Validation of a social-cognitive theory-based tool for measuring factors influencing obesity prevention behaviors in 4-6 years old children using confirmatory factor analysis (CFA)

Document Type : original article

Authors

1 Assistant Professor of Health Education and Promotion, Department of Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran

2 Assistant Professor of Health Education and Promotion, Department of Public Health, Behbahan Faculty of Medical Sciences, Behbahan, Iran

Abstract

Background: Child obesity is one of the main health problems all across the world, which leads to mental and physical health problems. There is no specific tool based on the constructs of social-cognitive theory (SCT) to assess the factors associated with child obesity. The aim of this study was to investigate the validity and confirmatory factor analysis of a SCT-based questionnaire for assessing obesity preventing behaviors among 4-6-year-old children.
Method: This cross-sectional study was conducted to validate a SCT-based instrument for measuring factors affecting obesity prevention behaviors among children aged 4-6 years. 240 preschool children aged 4 to 6 years in Behbahan city, southwest Iran participated in the study. After performing the forward-backward translation method, the face, content, and construct validity of the SCT-based questionnaire were confirmed. The content validity index (CVI) and the content validity ratio (CVR) were used to assess the difficulty, relevancy, and ambiguity of the items, and Confirmatory factor analysis (CFA) was performed to measure the construct validity. Structural Equation Modeling (SEM) was also performed to evaluate the fitness of the model. Reliability of the questionnaire was also measured through Cronbach’s alpha coefficient and Intraclass Correlation Coefficient (ICC). The obesity prevention behaviors used in the model included physical activity, consumption of fruit and vegetable, consumption of sugar-free drinks, and screen.
Results: Results of this study confirmed the acceptable content and face validity of the SCT-based questionnaire. The results of confirmatory factor analysis also confirmed the factor loading of more than 0.3 for all variables; therefore the SCT-based questionnaire had an acceptable validity and reliability.
Conclusions: Since the SCT-based questionnaire had an acceptable validity and reliability, it can be used to assess the obesity prevention behaviors in 4-6-year-old children, and also to design relevant educational interventions.

Keywords

References

  1. Sahoo K, Sahoo B, Choudhury AK, Sofi NY, Kumar R, Bhadoria AS. Childhood obesity: causes and consequences. Journal of family medicine and primary care. 2015; 4(2):187.
  2. Singh AS, Mulder C, Twisk JW, Van Mechelen W, Chinapaw MJ. Tracking of childhood overweight into adulthood: a systematic review of the literature. Obesity reviews. 2008; 9(5):474-88.
  3. Schneider M, Hall W, Hernandez A, Hindes K, Montez G, Pham T, et al. Rationale, design and methods for process evaluation in the HEALTHY study. International Journal of Obesity. 2009; 33(4):S60-S7.
  4. Meixner L, Cohrdes C, Schienkiewitz A, Mensink G. Health-related quality of life in children and adolescents with overweight and obesity: results from the German KIGGS survey. BMC Public Health. 2020 Dec; 20(1):1-1.
  5. Lindberg L, Danielsson P, Persson M, Marcus C, Hagman E. Association of childhood obesity with risk of early all-cause and cause-specific mortality: A Swedish prospective cohort study. PLoS medicine. 2020 Mar 18; 17(3):e1003078.
  6. Enright G, Allman-Farinelli M, Redfern J. Effectiveness of family-based behavior change interventions on obesity-related behavior change in children: a realist synthesis. International Journal of Environmental Research and Public Health. 2020 Jan; 17(11):4099.
  7. Bagherniya M, Taghipour A, Sharma M, Sahebkar A, Contento IR, Keshavarz SA, et al. Obesity intervention programs among adolescents using social cognitive theory: a systematic literature review. Health education research. 2018; 33(1):26-39.
  8. Zimiles H. A second way of defining cognition (which has emerged mainly from Piaget's work) focuses on conceptual func. Determinants of Behavioral Development. 2013 Sep 24:65.
  9. Knowlden AP. Feasibility and efficacy of the enabling mothers to prevent pediatric obesity through web-based education and reciprocal determinism (EMPOWER) randomized control trial: University of Cincinnati; 2013.
  10. Knowlden A, Sharma M. A feasibility and efficacy randomized controlled trial of an online preventative program for childhood obesity: Protocol for the EMPOWER intervention. JMIR Research Protocols. 2012; 1(1):e5.
  11. Gauthier KI, Krajicek MJ. Obesogenic environment: A concept analysis and pediatric perspective. Journal for Specialists in Pediatric Nursing. 2013; 18(3):202-10.
  12. Zamanzadeh V, Ghahramanian A, Rassouli M, Abbaszadeh A, Alavi-Majd H, Nikanfar A-R. Design and implementation content validity study: development of an instrument for measuring patient-centered communication. Journal of caring sciences. 2015; 4(2):165.
  13. Uy HO. Development and content validity of the readiness for Filial Responsibility Scale. Journal of Studies in Social Sciences and Humanities. 2020; 6(3):100-15.
  14. Aithal A, Aithal PS. Development and Validation of Survey Questionnaire & Experimental Data–A Systematic Review-based Statistical Approach. International Journal of Management, Technology, and Social Sciences (IJMTS). 2020 Nov 3; 5(2):233-51.
  15. Almanasreh E, Moles R, Chen TF. Evaluation of methods used for estimating content validity. Research in Social and Administrative Pharmacy. 2019; 15(2):214-21.
  16. Flores-Vázquez AS, Vizmanos-Lamotte B, Altamirano-Martínez MB, Corona-Figueroa BA, Flores-Vázquez LE, Macedo-Ojeda G. Validation of a Spanish-Language Questionnaire on Adolescent Eating Behavior Based on Social Cognitive Theory. Journal of Nutrition Education and Behavior. 2020; 52(9):833-9.
  17. Osgood GM, Shakoor D, Orapin J, Qin J, Khodarahmi I, Thawait GK, et al. Reliability of distal tibio-fibular syndesmotic instability measurements using weight bearing and non-weightbearing cone-beam CT. Foot and Ankle Surgery. 2019; 25(6):771-81.
  18. Artino Jr AR, La Rochelle JS, Dezee KJ, Gehlbach H. Developing questionnaires for educational research: AMEE Guide No. 87. Medical teacher. 2014; 36(6):463-74.
  19. Yazdani A, Safdari R, Ghazisaeedi M, Beigy H, Sharifian R. Scalable architecture for telemonitoring chronic diseases in order to support the CDSSs in a common platform. Acta Informatica Medica. 2018; 26(3):195.
  20. Zahmatkeshan M, Zakerabasali S, Farjam M, Gholampour Y, Seraji M, Yazdani A. The use of mobile health interventions for gestational diabetes mellitus: a descriptive literature review. Journal of Medicine and Life. 2021; 14(2):131.
  21. Glanz K, Rimer BK, Viswanath K. Health behavior and health education: theory, research, and practice: John Wiley & Sons; 2008.
  22. Asunta P, Viholainen H, Ahonen T, Rintala P. Psychometric properties of observational tools for identifying motor difficulties–a systematic review. BMC pediatrics. 2019; 19(1):1-3.
  23. Soleymanian A, Niknami S, Hajizadeh E, Shojaeizadeh D, Montazeri A. Development and validation of a health belief model based instrument for measuring factors influencing exercise behaviors to prevent osteoporosis in pre-menopausal women (HOPE). BMC musculoskeletal disorders. 2014; 15(1):61.
  24. Sharma M. Theoretical foundations of health education and health promotion: Jones & Bartlett Learning; 2021.
  25. Tsakos G, Blair YI, Yusuf H, Wright W, Watt RG, Macpherson LM. Developing a new self-reported scale of oral health outcomes for 5-year-old children (SOHO-5). Health and quality of life outcomes. 2012; 10(1):62.
  26. Taber KS. The use of Cronbach’s alpha when developing and reporting research instruments in science education. Research in Science Education. 2018; 48(6):1273-96.
  27. Bolarinwa OA. Principles and methods of validity and reliability testing of questionnaires used in social and health science research. Nigerian Postgraduate Medical Journal. 2015; 22(4):195.

 

Journal of Pediatric Perspectives
Volume 10, Issue 5
May 2022
Pages 15925-15936

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