The validation of culturally appropriate scales to assess the family health climate in a multi-ethnic Asian population
BackgroundThe Family Health Climate (FHC) is a family environment attribute postulated to influence the health behaviors of family members. It can be measured by domain scales for physical activity (FHC-PA) and nutrition (FHC-NU), which have been validated and used to identify health climate pattern...
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Frontiers Media S.A.
2022-10-01
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| Series: | Frontiers in Public Health |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpubh.2022.988525/full |
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| author | Yi-Ching Lynn Ho Yi-Ching Lynn Ho Mary Su-Lynn Chew Clement Zhong-Hao Ho Aisyah Binte Latib Vivian Shu-Yi Lee Gladis Jing Lin Gladis Jing Lin Julian Thumboo Julian Thumboo Julian Thumboo Kinjal Doshi |
| author_facet | Yi-Ching Lynn Ho Yi-Ching Lynn Ho Mary Su-Lynn Chew Clement Zhong-Hao Ho Aisyah Binte Latib Vivian Shu-Yi Lee Gladis Jing Lin Gladis Jing Lin Julian Thumboo Julian Thumboo Julian Thumboo Kinjal Doshi |
| author_sort | Yi-Ching Lynn Ho |
| collection | DOAJ |
| description | BackgroundThe Family Health Climate (FHC) is a family environment attribute postulated to influence the health behaviors of family members. It can be measured by domain scales for physical activity (FHC-PA) and nutrition (FHC-NU), which have been validated and used to identify health climate patterns in families in Western populations. To extend the use of the scales to Asian settings, this study aimed to adapt and validate the instruments for use in the multi-ethnic population of Singapore, accounting for language and cultural differences.MethodsIn Part A (n = 40) to adapt the scales for the Singapore population, we performed cognitive interviews, face validity testing and pre-testing of the instruments (n = 40). Besides English, the scales were translated into Chinese and Malay. In Part B (n = 400), we performed exploratory and confirmatory factor analyses respectively on two random samples. We also tested for item discriminant validity, internal consistency reliability, construct validity, and measurement invariance.ResultsThe findings from the cognitive interviews in Part A led to scale adaptations to accommodate cultural and linguistic factors. In Part B, EFA on Sample I resulted in a three-factor model for the PA scale (accounting for 71.2% variance) and a four-factor model for the NU scale (accounting for 72.8% variance). CFA on Sample II indicated acceptable model fits: FHC-PA: χ2 = 192.29, df = 101, p < 0.001, χ2/df = 1.90; SRMR = 0.049; RMSEA = 0.067; CFI = 0.969; TLI = 0.963; FHC-NU: χ2 = 170.46, df = 98, p < 0.001, χ2/df = 1.74; SRMR = 0.036; RMSEA = 0.061; CFI = 0.967; TLI = 0.960. The scores of family members demonstrated significant agreement on the FHC-PA (Sg) [ICC(2, 2) = 0.77] and FHC-NU (Sg) [ICC(2, 2) = 0.75] scales. Findings suggest good evidence for item discriminant validity, internal consistency reliability, construct validity, and measurement invariance. Short versions of the scales were also developed.ConclusionWe adapted, translated and validated the scales for assessing the health climate of families in Singapore, including the development of short versions. The results showed good psychometric properties and the constructs had significant relationships with health behaviors and routines. Improving our understanding of family influences on individual health behavior will be important in developing multi-level strategies for health promotion and chronic disease prevention. |
| first_indexed | 2024-04-12T00:57:09Z |
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| id | doaj.art-9185eb2aec0341f7854d5342c71a8bf4 |
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| issn | 2296-2565 |
| language | English |
| last_indexed | 2024-04-12T00:57:09Z |
| publishDate | 2022-10-01 |
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| series | Frontiers in Public Health |
| spelling | doaj.art-9185eb2aec0341f7854d5342c71a8bf42022-12-22T03:54:35ZengFrontiers Media S.A.Frontiers in Public Health2296-25652022-10-011010.3389/fpubh.2022.988525988525The validation of culturally appropriate scales to assess the family health climate in a multi-ethnic Asian populationYi-Ching Lynn Ho0Yi-Ching Lynn Ho1Mary Su-Lynn Chew2Clement Zhong-Hao Ho3Aisyah Binte Latib4Vivian Shu-Yi Lee5Gladis Jing Lin6Gladis Jing Lin7Julian Thumboo8Julian Thumboo9Julian Thumboo10Kinjal Doshi11Centre for Population Health Research and Implementation, Singapore Health Services, Singapore, SingaporeProgram in Health Services and Systems Research, Duke-NUS Medical School, Singapore, SingaporeCentre for Population Health Research and Implementation, Singapore Health Services, Singapore, SingaporeCentre for Population Health Research and Implementation, Singapore Health Services, Singapore, SingaporeCentre for Population Health Research and Implementation, Singapore Health Services, Singapore, SingaporeCentre for Population Health Research and Implementation, Singapore Health Services, Singapore, SingaporeCentre for Population Health Research and Implementation, Singapore Health Services, Singapore, SingaporeProgram in Health Services and Systems Research, Duke-NUS Medical School, Singapore, SingaporeCentre for Population Health Research and Implementation, Singapore Health Services, Singapore, SingaporeDepartment of Rheumatology and Immunology, Singapore General Hospital, Singapore, SingaporeMedicine Academic Clinical Program, Duke-NUS Medical School, Singapore, SingaporeDepartment of Neurology, Singapore General Hospital, Singapore, SingaporeBackgroundThe Family Health Climate (FHC) is a family environment attribute postulated to influence the health behaviors of family members. It can be measured by domain scales for physical activity (FHC-PA) and nutrition (FHC-NU), which have been validated and used to identify health climate patterns in families in Western populations. To extend the use of the scales to Asian settings, this study aimed to adapt and validate the instruments for use in the multi-ethnic population of Singapore, accounting for language and cultural differences.MethodsIn Part A (n = 40) to adapt the scales for the Singapore population, we performed cognitive interviews, face validity testing and pre-testing of the instruments (n = 40). Besides English, the scales were translated into Chinese and Malay. In Part B (n = 400), we performed exploratory and confirmatory factor analyses respectively on two random samples. We also tested for item discriminant validity, internal consistency reliability, construct validity, and measurement invariance.ResultsThe findings from the cognitive interviews in Part A led to scale adaptations to accommodate cultural and linguistic factors. In Part B, EFA on Sample I resulted in a three-factor model for the PA scale (accounting for 71.2% variance) and a four-factor model for the NU scale (accounting for 72.8% variance). CFA on Sample II indicated acceptable model fits: FHC-PA: χ2 = 192.29, df = 101, p < 0.001, χ2/df = 1.90; SRMR = 0.049; RMSEA = 0.067; CFI = 0.969; TLI = 0.963; FHC-NU: χ2 = 170.46, df = 98, p < 0.001, χ2/df = 1.74; SRMR = 0.036; RMSEA = 0.061; CFI = 0.967; TLI = 0.960. The scores of family members demonstrated significant agreement on the FHC-PA (Sg) [ICC(2, 2) = 0.77] and FHC-NU (Sg) [ICC(2, 2) = 0.75] scales. Findings suggest good evidence for item discriminant validity, internal consistency reliability, construct validity, and measurement invariance. Short versions of the scales were also developed.ConclusionWe adapted, translated and validated the scales for assessing the health climate of families in Singapore, including the development of short versions. The results showed good psychometric properties and the constructs had significant relationships with health behaviors and routines. Improving our understanding of family influences on individual health behavior will be important in developing multi-level strategies for health promotion and chronic disease prevention.https://www.frontiersin.org/articles/10.3389/fpubh.2022.988525/fullfamily health climateinstrument validationphysical activitynutritionhealth promotionhealth behaviors |
| spellingShingle | Yi-Ching Lynn Ho Yi-Ching Lynn Ho Mary Su-Lynn Chew Clement Zhong-Hao Ho Aisyah Binte Latib Vivian Shu-Yi Lee Gladis Jing Lin Gladis Jing Lin Julian Thumboo Julian Thumboo Julian Thumboo Kinjal Doshi The validation of culturally appropriate scales to assess the family health climate in a multi-ethnic Asian population Frontiers in Public Health family health climate instrument validation physical activity nutrition health promotion health behaviors |
| title | The validation of culturally appropriate scales to assess the family health climate in a multi-ethnic Asian population |
| title_full | The validation of culturally appropriate scales to assess the family health climate in a multi-ethnic Asian population |
| title_fullStr | The validation of culturally appropriate scales to assess the family health climate in a multi-ethnic Asian population |
| title_full_unstemmed | The validation of culturally appropriate scales to assess the family health climate in a multi-ethnic Asian population |
| title_short | The validation of culturally appropriate scales to assess the family health climate in a multi-ethnic Asian population |
| title_sort | validation of culturally appropriate scales to assess the family health climate in a multi ethnic asian population |
| topic | family health climate instrument validation physical activity nutrition health promotion health behaviors |
| url | https://www.frontiersin.org/articles/10.3389/fpubh.2022.988525/full |
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