors related to the preventive behaviors toward Covid-19 in the society

AbstractWith the emergence of new strains of Covid-19, the adoption of preventive behaviors is still considered a requirement to control this disease. Therefore, considering the importance of social cognitive factors in adopting various types of preventive behaviors, the present study was conducted to design and psychometrically measure the social cognitive factors related to Covid-19 preventive behaviors. A cross-sectional study was conducted on 526 people ages 18 and over with multi-stage stratified, cluster and random sampling in Isfahan, Iran in 2022. The questionnaire was validated and formulated in three stages: designing, creating and reducing items. After collecting information and creating a bank of items, qualitative and quantitative methods were used to calculate the tool’s validity. Data analysis was done in SPSS23 software at a significance level of less than 0.05. In the present study, the average age score of the participants was 39.16 ± 11.48. The results related to the construct validity in the exploratory part show that the five factors (Outcome expectations, self-efficacy, social support, self-regulation and barrier self-efficacy) obtained have a specific value higher than one and range from 1.376 to 9.343. Correlation between factors shows that all factors have a relatively high relationship with each other (P < 0.05). According to the exploratory factor analysis, the final questionnaire contains 29 items and 5 constructs from socio-cognitive theory. The results showed that the thematically and technically designed tool has been prepared in an appropriate way for each of the structures and can accurately measure the structures of outcome expectations, self-efficacy, social support, self-regulation and barrier self-efficacy to explain the preventive behaviors of Covid-19 to evaluate.

Constructing General Human Agency Indicators (GHAIs) and a General Personal Agency Scale (GPAS)

AbstractDespite its importance for the social sciences, human agency remains an ambiguous and underoperationalized construct. After engaging prior research to articulate clear criteria for defining agency and synthesize a multidimensional conceptual framework for human agency, this study develops and validates preliminary General Human Agency Indicators (GHAIs) to measure subconstructs within that framework. Utilizing the Midlife in the United States (MIDUS) dataset, we aggregated a list of 30 survey items previously used in agency research and conducted an iterative process of exploratory factor analysis (EFA) and item elimination to reduce that list to a set of 9–13 items with a strong, consistent factorial structure. Using confirmatory factor analysis (CFA), we identified two bifactor models that demonstrated good fit: a nine-item General Personal Agency scale (GPAS) and a nine-item GHAIs tool combining six items from the GPAS with three measuring agency achievement. Initial evidence for the construct validity of the tools was produced through tests of internal consistency and correlational analysis, indicating that the proposed GPAS and GHAIs effectively measure personal agency, intrinsic agency, instrumental agency, and agency achievement.

Evidence of validity of the Head-Toes-Knees-Shoulders Revised (HTKS-R) for Brazilian children

ABSTRACT This study aims to examine the reliability and validity of the Head-Toes-Knees-Shoulders Revised (HTKS-R) as a measure of self-regulation in Brazilian children aged 3–5. The early childhood period is crucial for laying the foundations for personal, social and cognitive functioning, influencing development throughout life. Self-regulation, a malleable construct, plays a vital role in academic performance and behaviors throughout life. The HTKS-R, a widely used measure, assesses behavioral self-regulation, including cognitive flexibility, working memory and inhibitory control. The study included 379 children between the ages of 3 and 5 from a variety of backgrounds. Data were collected using the HTKS-R, a standardized self-report measure that integrates executive functions into a game to assess self-regulation. Exploratory Graphical Analysis (EGA) and Confirmatory Factor Analysis (CFA) were employed to analyze the data. The results of the EGA and BootEGA indicated a unidimensional structure for the HTKS-R, confirming its internal consistency and stability. The CFA supported the fit of the unidimensional model, demonstrating the test’s construct validity. The HTKS-R showed factorial invariance between genders. The results suggest that the HTKS-R is a reliable and valid measure of self-regulation in Brazilian children aged 3–5. The applicability of the test in different age groups and environments provides valuable information about children’s self-regulation skills. The study contributes to the literature by validating the HTKS-R in the Brazilian context and highlights its potential for assessing self-regulation in diverse populations.

Development and validation of a questionnaire to measure educational agility: a psychometric assessment using exploratory factor analysis

BackgroundTo effectively navigate the growing complexities and rapid changes in today’s environment, universities must cultivate agility among their members. Over the past decade, students have encountered a variety of experiences related to E-Learning and the provision of educational services through electronic platforms. This study aimed to develop and validate a Questionnaire of Educational Agility (QEdu-Agility) to assess the capacity of educational institutions to adapt to these evolving demands.MethodThis survey research aimed to validate QEdu-Agility. The statistical sample consisted of 372 students from Shiraz University of Medical Sciences in Iran, who had completed at least one academic year online during the COVID-19 pandemic in 2022. Participants were selected using the Cochran formula. The initial questionnaire was based on three standard instruments related to organizational agility and adapted for educational contexts. After establishing face and content validity, the preliminary version was validated by a focus group of five educational experts, comprising 30 items across five dimensions: responsiveness, adequacy, flexibility, speed, and integrity, measured on a 5-point Likert scale. To confirm the construct validity, the questionnaire was randomly distributed to students via email. Data analysis was conducted using Exploratory Factor Analysis (EFA) with varimax rotation, employing SPSS 24 software.ResultsThe content validity was confirmed with Content Validity Ratio (CVR) = 0.847, Content Validity Index (CVI) = 0.877, and the reliability with internal consistency was confirmed with R = 0.944. The CVI sub-components for relevance, clarity, and simplicity were obtained as 0.867, 0.853, and 0.847, respectively. According to EFA, the sample adequacy was confirmed with Kaiser-Meyer-Olkin (KMO) index = 0.928 and significant Bartlett’s test (P < 0.001). The total variance explained of the QEdu-Agility was about 60%. The first component of responsiveness accounted for 38.79% of the variance, followed by adequacy (7.99%), flexibility (5.17%), speed (3.91%), and integrity (3.57%) in subsequent components.ConclusionThe findings of the construct validity indicated a good fit of the QEdu-Agility. Given that the concept of agility is highly contingent on the context, this tool could be retested for measuring educational agility in educational organizations, such as universities.

Reliability and Construct Validity of the Work Rehabilitation Questionnaire Domains in Patients with Persistent Low Back Pain

Abstract Purpose The Work Rehabilitation Questionnaire (WORQ) assesses patient functioning, including psychological, physical, and cognitive limitations. This study evaluates the WORQ domains in individuals with persistent low back pain (LBP), focusing on reliability and construct validity. Methods Individuals aged 18–65 with LBP completed WORQ and the workability index single item. A subgroup undertook sit-to-stand and 6-min walking tests and re-evaluated WORQ after 14 days. Reliability was assessed through internal consistency (McDonald’s omega and Cronbach’s alpha), test–retest reliability, and smallest detectable change. Construct validity was analyzed via Spearman’s rank correlation and known group validity, with physical functioning also examined against sit-to-stand and 6-min walk test results for sensitivity/specificity. Floor and ceiling effects were assessed through classical and scale width methods. Results Of 425 participants, 149 completed physical tests, and 102 re-assessed WORQ. McDonald’s omega and Cronbach’s alpha indicated high internal consistency (0.92–0.96) with strong test–retest reliability (intraclass-correlation coefficients: 0.74–0.82). The smallest detectable change ranged from 4.62 to 7.82. Predictions from 7 out of 8 hypotheses were confirmed. Notable differences in domain scores were observed based on disability level and sick leave status, with varied diagnostic performance in physical functioning items. Potential floor effects were noted using the scale width method. Conclusions The WORQ demonstrated good reliability and satisfactory validity in assessing work-related functioning in individuals with persistent LBP. These findings support its use as a comprehensive tool for evaluating psychological, physical, and cognitive limitations. However, varied diagnostic performance in physical functioning items and potential floor effects suggest cautious interpretation in diverse clinical settings.

Psychometric and network analysis of kinesiophobia in Iranian surgical patients

Kinesiophobia, the fear of movement, can significantly impede an individual’s ability to engage in daily activities. This fear often stems from past traumatic experiences or witnessing others in pain, leading to an increased fear of injury. This study aimed to evaluate the psychometric properties of the Persian version of the Tampa Scale for Kinesiophobia among Iranian post-surgery patients. A methodological study conducted in 2023 involved a sample of 400 post-surgery patients selected through convenience sampling. The translated scale underwent psychometric evaluation, including network analysis, exploratory and confirmatory factor analysis for construct validity, as well as assessments for convergent and discriminant validity. Internal consistency of the scale was also assessed. The mean age of the participants was 44.38 (SD = 13.49) years and the majority of them (77.8%) were women. Exploratory factor analysis with Promax rotation identified two factors explaining 60.28% of the variance, comprising 17 items. The final model was confirmed after necessary adjustments in confirmatory factor analysis. Both convergent and discriminant validity were established, and alpha and omega coefficients of the subscales were above 0.7. The Persian version of the Tampa Scale for Kinesiophobia showed robust psychometric properties among Iranian post-surgery patients, serving as a valuable tool for evaluating and addressing kinesiophobia in this population. These findings enhance the understanding and management of kinesiophobia within the Iranian healthcare context.

Validity and reliability of the short-form adolescent health promotion scale among adolescents and young adults in Ghana: methodological study

Background and aimAssessing health promotion among adolescents and young adults is vital to identify healthy and unhealthy behaviours as well as to evaluate health promotion interventions. However, there is no valid and reliable scale to assess health promotion among Ghanaians. For the first time, this study determined the validity and reliability of the original version of the Short‐Form Adolescent Health Promotion (AHP) scale among adolescents and young adults in Ghana.MethodThis cross-sectional methodological study included 617 adolescents and young adults within Kwame Nkrumah University of Science and Technology (KNUST) in Kumasi, Ghana. A well-structured questionnaire was used to collect sociodemographic data from study participants. The AHP-Scale was also used to collect data on participants health promoting behaviors. The scale’s validity was evaluated using Kaiser-Meyer-Olkin (KMO), Bartlett’s test of sphericity and Exploratory Factor Analysis (EFA), whilst the reliability was assessed using the Cronbach’s ɑ coefficient. Statistical analysis was performed using SPSS software version 26.ResultsThe KMO and the Bartlett’s test of sphericity were reported to be 0.899 and χ2 (276) = 6682.338 respectively, allowing for EFA with orthogonal rotation. The EFA revealed five factors covering 54.62% of the total variance. The factor loading order of the items did not exactly correspond to the order obtained in the original version of the scale’s validity analysis as the original scale had six factors. This six-factor loading scale was valid in regards to construct validity. The obtained factors included: life appreciation, exercise, stress management, nutrition, and social support. In this current study, Cronbach’s ɑ was calculated at 0.87 for the whole scale and between 0.71 and 0.92 for its subscales. Thus, indicating the current scale reliable.ConclusionThe six-factor loading scale of the Adolescent Health Promotion scale developed in the present study is acceptable for the validity and reliability assessment. However, the construct validity of this scale should be checked in other samples as it did not cover a large variance of the population. Large population wide studies are also needed to augment the current study findings with additional modifications for the adopted AHP scale.

Chronic corticosterone exposure causes anxiety- and depression-related behaviors with altered gut microbial and brain metabolomic profiles in adult male C57BL/6J mice

Chronic exposure to glucocorticoids in response to long-term stress is thought to be a risk factor for major depression. Depression is associated with disturbances in the gut microbiota composition and peripheral and central energy metabolism. However, the relationship between chronic glucocorticoid exposure, the gut microbiota, and brain metabolism remains largely unknown. In this study, we first investigated the effects of chronic corticosterone exposure on various domains of behavior in adult male C57BL/6J mice treated with the glucocorticoid corticosterone to evaluate them as an animal model of depression. We then examined the gut microbial composition and brain and plasma metabolome in corticosterone-treated mice. Chronic corticosterone treatment resulted in reduced locomotor activity, increased anxiety-like and depression-related behaviors, decreased rotarod latency, reduced acoustic startle response, decreased social behavior, working memory deficits, impaired contextual fear memory, and enhanced cued fear memory. Chronic corticosterone treatment also altered the composition of gut microbiota, which has been reported to be associated with depression, such as increased abundance of Bifidobacterium, Turicibacter, and Corynebacterium and decreased abundance of Barnesiella. Metabolomic data revealed that long-term exposure to corticosterone led to a decrease in brain neurotransmitter metabolites, such as serotonin, 5-hydroxyindoleacetic acid, acetylcholine, and gamma-aminobutyric acid, as well as changes in betaine and methionine metabolism, as indicated by decreased levels of adenosine, dimethylglycine, choline, and methionine in the brain. These results indicate that mice treated with corticosterone have good face and construct validity as an animal model for studying anxiety and depression with altered gut microbial composition and brain metabolism, offering new insights into the neurobiological basis of depression arising from gut-brain axis dysfunction caused by prolonged exposure to excessive glucocorticoids.

Construction and content validity of the Brazilian Portuguese Reading and Writing Neuropsychological Instruction program for early grades.

Construction and content validity of the Brazilian Portuguese Reading and Writing Neuropsychological Instruction program for early grades.

Evaluating the Diagnosis of Malnutrition Based on Global Leadership Initiative on Malnutrition (GLIM) Criteria in Community-Dwelling Older Adults (Singapore Longitudinal Aging Study)

Background: A minority of studies using the GLIM criteria for malnutrition diagnosis have performed formal empirical validation. Objectives: To evaluate the concurrent and predictive validity of GLIM criteria with and without prior screening among community-dwelling older adults in Singapore. Method: In the Singapore Longitudinal Aging Study (SLAS-2, n = 2477), malnutrition was diagnosed using single-step and two-step GLIM procedures using the Mini Nutritional Assessment Short Form (MNA-SF) and Elderly Nutritional Index for Geriatric Malnutrition Assessment (ENIGMA) for initial screening. Criterion validity was evaluated using MNA-Full Form (MNA-FF) as reference malnutrition diagnosis. Prognostic validity was evaluated using logistic and Cox regression analyses with respect to impaired quality of life (QoL) and 10-year mortality. Results: GLIM malnutrition with and without MNA-SF or ENIGMA screening showed significant associations with known clinical correlates; single-step GLIM malnutrition: sensitivity = 80%, specificity = 83%; two-step MNA-SF-GLIM malnutrition: sensitivity = 80%, specificity = 85%; two-step ENIGMA-GLIM malnutrition: sensitivity = 74%, specificity = 88%; positive predictive values of around 20% and negative predictive values above 98%. Cohen’s kappa values of agreement were uniformly low (0.26 to 0.32). All showed significant associations with about 50% increased odds of impaired QoL and 10-year mortality, adjusted for age, sex, ethnicity, education levels, and housing type, with the ENIGMA-GLIM malnutrition showing the highest risk estimates. Compared to MNA-FF malnutrition prevalence of 4.1%, GLIM-based malnutrition increased prevalence (14.6% to 19.7%) estimates. Conclusions: The GLIM criteria showed good construct and criterion validity. It increased the number of individuals diagnosed with malnutrition. The agreement between diagnoses of malnutrition was low. Diagnostic and prognostic accuracy vary with the screening instrument used. Early identification of malnutrition using appropriate tools can provide opportunities to delay or prevent the risk of important adverse outcomes such as impaired QoL and mortality.

Translation, reliability, and validity of the German version of the Activity Patterns Scale (APS) in musculoskeletal pain: a methodological study

In musculoskeletal pain (MSP), pain duration, disability, and mental health relate to how a person engages in daily activities. The self-reporting questionnaire Activity Patterns Scale (APS) assesses these activity patterns and their subscales: Pacing (Pacing to increase activity levels,Pacing to conserve energy for valued activities,Pacing to reduce pain); Avoidance (Pain avoidance,Activity avoidance); Pacing (Excessive persistence, Task-contingent persistence, Pain-contingent persistence). This investigation translated the APS into German and estimated its internal consistency, test-retest reliability, and construct validity. The APS translation was conducted following international guidelines for the transcultural adaptation of self-reported measures. For the construct validity, the Avoidance Endurance Fast-Screening (AE-FS), Tampa Scale of Kinesiophobia (TSK), and Coping Strategies Questionnaires (CSQ) scales were employed. Sixty-five participants with MSP contributed to a baseline survey with a follow-up at two weeks. The German version of the APS subscales demonstrated good internal consistency (Cronbach’s alpha = 0.670-0.89) and satisfactory test-retest reliability (intraclass correlation coefficient = 0.72-0.82); only Task-contingent persistence revealed a poor result. Construct validity was supported by significant correlations between APS subscales (pacing, avoidance, persistence) with related measures, including the Coping Strategies Questionnaire (0.27 to 0.40; -0.50 to 0.55; 0.27 to 0.50), the Tampa Scale for Kinesiophobia (0.28 to 0.47; 0.36 to 0.37; 0.38), and Avoidance-Endurance Fast Screening Pain Persistence Scale (none; none; 0.40). The findings demonstrate high construct validity by the substantial correlations in the predicted directions for the APS subscales and their corresponding questionnaires. The German version of the APS is a reliable and valid tool for assessing activity pattern subscales in individuals with MSP. This distinction could refine research and customize treatment instructions to regulate people’s activity in clinical practice.

The vague language use scale: Clinical utility and psychometrics from adults with traumatic brain injury.

Pragmatic communication difficulties encompass many distinct behaviours, including the use of vague and/or insufficient language, a common characteristic following traumatic brain injury (TBI) that negatively impacts psychosocial outcomes. Existing assessments evaluate pragmatic communication broadly, often with only one or two items capturing each behaviour, thus limiting sensitivity and precision to variations within each behaviour. Given that greater nuance is needed to detect subtle pragmatic communication differences and investigate underlying cognitive mechanisms, a more refined measure is critical to improve psychosocial outcomes. The Vague scale was developed to address those needs. To provide preliminary evidence supporting the novel Vague language use (Vague) scale's reliability, validity and clinical utility. The Vague scale rates each discourse sample utterance for vague language use on a 3-point scale; the measure's Vague score represents the mean of utterance-level ratings. Using the Vague scale, two raters naïve to diagnosis evaluated Cinderella narratives of 46 adults with severe TBI and 46 controls with no brain injury, providing reliability, construct validity and classification accuracy evidence. Vague scores were also compared to other clinical measures to gather criterion-related validity evidence. Interrater agreement across all transcripts was moderate. Construct validity was supported by expected group differences and criterion validation, including significant relationships with increased violations of Grice's maxim of quantity and measures of lexical variation; significant relationships with psychosocial outcomes, supporting clinical utility; and nonsignificant relationships with measures of syntax and overall pragmatic communication. Classification accuracy expectedly did not support using Vague scores in isolation for diagnosis, due to unacceptable sensitivity (0.696). Evidence supported the Vague scores' psychometric properties. Thus, the Vague scale shows promise as a measure of one distinct pragmatic communication behaviour: vague language use. Future research should apply the Vague scale to determine its sensitivity in individuals with subtle social communication challenges (e.g., mild TBI), explore its utility with more naturalistic discourse samples as part of a pragmatic communication battery, longitudinally examine changes in Vague scores, and investigate cognitive mechanisms underlying this specific pragmatic communication behaviour. What is already known on this subject Use of vague language is common following traumatic brain injury (TBI) and may contribute to negative psychosocial outcomes related to employment and relationships. However, existing measures of vague language lack sensitivity and precision, limiting their utility for identifying subtle performance variations or determining the cognitive mechanisms underlying this specific pragmatic communication behaviour. What this study adds to existing knowledge The current study gathered promising reliability, validity and clinical utility evidence to support using the novel Vague language use (Vague) scale, which was developed to address these limitations. Based on complex (Cinderella) stories of adults with and without TBI, Vague scores demonstrated moderate interrater agreement and promising construct validity based on expected group differences and criterion validation, including moderate associations with related constructs and weak associations with unrelated constructs. Because pragmatic communication profiles post-TBI can vary, classification accuracy expectedly indicated that Vague scores should not be used alone to identify communication differences post-TBI. What are the clinical implications of this work? Vague scores show promise for documenting clients' use of vague language and planning intervention to address associated discourse-level challenges. Future research should investigate applying the Vague scale to naturalistic discourse samples (1) as part of a battery that sensitively and precisely identifies pragmatic communication differences and (2) as a tool for investigating cognitive mechanisms underlying vague language use, with the goal of improving interventions that support pragmatic communication and enhance psychosocial outcomes.

A case study of the development of a valid and pragmatic implementation science measure: the Barriers and Facilitators in Implementation of Task-Sharing Mental Health interventions (BeFITS-MH) measure

BackgroundFew implementation science (IS) measures have been evaluated for validity, reliability and utility – the latter referring to whether a measure captures meaningful aspects of implementation contexts. We present a real-world case study of rigorous measure development in IS that assesses Barriers and Facilitators in Implementation of Task-Sharing in Mental Health services (BeFITS-MH), with the objective of offering lessons-learned and a framework to enhance measurement utility.MethodsWe summarize conceptual and empirical work that informed the development of the BeFITS-MH measure, including a description of the Delphi process, detailed translation and local adaptation procedures, and concurrent pilot testing. As validity and reliability are key aspects of measure development, we also report on our process of assessing the measure’s construct validity and utility for the implementation outcomes of acceptability, appropriateness, and feasibility.ResultsContinuous stakeholder involvement and concurrent pilot testing resulted in several adaptations of the BeFITS-MH measure’s structure, scaling, and format to enhance contextual relevance and utility. Adaptations of broad terms such as “program,” “provider type,” and “type of service” were necessary due to the heterogeneous nature of interventions, type of task-sharing providers employed, and clients served across the three global sites. Item selection benefited from the iterative process, enabling identification of relevance of key aspects of identified barriers and facilitators, and what aspects were common across sites. Program implementers’ conceptions of utility regarding the measure’s acceptability, appropriateness, and feasibility clustered across several common categories.ConclusionsThis case study provides a rigorous, multi-step process for developing a pragmatic IS measure. The process and lessons learned will aid in the teaching, practice and research of IS measurement development. The importance of including experiences and knowledge from different types of stakeholders in different global settings was reinforced and resulted in a more globally useful measure while allowing for locally-relevant adaptation. To increase the relevance of the measure it is important to target actionable domains that predict markers of utility (e.g., successful uptake) per program implementers’ preferences. With this case study, we provide a detailed roadmap for others seeking to develop and validate IS measures that maximize local utility and impact.

Validity of the Oral Hygiene Ability Instrument (OHAI).

To evaluate the validity of the newly developed Oral Hygiene Ability Instrument (OHAI), created to assess the cause of any inability of older adults to perform oral hygiene, and to revise the instrument based on the results. Good oral hygiene is among the most important prophylactic measures for oral health. This applies especially to older adults, among whom risk factors and physical and cognitive barriers are more common and can hamper oral hygiene. The OHAI contains (I) an interview, (II) clinical examination, (III) observation of oral hygiene activities and a summarising part. In the study, 149 older adults in three groups participated: stroke, cognitive disorder and general dental patients. Inclusion criteria were to be ≥65 years old, have at least one tooth and to manage oral hygiene without assistance. For criterion validity, sensitivity and specificity were calculated using eight reference instruments. To determine construct validity, we used known group validity, factor analysis and Rasch analysis. The criterion and construct validity of the OHAI were found to be acceptable to good. In the stroke group, balance and fine motor skills were assessed to affect oral hygiene most; in the cognitive disorder group, it was balance, coordination, spatial ability and cognitive functions. Analyses revealed that one item had no added value and that some response options were not optimal. The OHAI proved to be valid for the group it is intended for, with only minor revisions needed, resulting in a 32-item instrument. The OHAI could be a valuable person-centred tool in prophylactic work with older adults with failing oral hygiene.

Chinese translation and validation of the Personalized Psychological Flexibility Index (PPFI) for medical college students

BackgroundPsychological flexibility (PF) is defined as the ability to pursue valuable life goals despite the existence of distress. The Personalized Psychological Flexibility Index (PPFI) is a new measure of psychological flexibility that can address existing deficiencies. This study aimed to translate and validate the psychometric characteristics of the Chinese version of the PPFI among medical college students.MethodsThe study was conducted in two phases. Phase 1 involved the translation and cross-cultural adaptation of the PPFI according to guidelines recommended by the International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Phase 2 was a cross-sectional survey conducted on 945 medical college students in China. The psychometric performances of the scale were assessed using construct validity, divergent validity, criterion validity, incremental validity, internal consistency, and test-rest reliability.ResultsThe exploratory factor analysis (EFA, n1 = 440) showed that the Chinese version of the PPFI consisted of 3 factors, with a total of 15 items. The confirmatory factor analysis (CFA, n2 = 440) showed that the three-factor structure fit well (χ2/df\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$df$$\\end{document}=2.469, SRMR = 0.051, RMSEA = 0.058, GFI = 0.94, CFI = 0.985). The total Chinese PPFI score had a moderate positive association with the Comprehensive Assessment of Acceptance and Commitment Therapy (CompACT, r = 0.344) and a negative association with the Acceptance and Action Questionnaire-II (AAQ-II, r = -0.334). Furthermore, the Chinese PPFI demonstrated good internal consistency (Cronbach's α = 0.826) and test–retest reliability (ICC = 0.817, p < 0.001).ConclusionThe 15-item Chinese version of the PPFI is a reliable and valid tool for measuring PF in Chinese medical students. However, additional studies are needed to validate its psychometric properties in more generalizable samples and other contexts.

Psychometric evaluation and measurement invariance of the problematic smartphone use scale among college students: A national survey of 130 145 participants.

Given the insufficient validation of previously imported smartphone addiction scales in China, this study revised and evaluated the Problematic Smartphone Use Scale among Chinese college students (PSUS-C). We based our research on a national sample comprising 1324 higher education institutions and 130 145 participants. Using cross-sectional data, comprehensive methods were employed to examine validity, reliability and measurement invariance. The final scale consists of 20 items across four dimensions: withdrawal and loss of control, negative impact, salience behaviors and excessive use. All Heterotrait-Monotrait (HTMT) values were below 0.85, and the lower 90% and upper 95% confidence intervals were also below 0.85, except for factors 1 and 3. The amount of variance (AVE) values were greater than 0.5, composite reliability (ω) values exceeded 0.89 and all factor loadings were above 0.5. The criterion validity was supported as expected: problematic smartphone usage positively correlated with depression (r = 0.451), loneliness (8 items, r = 0.455), loneliness (6 items, r = 0.504), social media use (r = 0.614) and phone usage duration (r = 0.148); and negatively correlated with life satisfaction (r = -0.218) and self-esteem (r = -0.416). Across sex, type of university and place of residence, the measurement invariance performed well, with most changes in root mean square error of approximation (ΔRMSEA), comparative fit index (ΔCFI) and Tucker-Lewis index (ΔTLI) values being less than 0.005, and no indicator showing a difference greater than 0.010. The Problematic Smartphone Use Scale for College Students (PSUS-C) demonstrated good factor structure, internal consistency, construct validity, discriminant validity and criterion validity. Strict and structural invariance were demonstrated across sex, type of university and place of residence. The PSUS-C has the potential to assess smartphone addiction among Chinese university students.

Measuring validity and reliability of the Italian version of Physical Activity Questionnaire for Older Children in overweight and obese children

The measure of daily physical activity (PA) is one of the most important topics in the field of health promotion. In addition, self-efficacy and enjoyment are significant factors that can foster adherence to physical activity during a person’s lifetime. The present study aims to assess the validity and reliability of Physical Activity Questionnaire for Older Children-Italian version (PAQ-C-It) in a sample of normal weight, overweight, and obese children. Three studies were conducted to assess the (1) general characteristics of PAQ-C-It, (2) model fit and construct validity between PA, self-efficacy, and enjoyment, and (3) reliability and construct validity of PAQ-C-It in normal weight, overweight, and obese children. The sample involved a total of 914, 500, and 600 children (male = 466, female = 448) attending first grade of secondary school (age = 11–13 years), in the first, second and third study, respectively. Children were asked to respond to three scales: Physical Activity Questionnaire for Older Children (PAQ-C-It), the Perceived Physical Ability Scale (PPAS), and Physical Activity Enjoyment Scale (PACES). Then, explorative and confirmatory factor analyses were conducted to assess the validity and reliability of the PAQ-C-It by relating results with those of the other scales. The analysis showed acceptable value and internal consistency of items for the subscales (α &amp;gt; 0.7), as well as the average variance extracted (&amp;gt;0.5) in both normal weight, overweight, and obese children. The results of the present study show that PAQ-C-It can be applied in the field of physical activity to measure adherence to physical activity and healthy behaviors. Moreover, self-efficacy and enjoyment are significant factors that can best promote adherence to PA. The present study can extend our knowledge about PAQ-C-It and open up new research avenues for driving interventions aimed at reducing sedentary behavior and improving PA in overweight and obese children.

Translate and cross-culturally adapt the original English version of the lower extremity functional scale into the Sinhalese version

Objectives: Functional ability is critical for quality of life (QOF), and its evaluation is vital in a clinical context. However, there is a deficiency of a universally recognized grading scale in Sinhala for assessing functional capacity in athletes with lower extremity musculoskeletal conditions. This research aimed to validate the linguistic and cross-cultural adaptation of a translated Sinhala version of the lower extremity functional scale (S-LEFS). Materials and Methods: A two-stage observational study was conducted. The lower extremity functional scale was cross-culturally adapted to Sinhala through independent, double forward, and backward translation. An experienced clinical researcher tested the translated version to establish the linguistic validation of S-LEFS. The finalized version was validated for construct, convergent, and criterion validity. A total of 112 participants, comprising 57 healthy (50.89%) and 55 unhealthy (49.11%) lower limb athletes, completed S-LEFS. Results: S-LEFS demonstrated excellent reliability with a Cronbach’s alpha of 0.952. Exploratory factor analysis revealed good factor loadings (&gt;0.48) for all 20 items, with three components accounting for 70.63% of cumulative variance. Scale got a sensitivity of 87.5% and specificity of 81% at a cutoff point of 67.5. Kaiser-Meyer-Olkin (KMO) value was 0.918 (P &lt; 0.0001), and Bartlett’s Test of Sphericity was significant (P &lt; 0.01). No correlation was detected between S-LEFS and World Health Organization QOF-Bref (r = 0.281). Conclusion: S-LEFS is a reliable and valid tool for evaluating lower limb function in athletes.