Item-level Content Validity Index Research Articles

Contextualizing the revised Patient Perception of Patient-Centeredness (PPPC-R) scale in primary healthcare settings: a validity and reliability evaluation study

BackgroundAn English version of the Patient Perception of Patient-Centeredness (PPPC) scale was recently revised, and it is necessary to test this instrument in different primary care populations.AimThis study aimed to assess the validity and reliability of a Chinese version of the PPPC scale.DesignA mixed method was used in this study. The Delphi method was used to collect qualitative and quantitative data to address the content validity of the PPPC scale by calculating the Content Validity Index, Content Validity Ratio, the adjusted Kappa, and the Item Impact Score. Confirmatory factor analysis (CFA) and exploratory factor analysis (EFA) were used to assess the construct validity of the PPPC scale through a cross-sectional survey. The internal consistency was also assessed.Setting/participantsIn the Delphi consultation, seven experts were consulted through a questionnaire sent by email. The cross-sectional survey interviewed 188 outpatients in Guangzhou city and 108 outpatients in Hohhot City from community health service centers or stations face-to-face.ResultsThe 21 items in the scale were relevant to their component. The Item-level Content Validity Index for each item was higher than 0.79, and the average Scale-level content validity index was 0.97 in each evaluation round. The initial proposed 4-factor CFA model did not fit adequately. Still, we found a 3-factor solution based on our EFA model and the validation via the CFA model (model fit: {chi }^{2}=294.573, P < 0.001, RMSEA = 0.044, CFI = 0.981; factor loadings: 0.553 to 0.888). Cronbach's α also indicated good internal consistency reliability: The overall Cronbach's α was 0.922, and the Cronbach's α for each factor was 0.851, 0.872, and 0.717, respectively.ConclusionsThe Chinese version of the PPPC scale provides a valuable tool for evaluating patient-centered medical service quality.

The validity and reliability of the Persian version of the Athlete Sleep Screening Questionnaire.

Sleep as a biological phenomenon is effective in the performance and recovery of athletes. Questionnaires can be used as a cost-effective initial assessment tool for sleep. The Athlete Sleep Screening Questionnaire (ASSQ) demonstrated a clinically valid instrument for screening relevant sleep issues in athletic populations. Due to the lack of validated tools for adequate screening for sleep difficulties in the Iranian athlete population, the present study was conducted to evaluate the validity and reliability of the Persian version of the ASSQ. The translation process was performed using instructions by Beaton et al. Content validity was assessed by a panel of experts. Exploratory and confirmatory factor analysis was performed for two 5-item sleep difficulty scores (SDS) and a 4-item chronotype score. Internal consistency based on Cronbach's alpha and McDonald's omega and stability reliability were used to evaluate reliability. The ASSQ achieved conceptual and semantic equivalence with the original scale. The item-level content validity index (I-CVI) of each item ranged from 0.87 to 1, and the averaging scale-level CVI/average was 0.95. In factor analysis, one factor for SDS and one factor for chronotype score were identified and confirmed. The internal consistency of the SDS scale (α =0.77, Ω =0.83) and chronotype (α =0.74, Ω =0.77) was acceptable. Stability reliability was confirmed for SDS scale (intra-class correlation [ICC] =0.87) and for chronotype (ICC = 0.83). Persian ASSQ has acceptable psychometric measurement properties as a screening tool to assess sleep in Iranian athletes.

Development and Validation of a Multidimensional Rehabilitation Protocol for Postmenopausal Women: A Cross-sectional Study

Introduction: Menopause is a normal aging phenomenon in women. The overall prevalence of menopausal symptoms in all domains was reported as 87.7% which includes hot flushes, cognition, autonomic nervous disorders, sleep disturbances, mood changes, anxiety, etc. Therefore, it is necessary to manage these symptoms to improve the quality of life. Aim: To develop and validate a multidimensional rehabilitation protocol for Postmenopausal women. Materials and Methods: A cross-sectional study was conducted from December 2023 to February 2024 after thorough literature review, a 45-50 minute protocol was developed which included warm-up, resistance training, cognition training followed by a cool down session. After which a Delphi survey method was employed to evaluate the content validity of the formed protocol by a multidisciplinary expert panel on the basis of relevancy. Then I-CVI (Item-level Content Validity Index) and S-CVI (Scale- level Content Validity Index) of the developed protocol was calculated. Results: The protocol has been validated by a group of multidisciplinary experts with an average experience of 9.5 years working in Department of Obstetrics and Gynaecology/Women’s Health. A total of seven experts responded and evaluated each item of the protocol and suggested modifications. The I-CVI of each item was found to be between 0.86 and 1 whereas the S-CVI by average method was found to be 0.93 which was above the satisfactory level as suggested by Lynn i.e. above 0.83. Conclusion: The above generated multidimensional rehabilitation protocol for Postmenopausal women is valid.

Reliability, Validity, Modification and Expansion of the Chinese Version of the Disease-Specific Anxiety Questionnaire for Chronic Obstructive Pulmonary Disease.

To translate a disease-specific anxiety questionnaire on chronic obstructive pulmonary disease (COPD) and test its reliability and validity in China. The German version of the revised COPD Anxiety Questionnaire (CAF-R) was initially validated using step-by-step translation, back-translation, and cross-cultural adaptation. The reliability and validity of the Chinese version of the CAF-R (CAF-R-CN) were tested among 448 patients with COPD (mean age =71.42±9.33 years, 17.2% female) from four medical institutions in Suzhou, Jiangsu Province, using convenience sampling, from April 2022 to June 2023. The CAF-R-CN included six dimensions with a total of 25 items. The item-level content validity index was 0.860-1.000; the scale-level content validity index was 0.920. The structural validity χ2/df was 2.326, the root mean square error of approximation was 0.077, the comparative fit index was 0.924, and the Tucker-Lewis index was 0.912. The six-dimensional internal consistency index Cronbach's α coefficient was 0.696-0.910, and the test-retest reliability was 0.949. An optimal cut-off score of 50.5 was selected with a sensitivity of 0.786 and specificity of 0.870. The CAF-R-CN had satisfactory reliability and validity and can be used to identify and assess anxiety in COPD patients with a Chinese cultural background.

Potential of serious games as a competency assessment tool for acute care nurses on the blood transfusion procedure

Background: Blood transfusion is a life-saving treatment that requires comprehensive knowledge and compliance to safety, administration, and management of blood transfusion process. It is a core competency for a registered nurse. Competency assessments are annually conducted as regulatory requirement and for quality assurance within our institution. Prior to using serious games, competency assessment involved an online learning module followed by a face-to-face assessment. This had limitations such as such as limited opportunities, potential lack of standardisation, time, and resources. Aim: The aim of this study was to assess whether serious game for blood transfusion administration could be a valid and reliable nursing competency assessment tool through capturing and analysis of in-game empirical data. Methods: The nursing department from Singapore General Hospital (SGH) developed a serious game for blood transfusion administration. The game modules were developed to match the actual procedure with established learning objectives at each stage. The game’s content validity was assessed by four external subject-matter-experts. Gameplay data of 1093 nurses were tested for construct validity, internal-consistency reliability, and criterion validity of the game. Results: The item-level content validity index (I-CVI) ranged between 0.75 and 1, while the average of the I-CVI scores for all items on the scale (S-CVI/Ave) was 0.99. Six factors and 82 game actions were obtained using principle factor analysis. Most game actions had a communality value (h2) above 0.5. The Inter-factor correlations between the six factors ranged from 0.2 to 0.45. Internal-consistency reliability estimates (α) (together with their 95% CIs) for the stages were greater than 0.75, with an overall of 0.96 for the 82 game actions. Linear association between each predictor and the criterion were below 0.25. Conclusion: Based on the empirical data collated, we conclude that the serious game may be a valid competency assessment tool for nurses in SGH. For future work, we propose to conduct the blood transfusion serious game in other hospitals to further support its validity and reliability as a competency tool for multi-step complex procedural clinical skills.

Translation, Cultural Adaptation, and Content Validation of a Pleural Mesothelioma Questionnaire to Portuguese Context – A Key Tool for Epidemiological Surveillance

Objective: The main objective of this study was to describe the translation, cultural adaptation, and content validation process of the French National Surveillance Programme for Pleural Mesothelioma (FNSPPM) questionnaire for the Portuguese context. Methods: A search was conducted in the PubMed database and Web of Science, in the period from January 1, 1960, to December 31, 2022, to select the questionnaire. Forward and reverse translations, calculation of the content validity index (CVI) by a panel of experts (n = 9), and cognitive interviewing with individuals with at least one exposure to asbestos (n = 10) were performed. Experts rated items on a Likert scale (1-4) based on their relevance. The item-level content validity index (I-CVI), scale-level content validity index based on the average method (S-CVI/Ave), and scale-level content validity index based on the universal agreement method (S-CVI/UA) were calculated. Results: The final version of the FNSPPM questionnaire for the Portuguese context resulted from a translation and content validation process. The panel of experts considered the questionnaire relevant, with an I-CVI of up to 0.78 in 68 of 69 of the questions, an S-CVI/Ave of 0.98, and an S-CVI/UA of 0.90. The participants in the cognitive interviews reported an understanding of the questionnaire. Conclusion: A validated FNSPPM questionnaire for the Portuguese context is now available to study individuals with pleural mesothelioma (PM) and asbestos exposure.

Hindi Translation, Validation and Testretest Reliability of The Fugl Meyer Assessment Upper Extremity Scale: A Cross-sectional Study Protocol

Introduction: Stroke, a global health concern, causes substantial mortality and disability. The Fugl Meyer Assessment Upper Extremity (FMA-UE) scale evaluates sensorimotor impairment in stroke patients. Despite Hindi’s widespread use, with over 609 million speakers worldwide, the scale lacks a Hindi version. Bridging this gap could significantly enhance stroke rehabilitation outcomes. Aim: This study aims to translate the FMA-UE scale into Hindi, validate the translated version, and determine its test-retest reliability in Hindispeaking stroke patients. Materials and Methods: Permission from the author is required before meticulously translating the FMA-UE scale into Hindi by bilingual experts. This process will involve, combining perspectives from a medical expert and a linguistic specialist. Merged translations will be back-translated into English for accuracy. Content validation via the Delphi method by an expert panel will ensure linguistic equivalence. Pretesting will gauge comprehensibility and appropriateness. Test-retest reliability will be determined through correlation coefficient calculations on patients, assessed twice with an interval. Results: Study anticipates successful translation of FMA-UE scale into Hindi with robust linguistic translation. Delphi method will be used for item assessment, calculating Item-level Content Validity Index (I-CVI). Scale-level Content Validity Index Average (S-CVI/Ave) ensures unanimity. Test-retest reliability evaluated through ICCs and Bland-Altman plots, illustrating mean scores and standard deviations across sessions, with ICC values indicating reliability and Bland-Altman plots confirming score agreement visually. Conclusion: The Hindi FMA-UE scale will aid assessment in Hindispeaking stroke populations. This protocol ensures linguistic adequacy, enhancing clinical assessment and rehabilitation strategies.

Experience of Physical Rehabilitation in Empowering Individuals Living with Parkinson’s Disease: A Qualitative Study Protocol

ntroduction: Life expectancy is good, patients live with certain problems (tremors, difficulty in activities of daily living, cognitive impairment, lack of balance etc). Although mainstay treatment requires pharmacological treatment and regular physiotherapy. So, the first-hand experience of physiotherapy matters in these individuals. Need of the study: The present protocol will explore the experience of individuals with Parkinson’s Disease (PD). It will help in exploring the patients’ physical and emotional experiences as they return to the community, their barriers, facilitators and also gaps they experience in their rehabilitation journey. Aim: To explore the experience of physical rehabilitation in empowering individuals with Parkinson’s Disease (PD). Materials and Methods: An open-ended interview guide was formed and validated by multidisciplinary experts. Both male and female above the age of 40 years, undergoing rehabilitation for atleast 6 months and having mild and moderate PD (Hoehn and Yahr stage I-III). No depression and anxiety is assessed on Hospital Anxiety and Depression scale (HADS); HADS-depression score=9, HAD-anxiety=8 will be recruited. It will have 17 open ended questions regarding the experiences after Physical Rehabilitation, Cognitive impairment’s, Activities of Daily Living (ADLs), Freezing, Balance, Facilitators, Barriers. Semi-structured interviews will be conducted and transcribed verbatim into English language, then entered into Qualitative Data Analysis (QDA) miner software for analysis. The interview guide is validated by the experts and obtained an Itemlevel Content Validity Index (I-CVI) of all items/questions of 0.84-1 while Scale-level Content Validity Index (S-CVI) by Average method and Universal agreement is 0.914 and 0.647, respectively. Results will be depicted in form of word clouds and code tree.

Preparedness and Response Strategies for Chemical, Biological, Radiological, and Nuclear Incidents in the Middle East and North Africa: An Artificial Intelligence-Enhanced Delphi Approach.

Chemical, biological, radiological, and nuclear (CBRN) incidents require meticulous preparedness, particularly in the Middle East and North Africa (MENA) region. This study evaluated CBRN response operational flowcharts, tabletop training scenarios methods, and a health sector preparedness assessment tool specific to the MENA region. An online Delphi survey engaging international disaster medicine experts was conducted. Content validity indices (CVIs) were used to validate the items. Consensus metrics, including interquartile ranges (IQRs) and Kendall's W coefficient, were utilized to assess the panelists' agreement levels. Advanced artificial intelligence computing methods, including sentiment analysis and machine-learning methods (t-distributed stochastic neighbor embedding [t-SNE] and k-means), were used to cluster the consensus data. Forty experts participated in this study. The item-level CVIs for the CBRN response flowcharts, preparedness assessment tool, and tabletop scenarios were 0.96, 0.85, and 0.84, respectively, indicating strong content validity. Consensus analysis demonstrated an IQR of 0 for most items and a strong Kendall's W coefficient, indicating a high level of agreement among the panelists. The t-SNE and k-means identified four clusters with greater European response engagement. This study validated essential CBRN preparedness and response tools using broad expert consensus, demonstrating their applicability across different geographic areas.

Development and Validation of an Instrument for Upper Cross Syndrome: A Cross-sectional Study

Introduction: A sedentary lifestyle causes muscular imbalances and may lead to upper cross syndrome. This syndrome occurs due to the muscular imbalance of tonic and phasic muscles. If left unidentified for long duration can lead to secondary complications. There is a paucity of reliable and valid tools to identify this syndrome. Aim: To develop a valid and reliable tool to identify upper cross syndrome. Materials and Methods: This cross-sectional study was conducted at the Amity Institute of Health Allied Sciences, Department of Physiotherapy, Amity University, Noida, Uttar Pradesh, India, from November 2023 to March 2024. The instrument for upper cross syndrome is a self-designed tool. After an extensive literature review and focus group discussions, items were identified, and rounds of Delphi were held until an agreement was reached. The psychometric properties of the instrument were assessed by content validity, construct validity, and reliability. The instrument was tested on 240 patients with upper cross syndrome. Statistical analysis for construct validity was done by exploratory factor method with principal component analysis and varimax rotation. Test-retest reliability and Cronbach’s alpha were calculated for reliability analysis. Results: The final version of the draft consisted of 20 items with satisfactory item-level Content Validity Index (I-CVI≥0.78) and scale-level Content Validity Index (S-CVI=0.90). Seven domains were identified, including postural alignment, movement patterns, muscle imbalance, joint dysfunction, pain, functional limitations, and psychosocial factors, with a total variance of 60.11% and good internal consistency (Cronbach’s alpha=0.81). Conclusion: This work contributes to the development of a novel, valid, and reliable technique for the identification of upper cross syndrome. Healthcare providers will find this tool useful in promoting health and creating an early rehabilitation plan, both of which will aid in the prevention of subsequent complications.

Psychometric Properties of Chinese Version of the Barriers to Error Disclosure Assessment (C-BEDA) Tool.

The Barriers to Error Disclosure Assessment (BEDA) tool is used to measure barriers to the disclosure of medical errors by healthcare professionals. This study aimed to evaluate the psychometric properties of the Chinese version of the BEDA (C-BEDA). The culture of disclosure and transparency in response to medical errors has been recommended in recent years. However, there are no relevant assessment tools for measuring barriers to disclosing medical errors in China. The C-BEDA tool underwent translation, back translation, cross-cultural adaptation in a pilot study. It was tested with 1254healthcare professionals in Guizhou and Sichuan Provinces, China. The content validity index (CVI) was used to evaluate the content validity of the C-BEDA, and exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to evaluate its structural validity. The Cronbach's α coefficient and test-retest reliability were evaluated to determine its reliability. Three factors were extracted by EFA that explained 65.892% of the total variance of the C-BEDA tool. CFA showed a good fit for a three-factor structure with acceptable values: goodness-of-fit index=0.939; adjusted goodness-of-fit index=0.911; incremental fit index=0.967; comparative fit index=0.967; partial least squares path modeling for confirmatory factor analysis=0.735; and root mean square error of approximation=0.058. The item-level content validity index ranged from 0.86 to 1.00, and the average scale-level content validity index was 0.98. The Cronbach's α coefficient (0.909) and test-retest reliability (0.86) were acceptable. The C-BEDA toolis a valid and reliable tool for assessing the extent of barriers to error disclosure among Chinese healthcare professionals.

Cross-Cultural Adaptation and Validation of the Malay-Translated Version of the Food Neophobia Scale for Malaysian Young Adults.

The Food Neophobia Scale (FNS) is a research instrument, originally developed in English, to assess an individual's level of food neophobia. However, it has not yet been translated and validated for Malaysians. Therefore, we aimed to translate and validate a Malay-translated version of the FNS. Respondents were 200 young adults (mostly females, 73%; and students, 82.0%; M age = 22.3years, SD = 2.3). We first translated the FNS into Malay using the forward-backward translation method, and a panel of nutrition and dietetics experts then reviewed it for item relevance, clarity, simplicity, and ambiguity. The translated FNS suggested good content validity with an item-level content validity index (I-CVI) > .8, a scale-level content validity index (S-CVI)/average = .8 and a S-CVI/universal agreement = .96. Principal component analysis revealed a two-factor model: (i) willingness and trust; and (ii) rejection and fear. Cronbach's alpha for the Malay-translated FNS was .808, demonstrating high internal consistency and reliability among young Malaysian adults. Future investigators can now use this Malay-translated FNS instrument to determine levels of food neophobia among Malaysians.

Structural Validation and Measurement Invariance Testing of the Chinese Version of the eHealth Literacy Scale Among Undergraduates: Cross-Sectional Study.

The eHealth Literacy Scale (eHEALS) was introduced in China in 2013 as one of the most important electronic health literacy measurement instruments. After a decade of development in China, it has received widespread attention, although its theoretical underpinnings have been challenged, thus demanding more robust research evidence of factorial validity and multigroup measurement properties. This study aimed to evaluate the Chinese version of the eHEALS in terms of its measurement properties. A cross-sectional survey was conducted in a university setting in China. Item statistics were checked for response distributions and floor and ceiling effects. Internal consistency reliability was confirmed with Cronbach α, split-half reliability, Cronbach α if an item was deleted, and item-total correlation. A total of 5 representative eHEALS factor structures were examined and contrasted using confirmatory factor analysis. The study used the item-level content validity index (I-CVI) and the average of the I-CVI scores of all items on the scale to assess the content validity of the dominance model. Furthermore, the validated dominance model was subsequently used to evaluate the relevance and representation of elements in the instrument and to assess measurement invariance across genders. A total of 972 respondents were identified, with a Cronbach α of .92, split-half reliability of 0.88, and item-total score correlation coefficients ranging from 0.715 to 0.781. Cronbach α if an item was deleted showed that all items should be retained. Acceptable content validity was supported by I-CVIs ≥0.80. The confirmatory factor analysis confirmed that the 3-factor model was acceptable. The measurement model met all relevant fit indices: average variance extracted from 0.663 to 0.680, composite reliability from 0.810 to 0.857, chi-square divided by the df of 4.768, root mean square error of approximation of 0.062, standardized root mean squared residual of 0.020, comparative fit index (CFI) of 0.987, and Tucker-Lewis index of 0.979. In addition, the scale demonstrated error variance invariance (Δnormed fit index=-0.016, Δincremental fit index=-0.012, ΔTucker-Lewis index=0.005, Δcomparative fit index=-0.012, Δrelative fit index=0.005, and Δroot mean square error of approximation=0.005). A 3-factor model of the Chinese version of the eHEALS fits best, and our findings provide evidence for the strict measurement invariance of the instrument regarding gender.

Validation of a Questionnaire on Knowledge and Barriers of Breast Milk Expression among Mothers of Premature Infants

This study aimed to develop and validate a Malay language questionnaire to assess mothers' knowledge in providing breast milk for premature infants, and barriers to breast milk expression while the infants are in the Neonatal Intensive Care Unit (NICU). Two tertiary hospitals in Kelantan, Malaysia participated in this cross-sectional study. Relevant items of knowledge and barriers were identified through a literature search, clinical observations, and expert opinion. Ten breastfeeding experts validated the content of the knowledge and barriers to breast milk expression questionnaire.The effectiveness of the questionnaires was tested for face validity among ten mothers, followed by reliability tests comprising 50 mothers who gave birth prematurely. The 20 knowledge items and 16 barrier items have an Item-level Content Validity Index (I-CVI) of 0.99, indicating good relevance of the knowledge and barrier items. The knowledge and barrier questionnaires had Item-level Face Validity Indexes (I-FVIs) of 1.00 and 0.99, respectively, suggesting clear and comprehensible items. The questionnaires obtained a Cronbach alpha score of 0.726 for knowledge and 0.736 for barriers, showing that they are reliable tools for assessing knowledge and breast milk expression barriers. The validity and reliability of the newly developed Malay version of the questionnaire have been established for evaluating breastfeeding knowledge and barriers to expressing breast milk among mothers with premature infants.

Development and Assessment of the Media Impact on Health Information Perception and Behavior Scale (Mihipb-S) Using Content Validity Index Method

With the omnipresence of media in the digital age, understanding its impact on individuals' health information perception and behaviors has become paramount. This study presents the meticulous development and rigorous validation of the Media Influence on Health Information Perception and Behavior Scale (MIHIPB-S) using the Content Validity Index (CVI) method. The scale development process comprised several critical phases, including item generation, expert panel formation, content validity assessment, and pilot testing. A panel of nine experts, encompassing diverse backgrounds such as psychology, public health, communication studies, and measurement development, rigorously examined each item's relevance to the construct of "Media Influence on Health Information Perception and Behavior." These experts assigned ratings on a 4-point Likert scale, ranging from "Not relevant" (1) to "Highly relevant" (4). To determine content validity, the study adhered to established recommendations for acceptable cut-off scores which were contingent upon the number of experts involved Lynn, Davis, Polit &amp; Beck, and Polit et al.2006. Various validity indices, including the Item-Level Content Validity Index (I-CVI), Scale-Level Content Validity Index based on the Average Method (S-CVI/Ave), and Scale-Level Content Validity Index based on the Universal Agreement Method (S-CVI/UA), were meticulously calculated. The outcomes of the content validity assessment were resoundingly positive. All items within the MIHIPB-S attained remarkably high I-CVI scores, significantly exceeding the established acceptable threshold. Moreover, the S-CVI/Ave, calculated as the mean of the I-CVI scores for all items, unequivocally demonstrated robust content validity (Hamie et al. Ozair et al., Lau et al., and Marzuki et al.2018. Of particular significance, the S-CVI/UA, representing the proportion of items achieving the highest relevance rating by all experts, decisively met the prescribed cut-off score. These findings unequivocally affirm the MIHIPB-S as an exceptionally valid and comprehensive instrument for capturing the complex dynamics of media's influence on health information perception and behavior. The MIHIPB-S emerges as an invaluable and validated tool poised to make substantial contributions to research, practice, and policymaking within the domains of health communication, media literacy, and public health. Its versatility extends to assessing the efficacy of media-based health interventions, evaluating the impact of media campaigns on health decision-making, and informing targeted health communication strategies. Future endeavors should explore opportunities for cross-cultural validation, longitudinal assessments, and adaptations to account for emerging media modalities.

Content and Face Validation of the Lifestyle Medicine Assessment.

Introduction: There are no validated global lifestyle medicine brief screening tools that measure health behaviors in all six lifestyle domains. The Lifestyle Medicine Assessment (LMA) tool was initially developed and revised based on feedback elicited from colleagues, experts, and patients. During the developmental process, every item underwent language changes. Three of the original 24 items were removed. However, there have not been any formal validation efforts. This study aims to formally evaluate the face and content validity of the LMA. Methods: A survey was emailed to 12 board-certified lifestyle medicine experts asking them to rank items in the LMA on a 1-4 scale for content relevance and clarity. Content and face validity were quantitatively determined using the item-level content validity index (I-CVI), scale-level content validity index (S-CVI), and item-level face validity index (I-FVI), scale-level face validity index (S-FVI), respectively. Literature accepted thresholds of I-CVI/I-FVI ≥.79 and S-CVI/S-FVI average ≥ .80 were used. Results: Eleven experts returned evaluations of the 21-item LMA. All 21 items had I-CVI for relevance ≥.91 and I-FVI ≥.81 with excellent kappa values. The S-CVI/I-FVI average for relevance and clarity were .99 and .95, respectively. Conclusion: The 21-item LMA is a brief global lifestyle medicine tool that has demonstrated excellent content and face validity.

Development and Validation of The Media Influence on Health Information Perception and Behaviour Scale (MIHIPBS)

With the omnipresence of media in the digital age, understanding its impact on individuals' health information perception and behaviors has become paramount. This study presents the meticulous development and rigorous validation of the Media Influence on Health Information Perception and Behavior Scale (MIHIPBS) using the Content Validity Index (CVI) method. The scale development process comprised several critical phases, including item generation, expert panel formation, content validity assessment, and pilot testing. A panel of nine experts, encompassing diverse backgrounds such as psychology, public health, communication studies, and measurement development, rigorously examined each item's relevance to the construct of "Media Influence on Health Information Perception and Behavior." These experts assigned ratings on a 4-point Likert scale, ranging from "Not relevant" (1) to "Highly relevant" (4). To determine content validity, the study adhered to established recommendations for acceptable cut-off scores which were contingent upon the number of experts involved Lynn, Davis, Polit &amp; Beck, and Polit et al.2006. Various validity indices, including the Item-Level Content Validity Index (I-CVI), Scale-Level Content Validity Index based on the Average Method (S-CVI/Ave), and Scale-Level Content Validity Index based on the Universal Agreement Method (S-CVI/UA), were meticulously calculated. The outcomes of the content validity assessment were resoundingly positive. All items within the MIHIPBS attained remarkably high I-CVI scores, significantly exceeding the established acceptable threshold. Moreover, the S-CVI/Ave, calculated as the mean of the I-CVI scores for all items, unequivocally demonstrated robust content validity (Hamie et al. Ozair et al., Lau et al., and Marzuki et al.2018. Of particular significance, the S-CVI/UA, representing the proportion of items achieving the highest relevance rating by all experts, decisively met the prescribed cut-off score. These findings unequivocally affirm the MIHIPBS as an exceptionally valid and comprehensive instrument for capturing the complex dynamics of media's influence on health information perception and behavior. The MIHIPBS emerges as an invaluable and validated tool poised to make substantial contributions to research, practice, and policymaking within the domains of health communication, media literacy, and public health. Its versatility extends to assessing the efficacy of media-based health interventions, evaluating the impact of media campaigns on health decision-making, and informing targeted health communication strategies. Future endeavors should explore opportunities for cross-cultural validation, longitudinal assessments, and adaptations to account for emerging media modalities.

Reliability and validity of the Child Perception Questionnaire 8 ~ 10 (CPQ8~10) in China: an instrument for measuring oral health-related quality of life among 8-10-year-old children.

Children aged 8-10 are in a critical stage of growth and development, facing complex and specific oral health problems. In China, there is no specific assessment questionnaire for this age group. The Child Perception Questionnare 8 ~ 10 (CPQ8~10) has been widely used in many countries, with good reliability and validity. This study aimed to translate the CPQ8~10 into Chinese and assess its reliability and validity, and ascertain its applicability for 8-10-year-old children in China. Brislin's translation model was used in developing the Chinese version of CPQ8~10. Internal consistency, retest reliability, criterion validity, and confirmatory factor analysis were performed to evaluate the reliability and validity of the Chinese version of the CPQ8~10 among 494 8 ~ 10-year-old children in China. A Chinese version of the CPQ8~10, aligned with Chinese culture and social features, was developed. The criterion validity was 0.719 (P < 0.001). The item-level content validity index (I-CVI) and scale-level content validity index (S-CVI) for the Chinese version of the CPQ8~10 were 0.80 ~ 1.00 and 0.968, respectively. Factor analysis revealed a logical relationship among the items in the Chinese version of the CPQ8~10. The Cronbach's α coefficient, retest reliability, and Guttman split-half reliability coefficient for the Chinese version of the CPQ8~10 were 0.819, 0.830, and 0.849, respectively. The Chinese version of the CPQ8~10 exhibited a structure consistent with the original questionnaire, displaying good reliability and validity. This study facilitates the application of CPQ8~10 in China. The Chinese version of the CPQ8~10 is a brief and suitable tool to evaluate oral health-related quality of life of 8 ~ 10-year-old children.

Validating of Survey Instrument in the Perspective of Computer Technology-based Learning

ICT plays an essential component in Higher education institutes (HEIs).A critical step in confirming that the results to be achieved are reliable in solving a study's problem is content validation. The goal of this research paper is to describe usage of survey instrument Content Validity Index (CVI) to confirm content of survey instrument created based on ICT acceptance impact on students' academic performance. The content validity index was used to determine the usability of a survey questionnaire. Ten field specialist/professionals were selected, and used Expert Panel Rating chart (EPRC), the opinions of these experts were considered using an approach of item-level CVI (I-CVI) and scale-level CVI (S-CVI). While certain latent variables and study items were either eliminated or changed, the outcome achieved an acceptable level of validity for the remaining items maintained systematically. In conclusion, students’ academic performances will be analyzed to assess the generally performance of the proposed model.

Psychometric properties of End Stage Renal Disease-Adherence Questionnaire-Sinhalese version among patients receiving haemodialysis.

The chronic kidney disease is a leading public health concern, particularly in low-to middle-income countries, while the number of patients receiving haemodialysis is rapidly increasing. Adherence to a complex treatment regimen is vital for those patients on maintenance haemodialysis though the precise evaluation is reported inadequately. This study aimed to evaluate the psychometric properties of Sinhalese version of End Stage Renal Disease-Adherence Questionnaire (SINESRD-AQ) to assess treatment adherence behaviour among patients receiving haemodialysis in a Sri Lankan hospital. The cultural adaptation of ESRD-AQ involved forward and back translation, expert committee consolidation and pretesting among patients (n = 10). Face and content validity of the questionnaire was evaluated using a modified Delphi technique. Construct validity of the subscales of SINESRD-AQ was evaluated using confirmatory factor analysis (CFA). A descriptive cross-sectional study among a consecutive sample of 150 patients receiving haemodialysis in a selected Teaching hospital, Sri Lanka was involved in performing CFA. Reliability was confirmed with test-retest reliability. Excellent face and content validity were reported with Item level content validity index (0.83-1.0), Average Item level content validity index for whole scale (0.93), Item level content validity ratio (0.67-1.0) and modified kappa statistic coefficient (0.81-1.0). CFA of two subscales demonstrated better indices closure to the model fit with five- item two factor model for direct adherence behaviour subscale and eight-item two factor model for attitude/perception subscale. The intra class correlation coefficient of 0.837 (p<0.001) and 0.752 (p<0.001) indicated acceptable test-retest reliability of direct adherence behaviour and attitude/perception subscale respectively. The study confirmed SINESRD-AQ as a valid and reliable measure which enables periodic assessment of treatment adherence behaviour of the patients receiving haemodialysis in a Sri Lankan hospital.