Development and Validation of the Parsimonious Screening Tool of Adult Health Promotion Scale

Friday, 26 July 2019

Mei-Yen Chen, PhD, RN
Department of Nursing, Chang Gung University of Science and Technology, Chiayi, Taiwan

Purpose: Cardiovascular disease (CVD) in adults is the number one cause of death globally, and is majorly caused by disorders of the heart and blood vessels, such as coronary heart disease, stroke, and hypertension. Considerable evidence indicates that risk factors are associated with cardiovascular disease and all-cause mortality includes smoking, physical inactivity, unhealthy diet, psychosocial stress, and less social participation. Fortunately, many chronic diseases are preventable through early adoption of healthy behaviors. The aim of the study is to develop a parsimonious, quick, and valid screening tools for early detection of unhealthy habits, cardiometabolic risks and validate the psychometric properties of the adult health promotion scale (AHPs).

Methods: A community-based cross-sectional study. Two rural townships in Southern Taiwan. A total of 765 community adults including 377 women and 388 men aged 20-64 years. Cardiometabolic risks, number of remaining teeth, perception of life satisfaction, cigarette smoking and adult health promoting scale were measured. Scale development involved a three-step process: (1) development of items based on the literature and consensus from experts; (2) exploratory factor analysis and confirmatory factor analysis to establish construct and discriminant validity; (3) test-retest reliability was used to explore the stability of the final version of the developed scale after three weeks. Before conducting this study, the institutional ethical committee review board was approved (No 103-6943).

Results: The findings indicated a 23-item AHPs was developed to explain 67.3% of the total variance. The simple version of the AHPs comprises six-dimensions: stress management, physical activity, health responsibility, life appreciation, healthy eating, and oral hygiene. The total scale alpha coefficient was 0.85. The intra-class correlation showed good stability of test-retest reliability (0.78-0.92). Discriminant validity indicated that the AHPs are significantly associated with life satisfaction (p<0.001), smoking habit (p<0.001), and number of remaining teeth (p<0.05).

Conclusion: The findings indicate that AHPs is a valid and reliable instrument to be used as a screening tool for early detection of adult’s healthy behaviors. Healthcare providers in many community settings could use it to reduce unhealthy habits through regular assessment and initiation of health-promotion programs.