Item Separation Reliability Research Articles

Chinese version of the Physical Resilience Scale (PRS): reliability and validity test based on Rasch analysis

BackgroundPhysical resilience is known to minimize the adverse outcomes of health stressors for older people. However, validated instruments that assess physical resilience in older adults are rare. Therefore, the purpose of this study was to translate the Physical Resilience Scale (PRS) into Chinese and to validate its psychometric properties in a population of community-dwelling older adults following SARS-CoV-2 infection.MethodsThis study used a cross-sectional design and translated the Physical Resilience Scale into Chinese. A total of 426 older adults who had recovered from SARS-CoV-2 infection were chosen for assessment through convenience sampling. The measurement data were analyzed using the Rasch analysis.ResultsRasch analysis indicates that the Physical Resilience Scale demonstrates excellent reliability, validity, and unidimensionality. The Infit MNSQ and Outfit MNSQ of each entry were 0.77 ~ 1.19, and the degree of fit of each entry to the scale was good. Person and item separation reliability support the internal consistency of the studied samples and PRS items.ConclusionsThe Physical Resilience Scale has good reliability and is suitable for the assessment of physical resilience tests in older people. However, the overall difficulty of the scale is not suitable for older adults of all ability ranges, and it is possible to add higher and lower difficulty items and adjust the difficulty spacing between items in a later study.

Assessing mental health literacy in Jordan: a factor analysis and Rasch analysis study.

Mental health literacy (MHL) research in Jordan is sparse and validated MHL measures are lacking. The present study validated a Jordanian version of the Mental Health Literacy Scale (MHLS) and examined Jordanian individuals' MHL. A Google Forms survey was designed, and the link was shared through various Jordanian social media platforms. Factor analysis and Rasch analysis were performed to validate the Jordanian version of the MHLS. Binary logistic regression was performed to assess variables associated with MHL. The Jordanian MHLS was administered to 974 participants (74.4% females; median age 27 years). The mean MHL score of the participants was 71.1% indicating average literacy levels. The factor analysis indicated that 27 items distributed across four factors had the best model fit. The Rasch analysis confirmed item separation reliability and person reliability. The regression showed a correlation between educational attainment, income, marital status and MHL level. These findings emphasize the role of educational attainment in MHL, pointing to the necessity of integrating mental health education into formal curricula to enhance MHL across all societal levels. Stigma and limited-service availability act as barriers to mental health service and access, which compound the challenge of improving MHL. Targeted educational interventions and policy reforms may help improve MHL, thereby contributing to improving mental health outcomes in Jordan and potentially other similar settings.

The Patient Activation Measure-13 (PAM-13) in an oncology patient population: psychometric properties and dimensionality evaluation

BackgroundAccurate assessment and enhancement of health-related skills among oncology patients are pivotal for optimizing cancer care. The Patient Activation Measure (PAM-13), a questionnaire designed to reflect an individual’s knowledge, skills, and confidence in self-healthcare management, has been validated across diverse countries and settings. Concerns have been raised regarding the cross-situational applicability, as patients with specific diseases and cultural backgrounds interpret questionnaire items differently. This study aimed to examine the structural validity and psychometric properties of the PAM-13 in an oncological patient cohort.MethodsBaseline data from a longitudinal non-randomized controlled study involving cancer out-patients (n = 1,125) from Comprehensive Cancer Centres in Southern Germany were analysed. The German version of the PAM-13 was employed. With classical test and item response theory methods data quality, reliability, convergent and structural validity, as well as psychometric properties were assessed. Exploratory (EFA) and confirmatory factor analyses (CFA) were employed to investigate the postulated unidimensionality of the underlying construct. With a partial credit model (PCM) we examined item fit, targeting, local independence and differential item functioning.ResultsParticipants were predominantly female (73.0%) with a breast cancer diagnosis (41.3%). While items were generally well-accepted, ceiling effects were observed and a high mean PAM-13 score (69.7, SD = 14.2) was noted, potentially compromising responsiveness to interventions. Reliability was adequate (Cronbach’s α = 0.81), person and item separation reliability were good to excellent (0.81 and 0.99, respectively). Explorations of the unidimensionality of the construct (EFA, CFA, PCM) yielded inconclusive results, hinting towards a two-factor solution. Item difficulty rankings deviated from the original. No differential item functioning was identified, and local independence was confirmed.ConclusionsWhile the PAM-13 serves as a valuable instrument for comprehending and promoting health-related skills in cancer patients, the identification of ceiling effects, disordered item-difficulty rankings, and inconclusive findings regarding unidimensionality contribute to the expanding body of evidence, emphasizing the dependency of PAM-13’s validity and reliability on distinctive characteristics within the population under investigation. Future research should prioritize refining or adding PAM-13 items to better capture the specific health-related challenges within diverse populations, paving the way for more effective patient engagement strategies in oncology.Trial registration numberDRKS00021779

RASCH MODEL ON ECONOMICS MATHEMATICS BELIEF SCALE

This study aims to apply the Rasch Model to the Economics Mathematics Belief Scale (EMBS) instrument involving 144 student respondents from the Faculty of Economics. Instrument development was carried out by compiling items, testing, and analyzing using the Rasch Model with the WINSTEP application to identify unidimentionality, item fit, person fit, distribution on item/person map, and description of the EMB dimensions, namely self-confidence, belief in the mathematics learning process, and supportive social context during the mathematics learning process in economics. The results of the analysis show that this instrument has a high item separation reliability, which is 0.98 for item reliability and 0.88 for person reliability. In the item fit analysis, there are 5 items included in the unfit category based on the MNSQ and PT-Measure Correlation criteria. Descriptive analysis shows that 73% of students have confidence in their own abilities, 78% of students have confidence in the learning process in learning economic mathematics, and 81% of students have confidence in the role of lecturers and the application of mathematics in everyday life. This study contributes to developing an instrument to measure economics mathematics belief (EMB). Further development of this EMBS instrument is needed for better instrument results.

ASSESSMENT OF THE PSYCHOMETRIC PROPERTIES OF ATTITUDE TOWARDS ASSESSMENT TEST (ATAT)

This study is on the assessment of the psychometric properties of Attitude Towards Assessment Test (ATAT). Four research questions guided the study. An instrumentation research design was adopted. The population consisted of secondary school students in Delta State, Nigeria. The sample size comprised 1,000 students, selected through simple random and non-probability cluster sampling techniques. The test under assessment was developed by Megbele, et al. (2023). The Rasch Rating Scale Model was used to answer research 1, which assessed person and item reliability, item statistics, and ordering of response categories. Two fit indices including the infit and outfit mean square (MNSQ) statistics were used to answer research question 2. The data that were used to answer research questions 1 and 2 were analysed with the aid of the Jmetrik IRT software. The Categorical Confirmatory Factor Analysis (CCFA) was used to answer research question 3 while Chi-Square Goodness of Fit Statistics was used to answer research question 4 on construct validity, evidence of unidimensionality, and local independence respectively. The findings of this study revealed that the three components of the scale had high values of item separation index and reliability as well as an acceptable range of Person separation index and reliability; the difficulty index of items in the test was within an acceptable range; Each of the components of the Attitude Towards Assessment Test (ATAT) (Cognitive, affective and behavioural) had one construct each, which is evidence of unidimensionality for the different components of the Attitude Towards Assessment Test. Based on the findings of the study, it was concluded that all items in the different components that made up the test are reliable, have adequate item difficulty infit, and outfit MNSQ estimates, with evidence of unidimensionality and local independence assumptions. The study recommended that the test can be used by examination bodies for the assessment of students in the affective domain.<p> </p><p><strong> Article visualizations:</strong></p><p><img src="/-counters-/soc/0011/a.php" alt="Hit counter" /></p>

The psychometric properties of the Physical Resilience Instrument for Older Adults (PRIFOR): a Rasch analysis.

Prior psychometric evidence of the Physical Resilience Instrument for Older Adults (PRIFOR) showed good criterion-related validity, concurrent validity, known-group validity, predictive validity, and internal consistency. However, it is unclear whether older patients with different treatment diagnoses interpret the PRIFOR similarly. This study aimed to test the psychometric properties of the PRIFOR scores among different treatment diagnoses of older patients. We recruited 413 hospitalized older patients with a medical diagnosis and 207 with a surgical diagnosis in a 1343-bed tertiary-care medical center in Taiwan. Data analyses included Rasch models, Principal Components Analysis (PCA), and Pearson correlations. The Rasch analyses showed that all PRIFOR items were embedded within their belonged constructs, reflecting good construct validity and unidimensionality. Person and item separation reliability support the internal consistency of the studied samples and PRIFOR items. However, six PRIFOR items were found to have meaningful differential item functioning (DIF) problems among treatment diagnoses. The PRIFOR is a solid measurement and can be used for monitoring the status of older adults' physical resilience. However, because six items were found to have meaningful DIF among treatment diagnosis groups, future studies should consider designing specific items for different patient populations to assess their needs in physical resilience.

Nursing Students’ Clinical Confidence In Caring Tuberculosis: Indonesian Version Of The U.S Tuberculosis Curriculum Consortium Survey Using Rasch Analysis

Background: Nursing students who are prepared in clinical practicums to comprehend the knowledge, reflect their beliefs about tuberculosis instruction, and perceive their abilities in caring for tuberculosis patients are also at risk. Nursing students’ clinical confidence in caring for tuberculosis patients is essential to be assessed. Knowledge, beliefs, and clinical confidence, as unidimensional constructs based on Bandura’s theory of self-efficacy, had been used in the US National Tuberculosis Curriculum Consortium (NTCC) survey for nursing students. This study's objective was to investigate the Indonesian version of the NTCC survey among nursing students' experiences caring for tuberculosis patients. Methods: A quantitative study with cross-sectional using an online survey among 250 students 1st to 3rd-yearrd year students in one faculty of nursing in Banten, Indonesia. Prior to data collection, NTCC surveys were translated backward and forward, reviewed by experts, and tested in a pilot project. Results: Internal consistency using Rasch analysis on each subscale showed good results and gave strong evidence that three subscales are unidimensional. There was an item separation index and reliability score, in that order: knowledge about tuberculosis (8.68 and 0.99), beliefs regarding tuberculosis instructions (6.50 and 0.98), and clinical confidence in caring for tuberculosis patients (6.29 and 0.98). Conclusion: The Indonesian version of the NTCC survey has excellent internal consistency. This instrument might be improved since the original instrument is 13 years old and there is a cultural gap between the US and Indonesia. Moreover, this instrument might be needed for improving tuberculosis teaching in the nursing curriculum in Indonesia.

Rasch analysis of the scores of the difficulties in emotion regulation scale (DERS) in a traffic context

The functional approach of emotion regulation has been mainly used in the clinical context. However, other fields such as traffic psychology have also adopted this perspective, showing interest in how difficulties in emotion regulation might interfere in driving. Various driving styles have been associated with maladaptive emotion regulation. Difficulties in Emotion Regulation Scale (DERS) is the most commonly used instrument to assess ER difficulties and it is often used in the context of driving. Most studies have scored DERS by using procedures of the classical test theory approach instead of advanced psychometrics. In this study, a sample of 318 male drivers aged between 20 and 69 (M age = 41.6 years, SD = 11.0) completed the DERS. The total sample was divided in two halves: drivers with road traffic offences and matched controls. Data analysis was carried out using the Rasch Rating Scale Model (RSM). Results indicated that response categories performed inadequately. Collapsing the 5 original categories into 3 new categories was necessary. To meet the unidimensionality requirement, both the first DERS item and the awareness subscale were removed. Model-data fit was then good enough. Item Separation Reliability (ISR = 0.97) was excellent and Person Separation Reliability (PSR = 0.89) was quite good. Even though requirements of invariant measurement were met, there was low validity evidence for the driving context.

Item analysis of the Korean version of the Intensive Care Experience Questionnaire: Using the Rasch Model based on Item Response Theory

Purpose : This study aimed to examine the item characteristics of the Korean version of the intensive care experience questionnaire (K-ICEQ) using the Rasch analysis model of the item response theory.Methods : In this methodological study, the validity of the scale was examined, and a secondary analysis was conducted using cohort data of patients who were discharged from the intensive care units (ICU). Data from 891 patients who responded to the K-ICEQ upon ICU discharge were analyzed. The WINSTEP program was used to analyze item characteristics, including item difficulty, fit indices, appropriateness scale, and separation reliability.Results : The difficulty level of all 26 items of the K-ICEQ was appropriate, and the fit indices of the 25 items, except for item 18, were good. The 5-point scale of the K-ICEQ was not appropriate in the three subscales. The item separation reliability was good in all subscales, but did not meet the criteria in terms of respondents.Conclusion : The results of examining the item characteristics of the K-ICEQ revealed a good degree of difficulty, fitness, and item separation reliability. To increase the validity of the K-ICEQ, we suggest the rearrangement of the overall item order, modification of the item description of the “recall of experience” subscale, and reduction of the scale response level.

Development and validation of a sexual and reproductive health knowledge scale

The purpose of this study was to develop a reliable and valid instrument to measure primary school students’ sexual and reproductive health (SRH) knowledge. The instrument measures primary school students’ knowledge in four domains: i) puberty; ii) human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) and sexually transmitted diseases; iii) prevention of child sexual abuse; and iv) reproduction and reproductive systems. All items in the instrument were reviewed and screened by experts before they were administered to 125 primary five students. The instrument’s dimensionality, fit statistics, hierarchical ordering of item difficulty, and item and person separation reliability were assessed using the rasch measurement model (RMM). The results showed that the instrument demonstrated unidimensionality, and the items exhibited a wide range of difficulty level. Misfitting items were removed from the questionnaire, and the remaining 36 items were retained. The RMM outputs showed good item’s reliability (.97) with high separation index (5.52). However, the person reliability (.79) and the person separation index (1.94) were slightly the recommended value. Overall, the results show that the developed instrument can be used with confidence to assess sexual and reproductive health (SRH) knowledge among primary school students in Malaysia.

The Development and Validation of the Comprehensive Assessment of Acceptance and Commitment Therapy Processes (CompACT)-Malay Version.

Objectives: psychological flexibility is a crucial construct highly correlated with psychological wellness. There is a need for a tool to measure psychological flexibility in order to accurately ascertain the effects of treatment. The existing industry standard, the Acceptance and Action Questionnaire-II (AAQ-II), has issues with conflating psychological flexibility with distress; moreover, it does not cover the hexaflexes. The 23-item CompACT was designed to surmount these limitations. Methods: the classical test theory (CTT) and Rasch measurement theory (RMT) were used to check the validity and reliability of the Malay version of the CompACT Scale. Cronbach’s α, McDonald’s Ω, and greatest lower bound were used to measure internal consistency. A Pearson’s correlation test was used to measure test–retest reliability of the Malay versus the original English version. For validity, convergent validity was established by using the Malay AAQ-7 Scale. The dimensionality of the Malay version of the CompACT Scale was explored using exploratory factor analysis. For the RMT, weighted fit statistics (infit) and outlier sensitive fit statistic (outfit) mean square (MnSq) values were used at the item level, while item and person separation reliability values and item and person separation indices were applied at the scale level. Results: the internal consistency measures, including Cronbach α and McDonald’s Ω, passed the suggested cutoff points. Convergent validity with the AAQ-II was 0.693. The quality of the Malay version of the CompACT Scale was also satisfactory, as all item and person reliability values and indices exceeded the suggested cut-off points. Conclusions: the Malay CompACT is a psychometrically sound instrument to assess psychological flexibility in both clinical and research settings.

Evaluating the reliability and validity of a questionnaire used to measure experiences of teamwork among student pharmacists in a quality improvement course

IntroductionThe psychometric properties of instruments used to capture student pharmacists' perspectives of teamwork have not been well assessed. This study measured the reliability and validity of an instrument designed to assess teamwork experiences among student pharmacists in a quality improvement (QI) class at one United States pharmacy school. MethodsThe psychometric properties of a previously conducted 17-item questionnaire (response options: “strongly agree,” “agree,” “disagree,” or “strongly disagree”) about second-year student pharmacists' teamworking experiences were assessed. A Rasch rating scale model was used to construct measures of teamwork experience. Principal component analysis (PCA) assessed unidimensionality. Item- and person-fit statistics were assessed. Construct and content validity and reliability were estimated utilizing student and item separation indices (SI) and reliability coefficients (RC). ResultsSixty student pharmacists were included. PCA conveyed a unidimensional construct. Four items with infit and outfit mean-squared values outside the suggested range were removed. Item responses “disagree” and “strongly disagree” were merged to improve scale functionality. The average person measure was 1.74 ± 2.03 logits. Student and item RC were 0.81 (SI = 2.04) and 0.97 (SI = 2.17), respectively. The easiest item endorsed was team's ability to reach consensus, while the most difficult item was interest to do collaborative work again. Mismatch of student experience and item difficulty level on the continuum scale suggested additional items are needed to match student teamwork experience. ConclusionThe instrument demonstrated evidence of reliability and validity to measure student pharmacists' teamwork experience in a QI class, but additional instrument modifications are recommended.

Validation Assessment of a Pain Interference Questionnaire among Student Pharmacists.

Validation studies of pain interference instruments used among student pharmacists are rare yet essential for understanding their appropriate use and interpretation in pharmacy education and practice. This study conducted validation and reliability assessments of a five-item Pain Interference Scale previously administered to student pharmacists. Construct validity was assessed using Rasch analysis. Unidimensionality was measured using: point-biserial measure correlations; percent of raw variance explained by items; difference between expected; variance modeled by items; and Rasch model fit. To assess scale functioning, response frequency distribution, observed average and sample expected logit distribution, Andrich logit distribution, item separation, and item reliability were assessed. Visual examination of the Item-Person Map determined content validity. Items explained 64.2% of data raw variance. The difference between raw variance modeled and observed was 0.6. Point-biserial measure correlations were >0.77. Item mean-square infits were 0.7–1.3 while outfit measures were 0.72–1.16. There were >10 responses per response category, response frequency and Andrich thresholds progressively advanced, and observed average and sample expected logits advanced monotonically, Andrich logits = −2.33–1.69, item separation = 2.61, and item reliability = 0.87. Item probability curves indicated response categories were minimally yet adequately distinct. Cronbach’s alpha = 0.93. The Item-Person Map had a ceiling effect indicating content gaps. In conclusion, the pain interference instrument has acceptable construct validity yet contains content gaps. Additional difficult items should be added to the instrument to better capture pain interference among student pharmacists.

The Right PREMTM: Rasch analysis of a new patient reported experience measure for use by older people in hospital

Healthcare rights exist to protect older people from harm and to empower older people to participate in their care with independence, choice and control. Multiple investigations revealing abuse provide evidence that older people’s rights are being breached. Older people must have the opportunity to report on their experience of care against their rights. The Right PREMTM is a new instrument designed to measure older people’s experience of care against their healthcare rights. The objective of this cross-sectional validation study was to assess the psychometric properties of a new instrument to measure the experience of care consistent with the healthcare rights of older people in the hospital setting. Data were collected from older people who were current hospital inpatients of medical wards in four South Australian metropolitan hospitals. The Rasch model was used to assess the psychometric properties of the patient version of The Right PREMTM. The analysis was performed using the Winsteps® software program. Two hundred older patients completed the 50-item questionnaire. During the process of analysis, four items were removed as they did not fit the model and a further 11 items were removed due to high residual correlations. The final 23 items had a Person Separation Index of 2.23, a Person Separation Reliability Coefficient 0.83, an Item Separation Index of 7.70 and an Item Separation Reliability Coefficient of 0.98. Rasch analysis of the patient version of The Right PREMTM, based on a robust sample, demonstrated this new instrument is psychometrically sound and warrants ongoing development.

The client satisfaction with device: a Rasch validation of the Arabic version in patients with upper and lower limb amputation

BackgroundThe Client Satisfaction with Devices (CSD) module of the Orthotics and Prosthetics Users’ Survey is an extensively used questionnaire that measures patients’ satisfaction with orthosis and prosthesis. However, the validated version for Arabic speakers (CSD-Ar) is only applicable for orthosis users.ObjectivesThe aim of this study was to evaluate the psychometric proprieties of the CSD-Ar for prosthetics users.MethodsThe study used a convenience sample of prosthesis users from Saudi Arabia and Turkey (N = 183), who completed the CSD-Ar. The collected data were analysed using Rasch analysis to evaluate item fit, reliability indices, item difficulty, local item dependency, and differential item functioning (DIF) using WINSTEPS version 4.6.1.ResultsBased on the analysis, the four-response Likert-scale was acceptable, as shown by the category functioning test, All eight items did achieve a fit to the Rasch Model [(infit) and (outfit) mean-square 0.75 to 1.3]. Person separation reliability was 0.76, and item separation reliability was 0.94. A principal component analysis (PCA) showed satisfactory unidimensionality and no local item dependency. The DIF analysis showed no notable dependency among items on participant characteristics in terms of age, gender, duration of use, country, and level of amputation.ConclusionThis study contributes to the confidence of using CSD-Ar to evaluate users’ satisfaction with different prostheses, affirming the need for further refinement of the quality of the outcome measure.

Rasch Analysis of the Assessment of Quality of Activities (A-QOA), an Observational Tool for Clients With Dementia.

The Assessment of Quality of Activities (A-QOA) is an observation-based tool for assessing the strength of engagement in an activity by the person performing it in a natural context. By quantifying the quality of engagement, the A-QOA can help occupational therapy practitioners be better able to select meaningful activities and more clearly understand the effectiveness of various choices. To examine use of the A-QOA as a valid unidimensional scale and to clarify preliminary results on its internal scale validity and item reliability using the Rasch model. One hundred thirty-one participants with dementia performing 262 activities. We used the Rasch model to clarify the psychometric properties of A-QOA's measurement quality. Rasch analysis revealed that 21 of the 25 items reached an acceptable level of fit, and 4 did not. After eliminating the 4 misfitting items, the resulting A-QOA was determined to have both acceptable internal scale validity and item separation reliability, which are fundamental psychometric properties of a clinical observational instrument. The A-QOA can be used to quantitatively assess the strength of engagement in an activity by the person performing it by using the observational method. In clinical settings, the A-QOA can be used both to select activities for clients with dementia and to quantitatively show the effects of occupational therapy interventions.

Validation of the Activities-Specific Balance Confidence Scale With 5-Option Response Format in Slovene Lower-Limb Prosthetic Users

ObjectiveTo examine the psychometric properties of the Activities-specific Balance Confidence (ABC) scale administered in the Slovene version with a simplified 5-option response format (ABC-5/SLO) using Rasch analysis. DesignMethodological research on data gathered in a cross-sectional study. SettingOutpatient university rehabilitation clinic. ParticipantsA convenience sample of adults with unilateral lower-limb amputation (N=138; 75% men) longer than 6 months who regularly wear a prosthesis. InterventionNot applicable. Main Outcome MeasuresWe evaluated functioning of rating scale categories, internal construct validity, reliability indices, and dimensionality using the ABC-5/SLO (0=no confidence to 4=complete confidence). ResultsThe ABC-5/SLO rating scale fulfilled the category functioning criteria. All items fit the underlying scale construct (balance confidence) except item 8 (“walk outside the house to a car parked in the driveway”), which was overfitting. The person abilities-item difficulty matching (targeting) was good. The person separation reliability was .92, and the item separation reliability was .99. Analysis of the standardized Rasch residuals showed the scale’s unidimensionality and absence of high item dependency (residual correlations, <.30). The correlation between the ABC-5/SLO and the Prosthetic Mobility Questionnaire (Rasch measures) was high (ρ=.84), as expected. Minor signs of item redundancy were found. ConclusionsThe simplified ABC-5/SLO scale is a valid and reliable measure of balance confidence for individuals with lower-limb amputation. It is possible to transform the ordinal summed raw scores of the ABC-5/SLO into interval-level measurements using a nomogram.

A motivational factors assessment instrument for medication management center employees providing medication therapy management services: A Rasch analysis

BackgroundTelephonic medication management centers (MMCs) provide medication therapy management services to help alleviate medication-related issues and improve health outcomes. Motivation factors driving the performance of MMC personnel are key components in achieving these goals. Yet, published literature is limited on how motivation affects MMC personnel performance. ObjectiveTo assess validity and reliability of the employee motivation questionnaire (EMQ), a 19-item measure of barriers and facilitators to motivation associated with MMC employees’ work performance. MethodsPharmacist, nurse, pharmacy technician, and intern employees (N = 534) from 5 telephonic-based U.S. MMCs were invited to complete the electronic EMQ. Rasch analysis was conducted in Winsteps software using a rating scale model. Construct and content validity and reliability were analyzed with employee and item separation index (SI) and reliability coefficient (RC). Linear regression was conducted to test the association of employee characteristics with individual work performance motivation. ResultsA total of 319 employees completed the EMQ, 59.7% response rate. Principal components analysis suggested a unidimensional construct. Employee and item infit and outfit mean squared values met recommended fit criteria (0.5–1.5), suggesting that the data fit the model. An item-person map identified items that were easiest (joy of helping patients) and most difficult (motivated to work harder if incentives were tied to goal achievements) to agree with. Mismatch of employee motivation and item difficulty level on the measurement continuum (−1 to 0.92 logits) indicated a need for additional items that employees perceive as more difficult to agree with. The employee RC was 0.81 and the SI was 2.04; whereas, the item RC was 0.97 and the SI was 5.94. None of the variables tested illustrated statistically significant associations with the person motivation measure. ConclusionsThe EMQ illustrated reasonable content validity, good construct validity, and reliability evidence when used to measure motivation factors among MMC employees. Consideration of employee motivation factors may help to better meet MMC program goals and improve patient outcomes.

Validity of the Yale Food Addiction Scale for Children (YFAS-C): Classical test theory and item response theory of the Persian YFAS-C

PurposeTo examine whether the child/adolescent version of the Yale Food Addiction Scale (YFAS-C) is valid to assess the Iranian adolescents who are overweight.MethodsAfter using an internationally standardized method to translate the YFAS-C into Persian, 1186 overweight/obese adolescents aged between 13 and 18 years participated in the present study [666 males; mean age = 15.5 (SD = 1.9) years; zBMI = 2.5 (1.0) kg/m2]. All the participants completed the Persian YFAS-C alongside Persian versions of the following scales: Eating Disorder Examination Questionnaire (EDEQ), Clinical Impairment Assessment (CIA), Binge Eating Scale (BES), Eating Attitudes Test (EAT-26), and Depression, Anxiety, Stress Scale (DASS-21).ResultsAt the scale level, confirmatory factor analysis verified the single-factor structure of the Persian YFAS-C. Additionally, the Persian YFAS-C had promising properties regarding internal consistency (KR20 = 0.81), test–retest reliability (intraclass correlation coefficient = 0.83), separation reliability (person separation reliability = 0.77; item separation reliability = 0.98), and separation index (person separation index = 2.04; item separation index = 8.01). At the item level, all items had satisfactory properties in factor loadings, corrected item-total correlation, test–retest reliability, and infit and outfit mean square. Moreover, no substantial differential item functioning (DIF) was found concerning gender (male vs. female) or weight status (overweight vs. obesity). Significant and moderate correlations were found between the Persian YFAS-C and other psychometric scales assessing eating symptomatology and general psychopathology (r = 0.352 to 0.484).ConclusionThe Persian YFAS-C is a valid instrument that assists healthcare providers in assessing food addiction among Iranian adolescents.Level of evidenceLevel V, cross-sectional descriptive study.

Transition to Adulthood Autonomy Scale for Young People: Design and Validation.

Given that autonomy is a fundamental process in the transition to adulthood, there are several scales that measure the concept as a main construct or a constituent feature of broader constructs. However, most of these scales are based on a notion of autonomy focused on the individual, while the proposed scale aims to incorporate the idea of the individual mediated by others and society. This article aims to show the results of the design and validation process of the Transition to Adulthood Autonomy Scale (EDATVA), which was developed using this approach. A group of 61 items with a Likert-type response scale of four options was used on a sample of 1,148 Spanish and Colombian individuals, aged between 16 and 21. A systematic process was performed using an exploratory factorial analysis. Additional indexes were calculated from the Rasch Model. The matrices obtained from the factorial analysis gave rise to a 4-factor structure comprising a total of 19 items with weights >0.3. In the case of Spain, the KMO test returned a value of 0.80 and in the case of Colombia, 0.83. In the Rasch model, the Item Separation Reliability (0.99) indicates that the items constitute a well-defined variable that meets the local independence assumption. Cronbach's alpha for the Spanish sample was 0.86 and for the Colombian sample 0.85. In conclusion, this new scale consists of four dimensions: self-organization, understanding context, critical thinking, and socio-political engagement. The scale is easy to use and interpret, especially considering the age range of the target population and its possible uses within the contexts of assessing and intervening in young people's behavior. Due to its characteristics, it can be used in family, educational, and social contexts. This scale is valuable for research because its optimal psychometric properties provide an alternative way of understanding autonomy.