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Background: Globally, there is mounting evidence about the importance of father involvement for improving child and family wellbeing. However, there are limited measurement tools available for assessing father involvement in low-resource settings globally. The objective of this study was to develop and validate a scale for measuring fathers' engagement in caregiving activities for young children and families in rural Kenya. Methods: We used baseline data collected in February–March 2023 from a cluster-randomized controlled trial of a parenting intervention aimed at improving early child development in Nyamira and Vihiga counties in Western Kenya. The analytic sample comprised 460 primary caregivers of children under 18 months of age (91.3% mothers) who were in a relationship with a male caregiver of the young child (i.e., father). The primary caregiver reported on the 25-item father involvement scale. We conducted exploratory and confirmatory factor analyses to determine the dimensionality of the measure and estimated latent variable regression models to assess construct and predictive validity in terms of associations with sociodemographic factors, other paternal and maternal psychosocial measures, and early child development outcomes. Results: The scale had a four-factor structure representing father involvement in (1) childcare activities, (2) play and affection, (3) household chores, and (4) early learning activities. Each factor showed good internal consistency reliability and evidence of multiple forms of validity. The four factors were associated with child and household sociodemographic characteristics and more positive paternal and maternal psychosocial outcomes. Father involvement across all four domains was associated with higher early child cognitive, language, motor, and socioemotional development scores. Conclusions: Our findings highlight the multidimensional nature of fathers' caregiving roles in the lives of young children and their families. We establish a valid tool for assessing father involvement in rural Western Kenya that has potential for use in other similar contexts. [ABSTRACT FROM AUTHOR]

Abstract Background Globally, there is mounting evidence about the importance of father involvement for improving child and family wellbeing. However, there are limited measurement tools available for assessing father involvement in low-resource settings globally. The objective of this study was to develop and validate a scale for measuring fathers’ engagement in caregiving activities for young children and families in rural Kenya. Methods We used baseline data collected in February–March 2023 from a cluster-randomized controlled trial of a parenting intervention aimed at improving early child development in Nyamira and Vihiga counties in Western Kenya. The analytic sample comprised 460 primary caregivers of children under 18 months of age (91.3% mothers) who were in a relationship with a male caregiver of the young child (i.e., father). The primary caregiver reported on the 25-item father involvement scale. We conducted exploratory and confirmatory factor analyses to determine the dimensionality of the measure and estimated latent variable regression models to assess construct and predictive validity in terms of associations with sociodemographic factors, other paternal and maternal psychosocial measures, and early child development outcomes. Results The scale had a four-factor structure representing father involvement in (1) childcare activities, (2) play and affection, (3) household chores, and (4) early learning activities. Each factor showed good internal consistency reliability and evidence of multiple forms of validity. The four factors were associated with child and household sociodemographic characteristics and more positive paternal and maternal psychosocial outcomes. Father involvement across all four domains was associated with higher early child cognitive, language, motor, and socioemotional development scores. Conclusions Our findings highlight the multidimensional nature of fathers’ caregiving roles in the lives of young children and their families. We establish a valid tool for assessing father involvement in rural Western Kenya that has potential for use in other similar contexts.

Abstract Background Menopausal women should learn self-care practices to enjoy a healthy lifestyle, positive health behaviors, and health status. In addition, the lack of self-care knowledge can lead to unhealthy attitudes and lifestyles, resulting in many complications. Improved self-care knowledge can foster positive attitudes, leading to healthier lifestyles as a beneficial cycle. However, menopausal women have limited knowledge about self-care and evaluation tools. Therefore, this study aimed to develop and investigate the validity and reliability of the Women’s Self-care Knowledge and Attitude Questionnaire (WSKAQ) in Iranian menopausal women. Methods This cross-sectional study was conducted on 249 menopausal women, aged between 45 and 65 years and at least one year post-menopause, with a minimum literacy level of elementary education. Validation properties included construct validity, exploratory (EFA), and discriminant validity. Reliability was further established through Cronbach’s α and McDonald’s Omega. PASS 15 and SPSS 27 software were used to select centers, calculate sample size and analyze the data, respectively. Results The initial stage of construct validity involved the Kolmogorov–Smirnov test and EFA, resulting in a 6-item self-care knowledge subscale, 47.29% of the total data variance, and 7-item self-care attitude subscale, 55.50% of the total data variance. Independent t-test indicated that menopausal women with education level equal to or higher than diploma have significantly higher self-care attitude scores than those with lower than diploma (p = 0.007). Additionally, significant correlations were observed between self-care knowledge and attitude (r:0.30). Cronbach’s α and McDonald’s Omega coefficients of the 13-item WSKAQ were 0.77 and 0.78, respectively. Conclusions Based on the results, the WSKAQ, consisting of 13 items, was validated and reliable for assessing the self-care knowledge and attitude of Iranian menopausal women.

Abstract Background Burnout is an increasing public health concern. Its prevalence has extended across diverse professions globally, posing significant challenges to individuals, organizations, and society. This phenomenon has undermined employee well-being, productivity, and organizational effectiveness, making it a critical concern in contemporary work environments. The present study aimed to examine the adaptation and assess the validity of the Persian version of the Burnout Assessment Tool (BAT). Methods The adaptation process included the translation and back-translation of the BAT. Data were collected on a sample of 580 teachers using the convenience sampling. The BAT-Persian and Utrecht Work Engagement Scale were administered to collect the data. The reliability, factorial structure of the BAT-C and BAT-S, and the convergent and discriminant validity of BAT-C and work engagement were explored. Results Confirmatory factor analysis supported a four-factor structure for the core dimensions (BAT-C; exhaustion, mental distance, emotional impairment, cognitive impairment), and a two-factor structure for the secondary dimensions (BAT-S; psychological distress, psychosomatic complaints). In the second-order model, the item loadings on the four factors of BAT-C ranged from 0.35 to 0.85, and on two factors of BAT-S ranged from 0.63 to 0.89. The Persian versions of the BAT-C and BAT-S showed good internal consistency (respectively, α = 0.95 and 0.90). Additional evidence supports the convergent and discriminant validity of the BAT-GR. the BAT‐C and its scales were negatively correlated with work engagement and dimensions (i.e., vigor, dedication, and absorption). Moreover, the BAT‐S and its scales negatively correlated with work engagement and dimensions. Conclusions This study provided evidence that the Iranian version of BAT represents a reliable and valid tool for measuring burnout in the work context. A reliable and valid tool for assessing burnout in the Iranian workplace enables early detection of employee distress, allowing for timely intervention and support. This means that identifying the signs and symptoms of burnout in the early stages can prevent more severe consequences such as absenteeism, reduced productivity, or turnover.

Background: Burnout is an increasing public health concern. Its prevalence has extended across diverse professions globally, posing significant challenges to individuals, organizations, and society. This phenomenon has undermined employee well-being, productivity, and organizational effectiveness, making it a critical concern in contemporary work environments. The present study aimed to examine the adaptation and assess the validity of the Persian version of the Burnout Assessment Tool (BAT). Methods: The adaptation process included the translation and back-translation of the BAT. Data were collected on a sample of 580 teachers using the convenience sampling. The BAT-Persian and Utrecht Work Engagement Scale were administered to collect the data. The reliability, factorial structure of the BAT-C and BAT-S, and the convergent and discriminant validity of BAT-C and work engagement were explored. Results: Confirmatory factor analysis supported a four-factor structure for the core dimensions (BAT-C; exhaustion, mental distance, emotional impairment, cognitive impairment), and a two-factor structure for the secondary dimensions (BAT-S; psychological distress, psychosomatic complaints). In the second-order model, the item loadings on the four factors of BAT-C ranged from 0.35 to 0.85, and on two factors of BAT-S ranged from 0.63 to 0.89. The Persian versions of the BAT-C and BAT-S showed good internal consistency (respectively, α = 0.95 and 0.90). Additional evidence supports the convergent and discriminant validity of the BAT-GR. the BAT‐C and its scales were negatively correlated with work engagement and dimensions (i.e., vigor, dedication, and absorption). Moreover, the BAT‐S and its scales negatively correlated with work engagement and dimensions. Conclusions: This study provided evidence that the Iranian version of BAT represents a reliable and valid tool for measuring burnout in the work context. A reliable and valid tool for assessing burnout in the Iranian workplace enables early detection of employee distress, allowing for timely intervention and support. This means that identifying the signs and symptoms of burnout in the early stages can prevent more severe consequences such as absenteeism, reduced productivity, or turnover. [ABSTRACT FROM AUTHOR]

Abstract One Stop Crisis Center (OSCC) is a multi-sectorial center aimed to provide medical, social, legal, police and shelter services to survivors of domestic violence, rape, sexual assault, sodomy and child abuse. Although OSCCs have been established for almost three decades in different parts of the world including in Malaysia, there is a lack of a validated instrument to measure the service quality rendered in OSCCs. A validated instrument known as OSCC-Qual was developed using a 5-stage approach where (1) in stage 1, group discussions were conducted among all authors to identify potential items for the instrument; (2) in stage 2, content validation was performed by 13 experts using content validity index and modified kappa; (3) in stage 3, exploratory factor analysis was performed by 141 healthcare staff with experience in managing OSCC cases to validate the items as well as to identify the number of factors in the instrument; (4) in stage 4, confirmatory factor analysis was performed by 110 domestic violence survivors to ascertain the validity of the factors and items retained in stage 3 and (5) in stage 5, forward and backward translation into local Malay and Chinese languages was performed. Results: In stage 1, a total of 42 items were identified. No item was deleted in stage 2. In stage 3, a total of 7 factors (i.e., “information provision”, “competency of staff”, “professionalism”, “supportive environment”, “attitude of staff”, “multi-sectorial coordination” and “tangibles”) were identified. Four items were deleted due to poor factor loading. In stage 4, another 3 items were iteratively removed due to poor factor loading. Discriminant validity was good. Conclusion: With the availability of the 7-factor and 35-item OSCC-Qual instrument, it is hoped that the efficiency of OSCC in achieving its philosophical objectives after three decades of implementation can be unraveled and remedial actions can be taken, if necessary.

Abstract Background Health literacy measurement lays a solid foundation to identify associations with health outcomes and monitor population health literacy levels over time. In mainland China, most existing health literacy instruments are either knowledge-based or practice-based, making health literacy results incomparable between China and other countries. This study aimed to examine the reliability and validity of the 12-item Health Literacy Population Survey (HLS19-Q12) in a general population of Chinese adults. Methods A cross-sectional study was conducted to recruit primary carers of students from 11 schools in Zhengzhou, Henan Province, using convenience cluster sampling. Participants completed an online self-administered survey that collected information on key sociodemographics, health literacy (HLS19-Q12 and a comparison tool: Health Literacy Questionnaire (HLQ)), and health-related outcomes. Using the COnsensus-based Standards for the selection of health status Measurement Instruments (COSMIN) checklist as a guideline, we tested internal consistency, test-retest reliability, content validity, structural validity, concurrent predictive validity, and convergent validity of the HLS19-Q12. Results Overall, 14,184 participants completed the full survey. The HLS19-Q12 showed excellent internal consistency (Cronbach’s α = 0.93), moderate test-retest reliability (intra-class correlation coefficient = 0.54), satisfactory content validity (based on the 12-matrix health literacy model), and strong structural validity (comparative fit index = 0.94, Tucker and Lewis’s index of fit = 0.93, root mean square error of approximation = 0.095). Concurrent predictive validity results showed health literacy was associated with both health determinants and health-related outcomes. The HLS19-Q12 had weak to strong correlations (coefficients = 0.24 to 0.42) with the nine scales of the HLQ. Respondents had an average score of 81.6 (± 23.0) when using the HLS19-Q12, with 35.0% and 7.5% having problematic and inadequate levels of health literacy, respectively. Conclusions The HLS19-Q12 is a reliable and valid instrument to measure health literacy in our sample. Further validation is needed with a more nationally representative sample of Chinese adults. The HLS19-Q12 could be used as a comprehensive, skills-based, and easy-to-administer health literacy assessment tool integrated into population surveys and intervention evaluations.

Abstract Background This study was aimed to test adaptability of the Contraceptive Self-Efficacy Scale (CSES) for use on Persian-speaking women of reproductive age. Method A preliminary draft of the Contraceptive Self Efficacy Scale (CSES) was prepared according to the standard translation/back translation procedures and an expert panel appraised its content and face validities. The approved draft was tested on 400 randomly selected women of reproductive age (15–49 years) at the 29th Bahman Hospital of in Tabriz, the capital city of East Azerbaijan province, North West of Iran from May to August 2018. The exploratory and confirmatory factor analysis (EFA, CFA) was carried out to verify the implicit factor structure of the CSES for use on Persian-speaking women of fertile age. The Cronbach’s α and Interclass Correlation coefficients were estimated for internal consistency and accuracy assessment of the instrument. Results This translated scale indicated good internal consistency (0.9) and reliability (0.9). A four-factor solution best fitted the study data and the estimated fit indices were in the acceptable range (chi square/ degree of freedom = 2.956, the Root Mean Square Error of Approximation = 0.070, Confirmatory Fit Index = 0.667, The Tucker-Lewis Index = 0.599). Conclusion The CSES-P can be considered as a potentially valid and reliable tool to assess contraceptive self-efficacy among Persian-speaking women. The CSES-P is a general instrument to measure overall contraceptive self-efficacy of the Iranian reproductive age women and it would also be fascinating to work on method specific self-efficacy tools in future.

One Stop Crisis Center (OSCC) is a multi-sectorial center aimed to provide medical, social, legal, police and shelter services to survivors of domestic violence, rape, sexual assault, sodomy and child abuse. Although OSCCs have been established for almost three decades in different parts of the world including in Malaysia, there is a lack of a validated instrument to measure the service quality rendered in OSCCs. A validated instrument known as OSCC-Qual was developed using a 5-stage approach where (1) in stage 1, group discussions were conducted among all authors to identify potential items for the instrument; (2) in stage 2, content validation was performed by 13 experts using content validity index and modified kappa; (3) in stage 3, exploratory factor analysis was performed by 141 healthcare staff with experience in managing OSCC cases to validate the items as well as to identify the number of factors in the instrument; (4) in stage 4, confirmatory factor analysis was performed by 110 domestic violence survivors to ascertain the validity of the factors and items retained in stage 3 and (5) in stage 5, forward and backward translation into local Malay and Chinese languages was performed. Results: In stage 1, a total of 42 items were identified. No item was deleted in stage 2. In stage 3, a total of 7 factors (i.e., "information provision", "competency of staff", "professionalism", "supportive environment", "attitude of staff", "multi-sectorial coordination" and "tangibles") were identified. Four items were deleted due to poor factor loading. In stage 4, another 3 items were iteratively removed due to poor factor loading. Discriminant validity was good. Conclusion: With the availability of the 7-factor and 35-item OSCC-Qual instrument, it is hoped that the efficiency of OSCC in achieving its philosophical objectives after three decades of implementation can be unraveled and remedial actions can be taken, if necessary. [ABSTRACT FROM AUTHOR]

Background: Health literacy measurement lays a solid foundation to identify associations with health outcomes and monitor population health literacy levels over time. In mainland China, most existing health literacy instruments are either knowledge-based or practice-based, making health literacy results incomparable between China and other countries. This study aimed to examine the reliability and validity of the 12-item Health Literacy Population Survey (HLS19-Q12) in a general population of Chinese adults. Methods: A cross-sectional study was conducted to recruit primary carers of students from 11 schools in Zhengzhou, Henan Province, using convenience cluster sampling. Participants completed an online self-administered survey that collected information on key sociodemographics, health literacy (HLS19-Q12 and a comparison tool: Health Literacy Questionnaire (HLQ)), and health-related outcomes. Using the COnsensus-based Standards for the selection of health status Measurement Instruments (COSMIN) checklist as a guideline, we tested internal consistency, test-retest reliability, content validity, structural validity, concurrent predictive validity, and convergent validity of the HLS19-Q12. Results: Overall, 14,184 participants completed the full survey. The HLS19-Q12 showed excellent internal consistency (Cronbach's α = 0.93), moderate test-retest reliability (intra-class correlation coefficient = 0.54), satisfactory content validity (based on the 12-matrix health literacy model), and strong structural validity (comparative fit index = 0.94, Tucker and Lewis's index of fit = 0.93, root mean square error of approximation = 0.095). Concurrent predictive validity results showed health literacy was associated with both health determinants and health-related outcomes. The HLS19-Q12 had weak to strong correlations (coefficients = 0.24 to 0.42) with the nine scales of the HLQ. Respondents had an average score of 81.6 (± 23.0) when using the HLS19-Q12, with 35.0% and 7.5% having problematic and inadequate levels of health literacy, respectively. Conclusions: The HLS19-Q12 is a reliable and valid instrument to measure health literacy in our sample. Further validation is needed with a more nationally representative sample of Chinese adults. The HLS19-Q12 could be used as a comprehensive, skills-based, and easy-to-administer health literacy assessment tool integrated into population surveys and intervention evaluations. [ABSTRACT FROM AUTHOR]

Background: This study was aimed to test adaptability of the Contraceptive Self-Efficacy Scale (CSES) for use on Persian-speaking women of reproductive age. Method: A preliminary draft of the Contraceptive Self Efficacy Scale (CSES) was prepared according to the standard translation/back translation procedures and an expert panel appraised its content and face validities. The approved draft was tested on 400 randomly selected women of reproductive age (15–49 years) at the 29th Bahman Hospital of in Tabriz, the capital city of East Azerbaijan province, North West of Iran from May to August 2018. The exploratory and confirmatory factor analysis (EFA, CFA) was carried out to verify the implicit factor structure of the CSES for use on Persian-speaking women of fertile age. The Cronbach's α and Interclass Correlation coefficients were estimated for internal consistency and accuracy assessment of the instrument. Results: This translated scale indicated good internal consistency (0.9) and reliability (0.9). A four-factor solution best fitted the study data and the estimated fit indices were in the acceptable range (chi square/ degree of freedom = 2.956, the Root Mean Square Error of Approximation = 0.070, Confirmatory Fit Index = 0.667, The Tucker-Lewis Index = 0.599). Conclusion: The CSES-P can be considered as a potentially valid and reliable tool to assess contraceptive self-efficacy among Persian-speaking women. The CSES-P is a general instrument to measure overall contraceptive self-efficacy of the Iranian reproductive age women and it would also be fascinating to work on method specific self-efficacy tools in future. [ABSTRACT FROM AUTHOR]

Abstract Background Trust in government is associated with health behaviours and is an important consideration in population health interventions. While there is a reported decline in public trust in government across OECD countries, the tools used to measure trust are limited in their use for informing action to (re)build trust, and have limitations related to reliability and validity. To address the limitations of existing measures available to track public trust, the aim of the present work was to develop a new measure of trust in government. Methods Fifty-six qualitative interviews (Aug-Oct 2021; oversampling for equity-deserving populations) were conducted to design a national survey, including factor analyses and validation testing (N = 878; June 1-14th 2022) in Canada. Results The measure demonstrated strong internal consistency (α = 0.96) and test validity (CFI = 0.96, RMSEA = 0.09, SRMR = 0.03), suggesting that trust in government can be measured as a single underlying construct. It also demonstrated strong criterion validity, as measured by significant (p

Abstract Background Socioeconomic status (SES) is a critical multifactorial determinant of health and plays a significant role in shaping an individual’s health outcomes. While a composite scale has been proposed to measure SES in children, to our knowledge, limited composite scales were developed for adults in different contexts, highlighting the need for a comprehensive and valid SES measure to elucidate the relationship between SES and health in this population. Objective This study aimed to develop and validate a composite scale that measures the socioeconomic status in Lebanon and assess its correlates in a socioeconomic crisis context. Methods An online study was carried out between October and November 2022 across all Lebanese regions. Snowball sampling was used to enroll 448 adults living in Lebanon through a questionnaire created on Google Forms and shared by WhatsApp to a first sample from all geographic areas. Results The developed composite scale (SES-C) was found to be reliable and valid. It was based on several aspects of socioeconomic status, i.e., participant education level, family head education level, perceived social class, not being in debt, not receiving financial help, crowding index, participant work status, family head work status, monthly household income, and financial well-being. Furthermore, high SES was significantly associated with married status, older age, alcohol consumption, the absence of chronic disease, easy access to healthcare, private insurance coverage, and the number of rooms in the house in the bivariate analysis. In the multivariable analysis, high SES was significantly associated with age (ORa-1.13; p = 0.011) and easy access to healthcare (ORa = 7.81; p = 0.001) and inversely associated with chronic disease (ORa = 0.17; p = 0.002). Similar results with lower magnitude were found for moderate SES. Conclusion The study successfully developed and validated a composite scale (SES-C) for measuring the socioeconomic status in Lebanon, taking into account the complexities of the Lebanese context. The scale was found to be reliable and valid, and its results showed significant correlations with various factors such as older age, lower risk of chronic disease, and easy access to healthcare.

Abstract Background Most young adults and adolescents in the United Arab Emirates (UAE) do not meet the established internationally recommended physical activity levels per day. The Arab Teen Lifestyle Study (ATLS) physical activity questionnaire has been recommended for measuring self-reported physical activity of Arab adolescents and young adults (aged 14 years to mid-twenties). The first version of the ATLS has been validated with accelerometers and pedometers (r ≤ 0.30). The revised version of the questionnaire (ATLS-2, 2021) needs further validation. The aim of this study was to validate the self-reported subjective sedentary and physical activity time of the ATLS-2 (revised version) physical activity questionnaire with that of Fibion accelerometer-measured data. Methods In this cross-sectional study, 131 healthy adolescents and young adults (aged 20.47 ± 2.16 [mean ± SD] years (range 14–25 years), body mass index 23.09 ± 4.45 (kg/m2) completed the ATLS-2 and wore the Fibion accelerometer for a maximum of 7 days. Participants (n = 131; 81% non-UAE Arabs (n = 106), 13% Asians (n = 17) and 6% Emiratis (n = 8)) with valid ATLS-2 data without missing scores and Fibion data of minimum 10 h/day for at least 3 weekdays and 1 weekend day were analyzed. Concurrent validity between the two methods was assessed by the Spearman rho correlation and Bland-Altman plots. Results The questionnaire underestimated sedentary and physical activity time compared to the accelerometer data. Only negligible to weak correlations (r ≤ 0.12; p > 0.05) were found for sitting, walking, cycling, moderate intensity activity, high intensity activity and total activity time. In addition, a proportional/systematic bias was evident in the plots for all but two (walking and moderate intensity activity time) of the outcome measures of interest. Conclusions Overall, self-reported ATLS-2 sedentary and physical activity time had low correlation and agreement with objective Fibion accelerometer measurements in adolescents and young adults in the UAE. Therefore, sedentary and physical activity assessment for these groups should not be limited to self-reported measures.

Background: Trust in government is associated with health behaviours and is an important consideration in population health interventions. While there is a reported decline in public trust in government across OECD countries, the tools used to measure trust are limited in their use for informing action to (re)build trust, and have limitations related to reliability and validity. To address the limitations of existing measures available to track public trust, the aim of the present work was to develop a new measure of trust in government. Methods: Fifty-six qualitative interviews (Aug-Oct 2021; oversampling for equity-deserving populations) were conducted to design a national survey, including factor analyses and validation testing (N = 878; June 1-14th 2022) in Canada. Results: The measure demonstrated strong internal consistency (α = 0.96) and test validity (CFI = 0.96, RMSEA = 0.09, SRMR = 0.03), suggesting that trust in government can be measured as a single underlying construct. It also demonstrated strong criterion validity, as measured by significant (p < 0.0001) associations of scores with vaccine hesitancy, vaccine conspiracy beliefs, COVID-19 conspiracy beliefs, trust in public health messaging about COVID-19, and trust in public health advice about COVID-19. We present the Trust in Government Measure (TGM); a 13-item unidimensional measure of trust in Federal government. Conclusions: This measure can be used within high-income countries, particularly member countries within the OECD already in support of using tools to collect, publish and compare statistics. Our measure should be used by researchers and policy makers to measure trust in government as a key indicator of societal and public health. [ABSTRACT FROM AUTHOR]

Background: Psychosocial risk factors in the home may impair children's health and development and increase the risk of maltreatment. The Safe Environment for Every Kid (SEEK) model was developed to provide pediatric primary care professionals with a structured way to identify common psychosocial problems. The SEEK model includes use of the Parent Screening Questionnaire (SEEK-PSQ) at routine preventive child health visits, discussion with parents about their responses and, when indicated, referral to relevant services. The SEEK-PSQ has not previously been available in Swedish. The aim of the present study was to evaluate the psychometric properties of an adapted Swedish version of the SEEK-PSQ (PSQ-S). Methods: This study is part of a cluster-randomised controlled trial of SEEK in the Swedish child health services. To validate the PSQ-S, parents (n = 852) with children 0–18 months of age were invited to complete a survey including the PSQ-S as well as evidence-based standardized instruments for the targeted psychosocial risk factors: economic worries, depressive symptoms, parental stress, alcohol misuse and intimate partner violence (IPV). Baseline data from 611 (72%) parents were analysed regarding sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for each risk factor. Results: As a whole, the PSQ-S had a sensitivity of 93%, specificity of 52%, PPV of 67% and NPV of 87%. For mothers and fathers combined, sensitivity was 80% for economic worries, 89% for depressive symptoms, 78% for parental stress, 47% for intimate partner violence (IPV) and 70% for alcohol misuse. Specificity was highest for IPV and alcohol misuse (91%) and lowest for depressive symptoms (64%). NPV values were high (81–99%) and PPV values were low to moderate (22–69%) for the targeted problems. Sensitivity was higher for mothers compared to fathers for economic worries, depressive symptoms and IPV. This difference was particularly evident for IPV (52% for mothers, 27% for fathers). Conclusion: The SEEK-PSQ-S demonstrated good psychometric properties for identifying economic worries, depressive symptoms, parental stress and alcohol misuse but low sensitivity for IPV. The PSQ-S as a whole showed high sensitivity and NPV, indicating that most parents with or without the targeted psychosocial risk factors were correctly identified. Trial registration: ISRCTN registry, study record 14,429,952 (https://doi.org/10.1186/ISRCTN14429952) Registration date 27/05/2020. [ABSTRACT FROM AUTHOR]

Background: Given the worldwide reach of COVID-19, media coverage has amplified the psychological and social effects of this pandemic causing a widespread fear. Despite substantial research on the short-term psychological impact of COVID-19, its long-term consequences on mental health remain relatively unexplored. This research aims to develop and validate a Post-Pandemic Fear of Viral Disease (PPFVD) scale and to see its relationship with general anxiety disorder among the Pakistani population. Methods: A cross-sectional online-based survey was conducted with 457 respondents in August and September 2022. We adopted the modified fear of coronavirus scale (FCV-19 S) consisting of seven items and the Generalized Anxiety Disorder (GAD) questionnaire to measure anxiety disorder. Confirmatory factor analysis was applied using the maximum likelihood estimation method. Scale dimensions and item reliability were tested for their validity and goodness of fit. SPSS and AMOS were used for data management and analyses. Results: All inter-item correlations were found to be significant and ranged between 0.30 and 0.70. The value of Cronbach's alpha was 0.887, indicating good reliability. Corrected item-total correlations ranged between 0.632 and 0.754. Factor loadings ranged from 0.664 to 0.810, indicating a good internal consistency. Overall, these results clearly demonstrate that the one-factor solution model for PPFVD presents a good fit to the data. The composite reliability (CR = 0.747) was also good. Conclusions: The COVID-19 pandemic has negatively affected the mental health of people globally. This measurement scale can be trusted and used to test the PPFVD in the post-pandemic situation. Prospective research might validate this instrument in newly emerging scenarios and test it with diverse ethnic groups. [ABSTRACT FROM AUTHOR]

Abstract Background Health Literacy is a crucial factor for health. In Europe, many people have limited health literacy (i.e. difficulties with accessing, understanding, appraising and using health information). This study aimed to evaluate the psychometrics of the Swedish versions of the HLS-EU-Q16 and HLS-EU-Q6, instruments that aims to assess health literacy. Methods In this prospective psychometric study convenience sampling was used, which gave a study population of 347 Swedish-speaking adults. The psychometric evaluation included item distributional statistics, construct validity testing, and principal component analysis to assess structural validity. Internal consistency and test-retest reliability was also investigated. Results For the Swedish version of HLS-EU-Q16, no floor effects were detected but a ceiling effect was noted among 28% of the respondents. Construct validity was supported as four out of five expected correlations was confirmed (educational level, self-perceived health, electronic health literacy and HLS-EU-Q6). In terms of structural validity, the principal component analysis yielded a four-factor structure with most items loading significantly only to one factor. The Swedish version of HLS-EU-Q16 had acceptable internal consistency (Cronbach’s α = 0.89, split-half reliability = 0.93) and test-retest reliability showed stability over time (Cohen’s κ = 0.822). For the Swedish version of HLS-EU-Q6, neither floor nor ceiling effects were observed. Construct validity was supported as HLS-EU-Q6 correlated as our a priori stated hypothesis. The principal component analysis did not support the unidimensionality of the scale as a two-factor structure was identified. The Swedish version of HLS-EU-Q6 had acceptable internal consistency (Cronbach’s α = 0.77, split-half reliability = 0.80) and test-retest reliability showed stability over time (Cohen’s κ = 0.812). According to the Swedish version of the HLS-EU-Q16, 71% of the participants were classified as having sufficient comprehensive health knowledge (CHL), while only 33% were classified as having this when the HLS-EU-Q6 was used. Conclusions The Swedish versions of the HLS-EU-Q16 and HLS-EU-Q6 have acceptable psychometric properties, and based on the results we recommend its use to measure CHL. However, we are hesitant to use Sw-HLS-EU-Q6 in estimating different CHL levels and further studies need to be conducted to establish validity and accuracy of the thresholds of HLS-EU-Q6.

Background: Most young adults and adolescents in the United Arab Emirates (UAE) do not meet the established internationally recommended physical activity levels per day. The Arab Teen Lifestyle Study (ATLS) physical activity questionnaire has been recommended for measuring self-reported physical activity of Arab adolescents and young adults (aged 14 years to mid-twenties). The first version of the ATLS has been validated with accelerometers and pedometers (r ≤ 0.30). The revised version of the questionnaire (ATLS-2, 2021) needs further validation. The aim of this study was to validate the self-reported subjective sedentary and physical activity time of the ATLS-2 (revised version) physical activity questionnaire with that of Fibion accelerometer-measured data. Methods: In this cross-sectional study, 131 healthy adolescents and young adults (aged 20.47 ± 2.16 [mean ± SD] years (range 14–25 years), body mass index 23.09 ± 4.45 (kg/m2) completed the ATLS-2 and wore the Fibion accelerometer for a maximum of 7 days. Participants (n = 131; 81% non-UAE Arabs (n = 106), 13% Asians (n = 17) and 6% Emiratis (n = 8)) with valid ATLS-2 data without missing scores and Fibion data of minimum 10 h/day for at least 3 weekdays and 1 weekend day were analyzed. Concurrent validity between the two methods was assessed by the Spearman rho correlation and Bland-Altman plots. Results: The questionnaire underestimated sedentary and physical activity time compared to the accelerometer data. Only negligible to weak correlations (r ≤ 0.12; p > 0.05) were found for sitting, walking, cycling, moderate intensity activity, high intensity activity and total activity time. In addition, a proportional/systematic bias was evident in the plots for all but two (walking and moderate intensity activity time) of the outcome measures of interest. Conclusions: Overall, self-reported ATLS-2 sedentary and physical activity time had low correlation and agreement with objective Fibion accelerometer measurements in adolescents and young adults in the UAE. Therefore, sedentary and physical activity assessment for these groups should not be limited to self-reported measures. [ABSTRACT FROM AUTHOR]

Abstract Background Health literacy is closely related to health status. Measuring public health literacy levels helps to warn of health status and manage health problems through timely interventions. The items of relevant evaluation tools are complex and numerous in China, and there is no recognized health literacy brief scale for the whole population. To translate the 12-item short-form health literacy scale (HLS-SF12) and test the validity and reliability of the Chinese version of the HLS-SF12 in the Chinese population. Methods The HLS-SF12 was translated into Chinese using the procedures of translation, back translation, and cultural debugging. 10,951 residents were selected by quota sampling method to test the validity and reliability of the scale, and 33 people were selected to retest after 2 weeks. The reliability was tested by using internal consistency coefficient and test-retest reliability. The validity was tested by using confirmatory factor analysis, content validity, convergent validity and discriminant validity. Results The Cronbach’s Alpha coefficient for the total scale was 0.94, and the test-retest reliability was 0.89. The Cronbach’s Alpha coefficients for the three subscales of health care, disease prevention, and health promotion respectively were 0.86, 0.86, 0.87, and the test-retest reliability respectively were 0.91, 0.79, 0.63. The confirmatory factor analysis identified a three factors model and showed nice goodness of fit indices for Chinese HLS-SF12 (GFI = 0.96, CFI = 0.97, IFI = 0.97, TLI = 0.96, and RMSEA = 0.07). Conclusion The Chinese version of the HLS-SF12 has good reliability and validity, and can be used as a tool to evaluate the health literacy of Chinese people.

Abstract Background Health literacy is an important social determinant of health and affects the ability to make decisions and take action to manage one’s health. The purpose of this study was to psychometrically examine the Arabic versions of HLS-EU-Q16 and HLS-EU-Q6 and their response patterns among Arabic-speaking persons in Sweden. Methods By convenience sampling from a variety of settings, a total of 335 participants were invited to participate. The participants completed a self-assessment of comprehensive health literacy by answering the Ar-HLS-EU-Q16 questionnaire, also including the six items for Ar-HLS-EU-Q6. Statistical analysis was guided by The COnsensus-based Standards for the selection of health Measurement Instruments. Floor/ceiling effects, construct, structural and criterion validity, test-retest reliability and internal consistency reliability were analysed. Results In total, 320 participants were included in the psychometric evaluation. Mean age was 42.1 (SD 12.5), 63% (n = 199) were females and 53% (n = 169) had at least 10 years of education. No floor or ceiling effect were found for the Ar-HLS-EU-Q16 or Ar-HLS-EU-Q6. For both instruments, construct validity was confirmed in four out of five expected correlations (weak positive correlation to educational level, self-perceived health, and years in Sweden; moderate positive correlation with higher sum score on the Arabic electronic health literacy scale, and strong positive correlation to higher Ar-HLS-EU-Q16/Ar-HLS-EU-Q6). For Ar-HLS-EU-Q16, the principal component analysis resulted in a three-factor model with all items significantly correlating to only one factor. For Ar-HLS-EU-Q6, the principal component analysis supported a one-factor solution. Criterion validity showed poor agreement between the two questionnaires with a Cohen κ 0.58 (p

Abstract Background Post-stroke complications affect the informal caregivers equally as the stroke survivors, especially those who have a moderate to worst prognosis in functional capacity recovery. Caregiver Assessment of Function and Upset (CAFU) is one of the common tools used in both research and clinical practice to measure the patient’s dependency level and the stroke caregivers' upset level. Objective This study aimed to translate and validate the CAFU instrument into the Malay language and test the validity and reliability of the CAFU among informal stroke caregivers in Malaysia. Methods A standard forward-backward translation method was employed to translate CAFU. Subsequently, 10 expert panels were included in the validation process, and thereafter reliability testing was conducted among 51 stroke caregivers. The validation of the instrument was determined by computing the content validity indices (CVIs), and we used the Cronbach’s alpha method to explore the internal consistency of the overall score and subscales scores of the Malay-CAFU. Finally, the explanatory factor analysis used principal component extraction and a varimax rotation to examine construct validity. Results All items of the Malay-CAFU had satisfactory item-level CVI (I-CVI), with values greater than 0.80, and the scale-level CVI (S-CVI) was 0.95. These results indicate that the Malay-CAFU had good relevancy. The internal consistency for the reliability test showed a Cronbach’s alpha value of 0.95 for the overall score. The eigenvalues and scree plot supported a two-factor structural model of the instrument. From the explanatory factor analysis, the factor loadings ranged from 0.82 to 0.90 and 0.56 to 0.83, respectively. Conclusion The Malay-CAFU questionnaire is a valid and reliable instrument to assess the dependence level of stroke survivors and the upset level of informal stroke caregivers in Malaysia.

Abstract Background This study validated the Korean version of the Readiness to Return to Work (RRTW) scale, as an assessment measure, following a musculoskeletal, work-related injury and as a measure of following return to work. Methods The participants of this study were workers with experience in rehabilitation programs at the Workers’ Compensation and Welfare Service (KCOMWEL) Hospital in Korea. Factor analyses were employed to ensure the validity and reliability of the RRTW scale in claimants who were in treatment without working (the not-working group) or who had already returned to work (the working group). To test structural validity, we analyzed exploratory factor analysis (EFA) respectively for the not working group (exploratory factor analysis (EFA) (n = 200), confirmatory factor analysis (CFA) (n = 109), and the working group (n = 123). To verify concurrent validity (multidimensional and assignment approach), the variables that were identified as relevant variables in previous studies were analyzed. Results The not working group EFA, as shown in the original scale, had four dimensions, and one item was deleted: (1) Precontemplation (PC), (2) Contemplation (C), (3) Prepared for Action-Self-evaluative (PAS), and (4) Prepared for Action-Behavioral (PAB). The CFA revealed that a good model fit and reliability were suitable. Regarding the working group of EFA, it appeared in two dimensions as in the original scale, one item was modified from the UM scale to the PM scale, and the reliability was appropriate. Concurrent validity was satisfied based on the correlation between the RRTW factor and related variables. Conclusions RRTW in the Korean version of the instrument was similar to those reported for the original scale, indicating that it may be used in research and clinical settings.

Abstract Background Verbal autopsy (VA) has emerged as an increasingly popular technique to assign cause of death in parts of the world where the majority of deaths occur without proper medical certification. The purpose of this study was to examine the key characteristics of studies that have attempted to validate VA cause of death against an established cause of death. Methods A systematic review was conducted by searching the MEDLINE, EMBASE, Cochrane-library, and Scopus electronic databases. Included studies contained 1) a VA component, 2) a validation component, and 3) original analysis or re-analysis. Characteristics of VA studies were extracted. A total of 527 studies were assessed, and 481 studies screened to give 66 studies selected for data extraction. Results Sixty-six studies were included from multiple countries. Ten studies used an existing database. Sixteen studies used the World Health Organization VA questionnaire and 5 studies used the Population Health Metrics Research Consortium VA questionnaire. Physician certification was used in 36 studies and computer coded methods were used in 14 studies. Thirty-seven studies used high level comparator data with detailed laboratory investigations. Conclusion Most studies found VA to be an effective cause of death assignment method and compared VA cause of death to a high-quality established cause of death. Nonetheless, there were inconsistencies in the methodologies of the validation studies, and many used poor quality comparison cause of death data. Future VA validation studies should adhere to consistent methodological criteria so that policymakers can easily interpret the findings to select the most appropriate VA method. Prospero Registration CRD42020186886.

Abstract Background The overall aim of this study was to examine essential aspects of reliability and validity of a constructed Occupational Mechanical Job Exposure Index for use in analyses of Norwegian register data. Methods We utilized data from the Norwegian nationwide Survey of Living Conditions on work environment in 2006, 2009, 2013, 2016 and 2019. Occupations were classified on a 4-digit level based on the Norwegian version of the International Standard Classification of Occupations (ISCO-88). We constructed a 4-digit correspondence table between the occupational codes used in the 2006 and 2009 surveys (STYRK-98) and the codes used in 2013, 2016 and 2019 (STYRK-08). The mechanical exposures were collected by Statistics Norway using telephone interviews. As for reliability, we examined the agreement between the individual- and the occupational-based mechanical exposures using Cohen’s kappa, sensitivity and specificity measures. Construct, concurrent and predictive validity pertaining to the Occupational Mechanical Job Exposure Index were analysed using both survey data and nationwide register data. Results The analysis shows a fair-to-moderate overlap between occupational-based mechanical exposures and the individually reported exposures. Construct validity of the Occupational Mechanical Job Exposure Index, as estimated by a confirmatory factor analysis using the occupational-based mechanical exposures, showed that the 8 exposures formed one underlying factor. When assessing the concurrent value of the Occupational Mechanical Job Exposure Index to the index based on the individual reported exposures, the occupational mechanical index showed lower and reproducible associations with lower back pain for both men and women. For long-term sick leave, the occupational mechanical index showed higher and reproducible associations for both genders. As for predictive validity, the register data analysis shows that the occupational mechanical index was associated with disability and a higher number of long-term sickness benefits periods for both men and women. For men the index also predicted higher mortality. Conclusion Our tests of reliability and validity of the Occupational Mechanical Job Exposure Index indicate that the index overall has acceptable statistical properties and will be useful in analyses of Norwegian register data where individual information on these types of exposures is missing.

Background: Health Literacy is a crucial factor for health. In Europe, many people have limited health literacy (i.e. difficulties with accessing, understanding, appraising and using health information). This study aimed to evaluate the psychometrics of the Swedish versions of the HLS-EU-Q16 and HLS-EU-Q6, instruments that aims to assess health literacy. Methods: In this prospective psychometric study convenience sampling was used, which gave a study population of 347 Swedish-speaking adults. The psychometric evaluation included item distributional statistics, construct validity testing, and principal component analysis to assess structural validity. Internal consistency and test-retest reliability was also investigated. Results: For the Swedish version of HLS-EU-Q16, no floor effects were detected but a ceiling effect was noted among 28% of the respondents. Construct validity was supported as four out of five expected correlations was confirmed (educational level, self-perceived health, electronic health literacy and HLS-EU-Q6). In terms of structural validity, the principal component analysis yielded a four-factor structure with most items loading significantly only to one factor. The Swedish version of HLS-EU-Q16 had acceptable internal consistency (Cronbach's α = 0.89, split-half reliability = 0.93) and test-retest reliability showed stability over time (Cohen's κ = 0.822). For the Swedish version of HLS-EU-Q6, neither floor nor ceiling effects were observed. Construct validity was supported as HLS-EU-Q6 correlated as our a priori stated hypothesis. The principal component analysis did not support the unidimensionality of the scale as a two-factor structure was identified. The Swedish version of HLS-EU-Q6 had acceptable internal consistency (Cronbach's α = 0.77, split-half reliability = 0.80) and test-retest reliability showed stability over time (Cohen's κ = 0.812). According to the Swedish version of the HLS-EU-Q16, 71% of the participants were classified as having sufficient comprehensive health knowledge (CHL), while only 33% were classified as having this when the HLS-EU-Q6 was used. Conclusions: The Swedish versions of the HLS-EU-Q16 and HLS-EU-Q6 have acceptable psychometric properties, and based on the results we recommend its use to measure CHL. However, we are hesitant to use Sw-HLS-EU-Q6 in estimating different CHL levels and further studies need to be conducted to establish validity and accuracy of the thresholds of HLS-EU-Q6. [ABSTRACT FROM AUTHOR]

Background: Health literacy is closely related to health status. Measuring public health literacy levels helps to warn of health status and manage health problems through timely interventions. The items of relevant evaluation tools are complex and numerous in China, and there is no recognized health literacy brief scale for the whole population. To translate the 12-item short-form health literacy scale (HLS-SF12) and test the validity and reliability of the Chinese version of the HLS-SF12 in the Chinese population. Methods: The HLS-SF12 was translated into Chinese using the procedures of translation, back translation, and cultural debugging. 10,951 residents were selected by quota sampling method to test the validity and reliability of the scale, and 33 people were selected to retest after 2 weeks. The reliability was tested by using internal consistency coefficient and test-retest reliability. The validity was tested by using confirmatory factor analysis, content validity, convergent validity and discriminant validity. Results: The Cronbach's Alpha coefficient for the total scale was 0.94, and the test-retest reliability was 0.89. The Cronbach's Alpha coefficients for the three subscales of health care, disease prevention, and health promotion respectively were 0.86, 0.86, 0.87, and the test-retest reliability respectively were 0.91, 0.79, 0.63. The confirmatory factor analysis identified a three factors model and showed nice goodness of fit indices for Chinese HLS-SF12 (GFI = 0.96, CFI = 0.97, IFI = 0.97, TLI = 0.96, and RMSEA = 0.07). Conclusion: The Chinese version of the HLS-SF12 has good reliability and validity, and can be used as a tool to evaluate the health literacy of Chinese people. [ABSTRACT FROM AUTHOR]

Background: Health literacy is an important social determinant of health and affects the ability to make decisions and take action to manage one's health. The purpose of this study was to psychometrically examine the Arabic versions of HLS-EU-Q16 and HLS-EU-Q6 and their response patterns among Arabic-speaking persons in Sweden. Methods: By convenience sampling from a variety of settings, a total of 335 participants were invited to participate. The participants completed a self-assessment of comprehensive health literacy by answering the Ar-HLS-EU-Q16 questionnaire, also including the six items for Ar-HLS-EU-Q6. Statistical analysis was guided by The COnsensus-based Standards for the selection of health Measurement Instruments. Floor/ceiling effects, construct, structural and criterion validity, test-retest reliability and internal consistency reliability were analysed. Results: In total, 320 participants were included in the psychometric evaluation. Mean age was 42.1 (SD 12.5), 63% (n = 199) were females and 53% (n = 169) had at least 10 years of education. No floor or ceiling effect were found for the Ar-HLS-EU-Q16 or Ar-HLS-EU-Q6. For both instruments, construct validity was confirmed in four out of five expected correlations (weak positive correlation to educational level, self-perceived health, and years in Sweden; moderate positive correlation with higher sum score on the Arabic electronic health literacy scale, and strong positive correlation to higher Ar-HLS-EU-Q16/Ar-HLS-EU-Q6). For Ar-HLS-EU-Q16, the principal component analysis resulted in a three-factor model with all items significantly correlating to only one factor. For Ar-HLS-EU-Q6, the principal component analysis supported a one-factor solution. Criterion validity showed poor agreement between the two questionnaires with a Cohen κ 0.58 (p < 0.001). Test-retest reliability showed a substantial agreement, Cohen's κ for Ar-HLS-EU-Q16 and Ar-HLS-EU-Q6 were both 0.89. The internal consistency of both versions was acceptable, Cronbach alpha for Arabic-HLS-EU-Q16 was 0.91 and for Arabic-HLS-EU-Q6, 0.79. Split-half reliability was 0.95 and 0.78, respectively. Conclusion: The Arabic version of HLS-EU-Q16 shows good psychometric properties, validated in a Swedish setting. The findings can further inform and guide future validation studies in other settings worldwide. Furthermore, the results of the present study did not support criterion validity of Ar-HLS-EU-Q6. [ABSTRACT FROM AUTHOR]

Background: The Claim Evaluation Tools measure the ability to assess claims about treatment effects. The aim of this study was to adapt the German item sets to the target group of secondary school students (aged 11 to 16 years, grade 6 to 10) and to validate them accordingly. The scale's reliability and validity using Rasch's probabilistic test theory should be determined. Methods: We conducted a sequential mixed-method study comprising three stages: contextualisation and adaption of the items (stage 1), piloting of the item sets using qualitative interviews (stage 2) and a construct validation by testing the unidimensional Rasch scalability for each item set after data collection in one secondary school in Germany and two secondary schools in Austria. We explored summary and individual fit statistics and performed a distractor analysis (stage 3). Results: Secondary school students (n = 6) and their teachers (n = 5) participated in qualitative interviews in Germany. The qualitative interviews identified the need for minor modifications (e.g. reducing thematic repetitions, changing the order of the items). The data of 598 German and Austrian secondary school students were included to test for Rasch scalability. Rasch analyses showed acceptable overall model fit. Distractor analyses suggested that model fit could be improved by simplifying the text in the scenarios, removing and editing response options of some items. Conclusion: After the revision of some items, the questionnaires are suitable to evaluate secondary school students' ability to assess health claims. A future goal is to increase the pool of items being translated and tested. [ABSTRACT FROM AUTHOR]

Abstract Background Healthcare workers (HCWs) represents one of the highest-risk population to develop burnout symptoms. Recently, a new tool has been designed to measure several dimensions that capture an exhaustive expression of burnout symptoms by six dimensions (i.e., exhaustion; mental distance; cognitive impairment; emotional impairment; psychological distress; psychosomatic complaints). Methods The current study aims to adapt the Burnout Assessment Tool (BAT) to an Italian Healthcare workers’ sample confirming the original second-order factorial structure. Furthermore, we expected to find good indexes of reliability and validity tests. Participants were 697 Italian Health Care Workers (Female = 68.44%; mean age = 36.47; SD = 11.20). Data were collected by self-report questionnaires submitted by the snowball method. Results Findings show a good fit of the BAT’s structure, confirming the hypothesized second-order factorial model. Furthermore, good reliability has been established with the study’s measures. Conclusions The BAT for HCWs is eligible as a new tool to evaluate burnout in the at-risk HCWs as a multi-facet constellation of symptoms.

Abstract Background Burnout is related to huge costs, for both individuals and organizations and is recognized as an occupational disease or work-related disorder in many European countries. Given that burnout is a major problem it is important to measure the levels of burnout in a valid and reliable way. The Burnout Assessment Tool (BAT) is a newly developed self-report questionnaire to measure burnout. So far, studies concerning the psychometric properties of the original version of the Burnout Assessment Tool (BAT) including 23 items show promising results and suggest that the instrument can be used in many different settings. For various reasons there is a need of a shorter instrument. For example, burnout questionnaires are typically included in employee surveys to evaluate psychosocial risk-factors, which according to the European Occupational Safety and Health Framework Directive, should be carried out in organizations on a regular basis. The aims of this paper are to develop a shorter version of the BAT, including only 12 items (BAT12) and to evaluate its construct validity and differential item functioning regarding age, gender and country. Methods Using data from representative samples of working populations in the Netherlands and Belgium (Flanders) a shorter version of the BAT was developed by combining quantitative (Rasch analysis) and qualitative approaches (item content analysis and expert judgements). Construct validity of the new BAT12 was evaluated by means of Rasch analysis. Results In an iterative procedure, deleting one item from each subscale at each step, a short version of the BAT – BAT12 was developed. The BAT12 fulfils the measurement criteria according to the Rasch model after accounting for local dependency between items within each subscale. The four subscales can be combined into a single burnout score. Conclusion The new BAT12 developed in the present study maintains the breath of item content of the original version of the BAT. The new BAT12 has sound psychometric properties. The scale works invariantly for older and younger, women and men and across two countries. A shorter version of the BAT is timesaving compared to the BAT23 and can be used in e.g. employee surveys.

Background: The overall aim of this study was to examine essential aspects of reliability and validity of a constructed Occupational Mechanical Job Exposure Index for use in analyses of Norwegian register data.  METHODS: We utilized data from the Norwegian nationwide Survey of Living Conditions on work environment in 2006, 2009, 2013, 2016 and 2019. Occupations were classified on a 4-digit level based on the Norwegian version of the International Standard Classification of Occupations (ISCO-88). We constructed a 4-digit correspondence table between the occupational codes used in the 2006 and 2009 surveys (STYRK-98) and the codes used in 2013, 2016 and 2019 (STYRK-08). The mechanical exposures were collected by Statistics Norway using telephone interviews. As for reliability, we examined the agreement between the individual- and the occupational-based mechanical exposures using Cohen's kappa, sensitivity and specificity measures. Construct, concurrent and predictive validity pertaining to the Occupational Mechanical Job Exposure Index were analysed using both survey data and nationwide register data.Results: The analysis shows a fair-to-moderate overlap between occupational-based mechanical exposures and the individually reported exposures. Construct validity of the Occupational Mechanical Job Exposure Index, as estimated by a confirmatory factor analysis using the occupational-based mechanical exposures, showed that the 8 exposures formed one underlying factor. When assessing the concurrent value of the Occupational Mechanical Job Exposure Index to the index based on the individual reported exposures, the occupational mechanical index showed lower and reproducible associations with lower back pain for both men and women. For long-term sick leave, the occupational mechanical index showed higher and reproducible associations for both genders. As for predictive validity, the register data analysis shows that the occupational mechanical index was associated with disability and a higher number of long-term sickness benefits periods for both men and women. For men the index also predicted higher mortality.Conclusion: Our tests of reliability and validity of the Occupational Mechanical Job Exposure Index indicate that the index overall has acceptable statistical properties and will be useful in analyses of Norwegian register data where individual information on these types of exposures is missing. [ABSTRACT FROM AUTHOR]

Abstract Aim To examine the external validity of the Family Affluence Scale (FAS) among adolescents in Sweden by using register data for parental earned income, level of education and occupational status. Methods Data from the baseline (2015–2019) of the Study of Adolescence Resilience and Stress (STARS), comprising 2283 13-year-olds in the region of Västra Götaland, were used. The FAS III consists of six items: unshared bedroom, car ownership, computer/tablet ownership, dishwasher, number of bathrooms and number of holidays abroad. Register data regarding earned income, educational level and occupational status from Statistics Sweden (2014–2018) were linked to adolescents. In total, survey data were available for 2280 adolescents, and register data were available for 2258 mothers and 2204 fathers. Results Total parental earned income was moderately correlated with adolescents’ scoring on FAS (0.31

Abstract Background Approximately 545,000 women and girls in the USA have undergone Female Genital Mutilation/ Cutting (FGM/C) or have mothers from a country where FGM/C is practiced. Women and girls living with FGM/C in the USA may experience stigma and bias due to their FGM/C, immigration, racial, and language status. Health care provider attitudes toward FGM/C and confidence for related clinical care may affect the quality of care, yet there are no validated instruments to measure these constructs. Methods We developed the instruments via review of the FGM/C literature, the development of scale items, expert review, and pre-testing. We validated the instruments using a convenience sample of providers in Arizona and Maryland. We used exploratory factor analysis (EFA) to confirm factor structures, and compared scores between known groups to assess validity. Results The EFA revealed a two-factor solution for attitudes, including subscales for Negative Attitudes and Empathetic Attitudes toward FGM/C and those who practice with Cronbach’s alphas of 0.814 and 0.628 respectively. The EFA for confidence revealed a two-factor solution including Confidence in Clinical FGM/C Care and Confidence in Critical Communication Skills for FGM/C Care with Cronbach’s alphas of 0.857 and 0.694 respectively. Conclusions Health care provider attitudes and confidence toward FGM/C care may affect quality of care and health outcomes for women and girls. Our study describes the rigorous psychometric analysis to create reliable and valid instruments to assess health care provider attitudes and confidence for the care of women and girls who have experienced FGM/C. Trial registration ClinicalTrials.gov , NCT03249649 . Registered on 15 August 2017. Retrospectively registered.

Abstract Background The physical activity-environment relationship has been infrequently investigated in Chinese children. Reliable and valid environmental measures specific to the age group and the local context are crucial for better understanding this relationship. The purposes of this study were to adapt the Neighborhood Environment Walkability Scale for youth (NEWS-Y) for Chinese children (termed NEWS-CC), and to examine the reliability and factorial validity of the NEWS-CC. Methods The development of the NEWS-CC involved the translation of the NEWS-Y to Chinese and the addition of nine new items capturing Hong Kong specific environmental attributes which were generated in our previous study. A total of 953 Hong Kong children aged 9–14 years volunteered to complete the NEWS-CC twice with 7–14 days apart. Confirmatory factor analysis (CFA) was performed to examine the factorial validity of the NEWS-CC. Test-retest reliability of subscales and individual items in the NEWS-CC was examined by intraclass correlation coefficients (ICCs). Results The CFA identified a 7-factor measurement model for the NEWS-CC which fitted the data well, with an additional “pollution” factor not included in the original NEWS-Y. The final NEWS-CC consisted of 67 items in 10 subscales. The test-retest reliability of subscales (range of ICC = 0.47–0.86) and individual items (range of ICC = 0.41–0.79) in the final NEWS-CC was moderate to good. Conclusion The results of this study support the psychometric properties of the NEWS-CC. The NEWS-CC can be used to assess physical activity-related neighborhood environment among children in Hong Kong, as well as cities that share similar urban forms with Hong Kong.

Abstract Background Social science models find the ecological impacts of climate change (EICC) contribute to internal migration in developing countries and, less so, international migration. Projections expect massive climate-related migration in this century. Nascent research calls to study health, migration, population, and armed conflict potential together, accounting for EICC and other factors. System science offers a way: develop a dynamic simulation model (DSM). We aim to validate the feasibility and usefulness of a pilot DSM intended to serve as a proof-of-concept and a basis for identifying model extensions to make it less simplified and more realistic. Methods Studies have separately examined essential parts. Our DSM integrates their results and computes composites of health problems (HP), health care (HC), non-EICC environmental health problems (EP), and environmental health services (ES) by origin site and by immigrants and natives in a destination site, and conflict risk and intensity per area. The exogenous variables include composites of EICC, sociopolitical, economic, and other factors. We simulate the model for synthetic input values and conduct sensitivity analyses. Results The simulation results refer to generic origin and destination sites anywhere on Earth. The effects’ sizes are likely inaccurate from a real-world view, as our input values are synthetic. Their signs and dynamics are plausible, internally consistent, and, like the sizes, respond logically in sensitivity analyses. Climate migration may harm public health in a host area even with perfect HC/ES qualities and full access; and no HP spillovers across groups, conflict, EICC, and EP. Deviations from these conditions may worsen everyone’s health. We consider adaptation options. Conclusions This work shows we can start developing DSMs to understand climate migration and public health by examining each case with its own inputs. Validation of our pilot model suggests we can use it as intended. We lay a path to making it more realistic for policy analysis.

Background: Burnout is related to huge costs, for both individuals and organizations and is recognized as an occupational disease or work-related disorder in many European countries. Given that burnout is a major problem it is important to measure the levels of burnout in a valid and reliable way. The Burnout Assessment Tool (BAT) is a newly developed self-report questionnaire to measure burnout. So far, studies concerning the psychometric properties of the original version of the Burnout Assessment Tool (BAT) including 23 items show promising results and suggest that the instrument can be used in many different settings. For various reasons there is a need of a shorter instrument. For example, burnout questionnaires are typically included in employee surveys to evaluate psychosocial risk-factors, which according to the European Occupational Safety and Health Framework Directive, should be carried out in organizations on a regular basis. The aims of this paper are to develop a shorter version of the BAT, including only 12 items (BAT12) and to evaluate its construct validity and differential item functioning regarding age, gender and country.Methods: Using data from representative samples of working populations in the Netherlands and Belgium (Flanders) a shorter version of the BAT was developed by combining quantitative (Rasch analysis) and qualitative approaches (item content analysis and expert judgements). Construct validity of the new BAT12 was evaluated by means of Rasch analysis.Results: In an iterative procedure, deleting one item from each subscale at each step, a short version of the BAT - BAT12 was developed. The BAT12 fulfils the measurement criteria according to the Rasch model after accounting for local dependency between items within each subscale. The four subscales can be combined into a single burnout score.Conclusion: The new BAT12 developed in the present study maintains the breath of item content of the original version of the BAT. The new BAT12 has sound psychometric properties. The scale works invariantly for older and younger, women and men and across two countries. A shorter version of the BAT is timesaving compared to the BAT23 and can be used in e.g. employee surveys. [ABSTRACT FROM AUTHOR]

Background: Healthcare workers (HCWs) represents one of the highest-risk population to develop burnout symptoms. Recently, a new tool has been designed to measure several dimensions that capture an exhaustive expression of burnout symptoms by six dimensions (i.e., exhaustion; mental distance; cognitive impairment; emotional impairment; psychological distress; psychosomatic complaints).Methods: The current study aims to adapt the Burnout Assessment Tool (BAT) to an Italian Healthcare workers' sample confirming the original second-order factorial structure. Furthermore, we expected to find good indexes of reliability and validity tests. Participants were 697 Italian Health Care Workers (Female = 68.44%; mean age = 36.47; SD = 11.20). Data were collected by self-report questionnaires submitted by the snowball method.Results: Findings show a good fit of the BAT's structure, confirming the hypothesized second-order factorial model. Furthermore, good reliability has been established with the study's measures.Conclusions: The BAT for HCWs is eligible as a new tool to evaluate burnout in the at-risk HCWs as a multi-facet constellation of symptoms. [ABSTRACT FROM AUTHOR]

Abstract Background Family health is an important issue which has attracted researchers from different fields. The present study aimed to validate the Persian version of the Family Health Climate Scale (FHC-Scale). Methods In this methodological research, a total of 620 individuals presenting to Comprehensive Healthcare centers affiliated with Mashhad University of Medical Sciences and Gonabad University of Medical Sciences were selected through random multistage sampling. Validation of the FHC-Scale was performed. First, the original scale was translated and back-translated. Then its content validity and construct validity were assessed using exploratory and confirmatory factor analysis. Reliability was assessed using internal consistency and stability. Data were analyzed using SPSS version 20 (IBM Corp., Armonk, NY, USA) and LISREL version 8.5 (SSI Inc., Skokie, IL, USA). Results Results of exploratory factor analysis showed that “physical activity” of family health climate scale (FHC-PA) has three dimensions: value, cohesion and information explaining 61.99% of the variance. “Nutrition” of family health climate scale (FHC-NU) had four dimensions of value, communication, cohesion and consensus explaining 66.19% of the variance. Internal consistency of the dimensions of (FHC-PA) ranged 0.82–0.85 and that for FHC-NU ranged 0.82–0.84. Confirmatory factor analysis revealed goodness of fit and confirmed family health climate scale (Nutrition and physical activity). Conclusion Results of the study revealed that the FHC-Scale has appropriate reliability and validity for Iranian families. Therefore, the Persian version of the scale can be used for assessing health-related aspects of family.

Abstract Climate change is predicted to increase the frequency and intensity of floods in the province of Quebec, Canada. Therefore, in 2015, to better monitor the level of adaptation to flooding of Quebec residents living in or near a flood-prone area, the Quebec Observatory of Adaptation to Climate Change developed five indices of adaptation to flooding, according to the chronology of events. The present study was conducted 4 years later and is a follow-up to the 2015 one. Two independent samples of 1951 (2015) and 974 (2019) individuals completed a questionnaire on their adoption (or non-adoption) of flood adaptation behaviors, their perception of the mental and physical impacts of flooding, and their knowledge of the fact that they lived in a flood-prone area. The results of the study demonstrated the measurement invariance of the five indices across two different samples of people over time, ensuring that the differences (or absence of differences) observed in flood-related adaptive behaviors between 2015 and 2019 were real and not due to measurement errors. They also showed that, overall, Quebeckers’ flood-related adaptive behaviors have not changed considerably since 2015, with adaptation scores being similar in 2019 for four of the five flood indices. Moreover, the results indicated an increase in self-reported physical and mental health issues related to past flooding events, as well as a larger proportion of people having consulted a health professional because of these problems. Thus, this study provides a better understanding of flood adaptation in Quebec over the past 4 years and confirms that the five adaptive behavior indices developed in 2015 are appropriate tools for monitoring changes in flood adaptation in the province. Finally, our results showed that little has changed in Quebeckers’ adoption of adaptive behaviors, highlighting the need for awareness raising in order to limit the impacts that climate change will have on the population.

Abstract Background In Denmark, vaccination coverage is measured using the Danish Vaccination Register (DDV). In general, the vaccination coverage is high, but for some vaccinations, the coverage is suboptimal with geographical variation. This study aims to validate the vaccination coverage of the 5-year booster and identify overall reasons for non-vaccination in Copenhagen. Methods We validated the coverage of the 5-year tetanus, diphtheria, pertussis and polio booster for children born in 2010 and living in Copenhagen municipality in 2018, an area with low coverage (current estimate: 89%). We identified all children born in 2010 in the Civil Registration System and sent an electronic questionnaire to parents of children without a record of the 5-year booster in the DDV. Results Parents of 692 children were contacted and 49% participated. Of those, 186 (55%) reported that the child was vaccinated: 61% by their general practitioner and 34% abroad. The most common reason for non-vaccination was forgetfulness (31%), 26% did not want their child vaccinated and 17% had migrated from abroad and were not aware of the vaccination schedule. Considering only children with documentation for the vaccination, the corrected vaccination coverage was 91%. Conclusions We conclude that the coverage of the 5-year booster in Copenhagen is currently underestimated and should be adjusted by 2%. We recommend increased awareness from general practitioners and tailored communication about the vaccination programme targeting immigrants in Denmark.

Abstract Background As a consequence of ‘Western’ acculturation, eating disorders and body image disturbances, such as fatness phobia and body dysmorphic disorders towards musculature and body shape, are emerging in Africa, with young people the most affected. It is therefore important to accurately assess perceptions of body shape. However, the existing body image assessment scales lack sufficient accuracy and validity testing to compare body shape perception across different African populations. The purpose of this study was to develop and validate the Body Shape Scale (BOSHAS) to evaluate body shape perceptions related body image disorders in African populations. Methods To develop the BOSHAS, anthropometric measures of 80 Cameroonians and 81 Senegalese (both sexes included; 40.1% females overall) were taken for three body shape criteria: somatotype components, body mass index (BMI) and waist-to-hip ratio. Subjects were selected to cover a wide variability in body shape and were photographed in full face and profile positions. To validate the BOSHAS, the scale was administered twice (2 weeks apart) to 106 participants (aged 31.2 ± 12.6 years) to assess its reliability. In addition, a questionnaire measuring different aspects of body shape (e.g. musculature) was also administered (n = 597; aged 36.7 ± 15.6 years) to assess its convergent validity. Results The BOSHAS includes two sex-specific subscales of 10 photographs each. Most participants were able to repeat their BOSHAS preference order. Test-retest reliability was also consistent in estimating Current Body Shape (CBS), Desired Body Shape and Ideal Body Shape for participants and their partners. CBS was correlated with BMI, and different BOSHAS indices were consistent with declarations obtained by questionnaire. Conclusions The BOSHAS is the first sex-specific scale of real African models photographed in face and profile, including large body shape variability. The validation protocol showed good validity and reliability for evaluating body shape perceptions and dissatisfaction of Africans.

Abstract Background The UNICEF/Washington Group Child Functioning Module (CFM) assesses child functioning among children between 5 and 17 years of age. This study adapted and validated the CFM at the Iganga-Mayuge Health and Demographic Surveillance Site (IM-HDSS) in Uganda. Methods This cross-sectional study was conducted between September 2018–January 2019 at the IM-HDSS. Respondents were caregivers of children between 5 and 17 years of age who were administered modified Washington Group short set (mWG-SS) and CFM. The responses were recorded on a 4-point Likert scale. Descriptive analysis was conducted on child and caregiver demographic characteristics. Exploratory factor analysis (EFA) assessed underlying factor structure, dimensionality and factor loadings. Cronbach’s alpha was reported as an assessment of internal consistency. Face validity was assessed during the translation process, and concurrent validity of CFM was assessed through comparison with disability short form. Results Out of 1842 caregivers approached, 1439 (78.1%) participated in the study. Mean age of children was 11.06 ± 3.59 years, 51.4% were males, and 86.1% had a primary caregiver. Based on EFA, vision, hearing, walking, self-care, communication, learning, remembering, concentrating, accepting change, behavior control, and making friends loaded on factor 1 - “Motor and Cognition,” while anxiety and depression loaded on factor 2 - “Mood”. Cronbach’s alpha for the overall CFM was 0.899 (good internal consistency). Cronbach’s alpha for each extracted factor was excellent, motor and cognition (0.904), and mood (0.902). CFM had acceptable face validity. Spearman’s rank correlation between scores of CFM and modified WG short set was 0.51 (p-value

Abstract Background Recent evidence suggests that climate change and other factors are leading to the emergence of Lyme disease in the province of Quebec, where it previously did not exist. As risk areas expand further north, the population can adopt specific preventive behaviors to limit chances of infection. The objectives of this study were to (1) create an index of Lyme disease prevention behaviors (LDPB), and (2) use the theory of planned behavior (TPB) to explain the decision-making process of people who choose to adopt LDPB. Methods A sample of 1959 adults living in a Lyme disease risk area completed a questionnaire by phone (n = 1003) or on the Web (n = 956). The questionnaire measured whether they did or did not adopt the LDPB proposed by public health officials. It also measured some TPB variables, including their attitude or perceived social norms regarding LDPB. Results Our findings led to the creation of a Lyme disease prevention index consisting of 10 behaviors, down from the 19 behaviors initially considered for inclusion in the index. Rates of adoption of each behavior varied tremendously, from 4.30 to 83.80%. All variables of the TPB model (attitude, social norms, and perceived control) were significantly associated with intention to adopt preventive behaviors. Intention itself was significantly associated with adoption of LDPB. Likewise, risk perception was positively correlated with the adoption of LDPB. Conclusions This study led to the creation of a Lyme disease prevention index that can be used by public health agencies, researchers, and professionals to monitor the evolution over time of individuals’ LDPB adoption rates. It also showed the usefulness of the TPB in understanding the adoption of LDPB and how intention to adopt such behaviors is formed.