The Sleep Condition Indicator: a clinical screening tool to evaluate insomnia disorder

OBJECTIVE

Describe the development and psychometric validation of a brief scale (the Sleep Condition Indicator (SCI)) to evaluate insomnia disorder in everyday clinical practice.

DESIGN

The SCI was evaluated across five study samples. Content validity, internal consistency and concurrent validity were investigated.

PARTICIPANTS

30 941 individuals (71% female) completed the SCI along with other descriptive demographic and clinical information.

SETTING

Data acquired on dedicated websites.

RESULTS

The eight-item SCI (concerns about getting to sleep, remaining asleep, sleep quality, daytime personal functioning, daytime performance, duration of sleep problem, nights per week having a sleep problem and extent troubled by poor sleep) had robust internal consistency (α≥0.86) and showed convergent validity with the Pittsburgh Sleep Quality Index and Insomnia Severity Index. A two-item short-form (SCI-02: nights per week having a sleep problem, extent troubled by poor sleep), derived using linear regression modelling, correlated strongly with the SCI total score (r=0.90).

CONCLUSIONS

The SCI has potential as a clinical screening tool for appraising insomnia symptoms against Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria.

Comparison between the EQ-5D-5L and the EQ-5D-3L in patients with hepatitis B

OBJECTIVES

The purpose of the study was to compare psychometric properties of the EQ-5D-5L (5L) and the EQ-5D-3L (3L) health outcomes assessment instruments in patients with hepatitis B in China.

METHODS

Patients, including hepatitis B virus carriers and those with active or inactive chronic hepatitis B, compensated cirrhosis, decompensated cirrhosis or hepatocellular carcinoma, answered a questionnaire composed of 5L, socio-demographic information, 3L, and the visual analog scale (VAS), respectively. After 1 week, a retest was conducted for inpatients. We compared acceptability, face validity, redistribution properties, convergent validity, known-group validity, discriminatory power, ceiling effect, test-retest reliability, and responsiveness of 5L and 3L.

RESULTS

A total of 369 outpatients and 276 inpatients were recruited for the first interview. Of the inpatients, 183 were used in the retest. Most patients preferred 5L-3L. The 3L-5L response pairs had an inconsistency rate of 2.4%. Correlation with the VAS was greater with 5L than with 3L. Age, education, and comorbidity were associated with health-related quality of life (HRQoL). 5L discriminated more infectious conditions than 3L. In all dimensions, the Shannon's index from 5L was larger while in three dimensions the Shannon's evenness index from 5L was slightly larger. The ceiling effect was reduced in 5L. In patients with stable health states, no significant difference was detected in the weighted kappa between 5L and 3L, but intraclass correlation coefficient of 5L was higher than that of 3L. In patients with improved health states, HRQoL was seen as increased in both 5L and 3L, without significant difference.

CONCLUSIONS

The EQ-5D-5L was more suitable than the EQ-5D-3L in the patients with hepatitis B in China.

Brief version of the Internalized Stigma of Mental Illness (ISMI) scale: psychometric properties and relationship to depression, self esteem, recovery orientation, empowerment, and perceived devaluation and discrimination

OBJECTIVE

The internalized stigma of mental illness impedes recovery and is associated with increased depression, reduced self-esteem, reduced recovery orientation, reduced empowerment, and increased perceived devaluation and discrimination. The Internalized Stigma of Mental Illness (ISMI) scale is a 29-item self-report questionnaire developed with consumer input that includes the following subscales: Alienation, Discrimination Experience, Social Withdrawal, Stereotype Endorsement, and Stigma Resistance. Here we present a 10-item version of the ISMI containing the two strongest items from each subscale.

METHOD

Participants were all outpatient veterans with serious mental illness. Following the rigorous scale-reduction methods set forth by Stanton and colleagues (2002), we selected the 10 items, tested the psychometrics of the shortened scale in the original validation sample (N = 127), and cross-checked the results in a second dataset (N = 760).

RESULTS

As expected, the ISMI-10 retained the essential properties of the ISMI-29, including adequate internal consistency reliability and external validity in relation to depression, self-esteem, recovery orientation, perceived devaluation and discrimination, and empowerment. The ISMI-10 scores are normally distributed and have similar descriptive statistics to the ISMI-29. The reliability and depression findings were replicated in a cross-validation sample.

CONCLUSIONS AND IMPLICATIONS FOR PRACTICE

We conclude that the ISMI-10 has strong psychometric properties and is a practical, reliable, and valid alternative to the original ISMI-29. Future work should test the ISMI-10 in more diverse samples. This shorter version should reduce respondent burden in program evaluation projects that seek to determine whether participation in psychosocial rehabilitation programming reduces internalized stigma.

The impact on family scale: psychometric analysis of long and short forms in parents of children with epilepsy

Epilepsy in a child or adolescent can have severe psychosocial impact on the whole family and burdens them, especially the parents. As the familial background is essential for the child's coping and the progression of the epilepsy, parental burden should be considered within a comprehensive treatment approach. This study validated the applicability of the Impact on Family Scale (IOFS), a well-established instrument that assesses the strains of families with chronically ill or disabled children, in parents of children with epilepsy. In a sample of 219 parents, the psychometric properties of the original IOFS version (33 items) and two short forms (15 and 11 items, respectively) were examined. Both short forms revealed good reliability (Cronbach's alpha, test-retest reliability), and construct validity was verified by correlations with epilepsy- and burden-related variables. However, exploratory and confirmatory factor analyses indicated superior characteristics of the short form with 11 items (IOFS-11). In conclusion, the IOFS-11 as well as the IOFS-15 proved to be practicable, reliable, and valid tools to assess the impact of childhood epilepsy on family life in research and clinical practice.

Psychometric properties of the Scale for Quality Evaluation of the Bachelor Degree in Nursing Version 2 (QBN 2)

To evaluate all the variables that affect nursing education is important for nursing educators to have valid and reliable instruments that can measure the perceived quality of the Bachelor Degree in Nursing. This study testing the Scale for Quality Evaluation of the Bachelor Degree in Nursing instrument and its psychometric properties with a descriptive design. Participant were first, second and third year students of the Bachelor Degree in Nursing Science from three Italian universities. The Scale for Quality Evaluation of Bachelor Degree in Nursing consists of 65 items that use a 4 point Likert scale ranging from "strongly disagree" to "strongly agree". The instrument comes from a prior version with 41 items that were modified and integrated with 24 items to improve reliability. Six hundred and fifty questionnaires were completed and considered for the present study. The mean age of the students was 24.63 years, 65.5% were females. Reliability of the scale resulted in a very high Cronbach's alpha (0.96). The construct validity was tested with factor analysis that showed 7 factors. The Scale for Quality Evaluation of the Bachelor Degree in Nursing, although requiring further studies, represents a useful instrument to measure the quality of the Bachelor Nursing Degree.

Evaluation of the validity and reliability of the Korean version of the Nursing Professional Values Scale-Revised

BACKGROUND

The development of professional values is a significant factor in improving nursing practice. It is important to develop nursing curricula for establishing and investigating nursing students' professional values. Professional values of Korean nursing students may differ from those of nursing students in other countries, and research on the professional values of Koreans using a validated scale is needed.

OBJECTIVES

The purpose of this study was to test the validity and reliability of the Korean version of the Nursing Professional Values Scale-Revised.

METHODS

Convenience samples of 1077 baccalaureate nursing students were recruited from four universities in Korea. Construct validity and internal consistency reliability using explanatory factor analysis were examined.

RESULTS

The validity was obtained using a principle component analysis of a five-factor structure (variance explained 58.90%). The five factors were labeled human dignity, professionalism, innovation, contribution, and advocacy. The Cronbach's alphas were .93 for the total scale and .89-.62 for the subscales.

CONCLUSIONS

The overall Korean version of the Nursing Professional Values Scale-Revised was valid and reliable for measuring nursing professional values. Criterion-related validation of the Korean version of the Nursing Professional Values Scale-Revised and the development of items congruent with Korean culture are needed to support the validity and reliability of the Korean version of the Nursing Professional Values Scale-Revised.

Validation of the Orbach & Mikulincer Mental Pain Scale (OMMP) on a drug addicted population

PURPOSE

Recognizing the relevance of mental pain in drug addiction, this study aimed to adapt and validate the Portuguese translation of the Orbach & Mikulincer Mental Pain Scale (OMMP) on a drug addicted population and assess its psychometric properties.

METHODS

The study sample (N = 403) was collected from several outpatient treatment centres for drug addiction and in therapeutic communities located in the north of Portugal. The validation of the OMMP Scale followed the same method considered by the authors of the original scale.

RESULTS

A confirmatory factor analysis (CFA) was performed and did not confirm the structure of eight factors provided by the authors. An exploratory factor analysis revealed a five-factor model (labeled emptiness, irreversibility, emotional flooding, helplessness and confusion) leading to a reduction from 40 to 24 items. The OMMP-24-P showed acceptable levels for internal consistency and test-retest reliability. Confirmatory factor analysis indices supported the five-factor model. OMMP-24-P factors were positively correlated with measures of stress, anxiety and depression, negatively associated with quality of life, and showed small to moderate positive correlations with drug addiction severity, with exception of the helplessness factor.

CONCLUSIONS

This study has shown the OMMP-24-P to be a valid and reliable scale for assessment and evaluation of mental pain among drug addicts. Further research should attempt to determine the contribution that mental pain can provide towards an understanding of drug addiction dynamics and other psychopathological syndromes, and thereby contribute to the development of more effective treatment programs.

Measuring workload in collaborative contexts: trait versus state perspectives

OBJECTIVE

In the present study, we explored the state versus trait aspects of measures of task and team workload in a disaster simulation.

BACKGROUND

There is often a need to assess workload in both individual and collaborative settings. Researchers in this field often use the NASATask Load Index (NASA-TLX) as a global measure of workload by aggregating the NASA-TLX's component items. Using this practice, one may overlook the distinction between traits and states.

METHOD

Fifteen dyadic teams (11 inexperienced, 4 experienced) completed five sessions of a tsunami disaster simulator. After every session, individuals completed a modified version of the NASA-TLX that included team workload measures.We then examined the workload items by using a between-subjects and within-subjects perspective.

RESULTS

Between-subjects and within-subjects correlations among the items indicated the workload items are more independent within subjects (as states) than between subjects (as traits). Correlations between the workload items and simulation performance were also different at the trait and state levels.

CONCLUSION

Workload may behave differently at trait (between-subjects) and state (within-subjects) levels.

APPLICATION

Researchers interested in workload measurement as a state should take a within-subjects perspective in their analyses.

Using mixed methods to select optimal mode of administration for a patient-reported outcome instrument for people with pressure ulcers

BACKGROUND

When developing new measuring instruments or deciding upon one for research, consideration of the 'best' method of administration for the target population should be made. Current evidence is inconsistent in differentiating superiority of any one method in terms of quantity and quality of response. We trialed a novel mixed methods approach in early scale development to determine the best administration method for a new patient-reported outcome instrument for people with pressure ulcers (the PU-QOL).

METHODS

Cognitive interviews were undertaken with 35 people with pressure ulcers to determine appropriateness of a self-completed version of the PU-QOL instrument. Quantitative analysis, including Rasch analysis, was carried out on PU-QOL data from 70 patients with pressure ulcers, randomised to self-completed or interview-administered groups, to examine data quality and differential item functioning (DIF).

RESULTS

Cognitive interviews identified issues with PU-QOL self-completion. Quantitative analysis supported these findings with a large proportion of self-completed PU-QOLs returned with missing data. DIF analysis indicated administration methods did not impact the way patients from community care settings responded, supporting the equivalence of both administration versions.

CONCLUSIONS

Obtaining the best possible health outcomes data requires use of appropriate methods to ensure high quality data with minimal bias. Mixed methods, with the inclusion of Rasch, provided valuable evidence to support selection of the 'best' administration method for people with PUs during early PRO instrument development. We consider our approach to be generic and widely applicable to other elderly or chronically ill populations or suitable for use in limited samples where recruitment to large field tests is often difficult.

Sexual dysfunction in infertile couples: evaluation and treatment of infertility

OBJECTIVE

To evaluate the diagnostic and the predictive value of Arizona Sexual Experience Scale among primary infertile couples regarding sexual dysfunction.

METHODS

The cross-sectional and prospective pre, post study comprising primary infertile patients was carried out at Bulent Ecevit University Hospital, Zonguldak, Turkey. Fifty consecutive primary infertile couples not treated previously were investigated between 2003 and 2007 for the presence of sexual dysfunction by a psychiatrist. Arizona Sexual Experience Scale scoring was self-administered to determine sexual dysfunction among couples before treatment and also 3 months after the initiation of the treatment.

RESULTS

Pretreatment mean values of the index parametres in both women and men were significantly increased after treatment. Statistically significant positive correlation was observed between pre- and post-treatment total scores in both women (r = 0.83; p < .001) and men (r = 0.92; p < .001). Receiver operating characteristic curve analyses revealed optimum cut-offs of pre- and post-treatment scores in women were were > 14 (Sensitivity: 57%; Specificity: 90%) and > 13 (Sensitivity: 83%; Specificity: 93%), respectively. Pre- and post-treatment scores in men were > 10 (Sensitivity: 65%; Specificity: 61%), > 11 (Sensitivity: 83%; Specificity: 62%), respectively. Binary logistic regression analyses revealed women's pre-treatment and post-treatment scores as a significant factor for prediction of sexual dysfunction independent of sociodemographic factors (p = 0.001 and p = 0.001, respectively).

CONCLUSION

Evaluation and treatment of infertility is an important risk factor for sexual dyfunction. Pre- and posttreatment Arizona Sexual Experience Scale score could be used as a screening test for sexual dysfunction and might be used to decide pre/post-treatment consultation of couples with a specialist.

[Development of the Coparental Regulation Inventory and cross-sectional analysis of mothers' encouragement and criticism]

We developed the Coparental Regulation Inventory to assess the regulatory behavior of the mothers in involving fathers with child rearing. We translated and modified the short form of the Parental Regulation Inventory (PRI) for Japanese couples in different stages of child rearing. An online questionnaire was conducted with mothers (n = 500) and fathers (n = 500) whose youngest child was less than 21-years-old. Exploratory factor analysis identified two factors, which were labeled "encouragement" and "criticism". The resulting Coparental Regulation Inventory (the modified PRI) had high internal consistency and test-retest reliability. The construct validity of the scale was supported by its correlation with parenting alliance, marital satisfaction, and the father's involvement. These findings suggest that the scale is an adequate instrument for identifying the behaviors of mothers related to coparenting. In addition, we examined the frequency of encouragement and criticism used by the mother in relation to the child-rearing stage using cross-sectional analysis. In the mothers' reports, mothers with infants and children encouraged fathers more than mothers with early and late adolescents. Mothers with late adolescents criticized fathers less than mothers with infants. In the fathers' reports, mothers gave more encouragement to fathers who had infants than at any other age, whereas the child's age was not related to mothers' criticism perceived by the fathers.

Psychometric properties of Chinese language Liverpool Seizure Severity Scale 2.0 (LSSS 2.0) and status and determinants of seizure severity for patients with epilepsy in China

OBJECTIVES

This study aimed to translate and validate the Liverpool Seizure Severity Scale (LSSS) in Chinese-speaking patients with epilepsy and explore the determinants of seizure severity in China.

METHODS

Accepted procedures were followed to translate the LSSS. Each participant was interviewed to complete the LSSS, Seizure Severity Index, Quality of Well-being Scale Self-Administered (QWB-SA), EuroQol (EQ-5D), and Mini Mental State Examination (MMSE). Construct validity and internal consistency were assessed. The determinants of seizure severity were explored.

RESULTS

The construct validity of the LSSS was demonstrated by good convergent and discriminant validities. Cronbach's alpha and the intraclass correlation coefficient were 0.886, respectively. In the multivariate analysis, seizure types (p=0.001), seizure frequency (p=0.001), and numbers of antiepileptic drugs (p=0.042) predicted the scores on the LSSS. Types of antiepileptic drugs also contributed to the variation in the LSSS scores.

CONCLUSIONS

Chinese LSSS is a valid, reliable, and sensitive seizure severity scale. Seizure frequency, seizure types, and quantities and types of AEDs predict seizure severity.

Measuring phonological awareness in deaf and hard-of-hearing children

PURPOSE

This study evaluated psychometric properties of 2 phonological awareness (PA) tests normed for hearing children when used with deaf and hard-of-hearing (DHH) children with functional hearing. It also provides an in-depth description of these children's PA.

METHOD

One hundred and eight DHH children (mean age = 63.3 months) with cochlear implants or hearing aids were assessed in the fall and spring of the school year. Sixty-three percent communicated only with spoken language; 37% communicated with both sign and speech. Examiners administered PA subtests from the Phonological Awareness Test-2 and the Test of Preschool Early Literacy, along with assessments of speech perception and early literacy.

RESULTS

Item analyses indicated that both tests showed good psychometric properties (e.g., high item discriminations and internal consistencies). DHH children scored higher on subtests and items that measured words, rhymes, and syllables than those that assessed phonemes. Although subtest difficulty influenced the factor structure in the fall, spring PA was best characterized as a single factor. PA correlated concurrently and predictively with early literacy.

CONCLUSIONS

This study suggests that these 2 standardized tests are valid for use with DHH children with functional hearing. Although delayed, these children's PA was structurally similar to that of hearing children.

Revision and validation of Medication Adherence Reasons Scale (MAR-Scale)

BACKGROUND

Medication non-adherence is a complex phenomenon that requires tailored interventions to improve it. A new self-reported measure of medication non-adherence was previously reported based on the commonly reported reasons underlying non-adherence with the intention to match the items in the scale with tailored interventions.

OBJECTIVE

The objectives were to revise the original Medication Adherence Reasons Scale (MAR-Scale) based on expert opinion and cognitive interviewing, and establish the psychometric properties of the revised scale.

METHODS

A cross-sectional design was used in cholesterol lowering and asthma maintenance medications in collaboration with an integrated medical center in the Mountain West. In the first phase, the original MAR-Scale was revised based on expert opinion and cognitive interviewing. In the second phase, the revised MAR-Scale was tested for psychometric properties in a random sample of 350 subjects on each medication.

RESULTS

Revisions based on expert opinion included asking a global question about adherence in the past 7 days, simplifying the items and converting them into first person sentences, objective anchoring of the scale, and expanding the 'forgetfulness' item. Cognitive interviewing added one additional item to the survey. The revised MAR- Scale identified 50% of the cholesterol lowering respondents and 68% of the asthma maintenance respondents as non-adherents. An exploratory factor analysis identified four domains in the scale, with Cronbach's alpha ranging from 0.848-0.953 in cholesterol lowering and 0.827-0.891 in asthma maintenance medications. The scale also exhibited significant correlations with few other self-reported measures, consistent with hypotheses. A key limitation of the study was the moderate response rate to the survey for both medications.

CONCLUSION

The revised MAR-Scale demonstrates better psychometric properties than the original.

[Development of the Scale of Social Interest for Elementary School Children]

This study reports the development of The Scale of Social Interest for Elementary School Children and examines its reliability and validity. Elementary school students of fourth, fifth, and sixth grades responded to provisional items of the scale, as well as scales assessing mental health, adaptation to school, and sympathy. An exploratory factor analysis was conducted using the provisional items. The following three factors, which had also been identified by Kosaka (2011), were extracted: feelings of contribution, feelings of belonging to society and trust in society, and self-acceptance. Confirmatory factor analysis indicated sufficient fitness. The reliability of the scale was confirmed based on internal consistency and stability. The predicted relationships among the scale and mental health, school adaptation, and sympathy were demonstrated. Based on these results, the reliability and validity of the Scale of Social Interest for Elementary School Children were confirmed.

Range of confidence scale and consumer knowledge calibration

The study examined the effect of range of a confidence scale on consumer knowledge calibration, specifically whether a restricted range scale (25%-100%) leads to difference in calibration compared to a full range scale (0%-100%), for multiple-choice questions. A quasi-experimental study using student participants (N = 434) was employed. Data were collected from two samples; in the first sample (N=167) a full range confidence scale was used, and in the second sample (N = 267) a restricted range scale was used. No differences were found between the two scales on knowledge calibration. Results from studies of knowledge calibration employing restricted range and full range confidence scales are thus comparable.

Is there a practical way of predicting therapeutic success in type 2 diabetes on the basis of psychological features? Development and validation of the Psychological Predictors of Therapeutic success in Diabetes (PPTD) questionnaire

Many psychiatric disorders and symptoms have been associated with impaired metabolic control in type 2 diabetes; several studies focused on non-pathological psychological features. Aims of this observational, longitudinal study are: the assessment of the impact of a wide range of psychological factors on metabolic control in type 2 diabetes; and the development and validation of a simple questionnaire to assess the impact of psychological factors on therapeutic success. To identify psychological factors interfering with attainment of glycemic targets, a prospective 1-year study was performed on a sample of 250 patients with type 2 diabetes. The impact of identified factors on therapeutic outcome was then subsequently verified on a further, independent sample of 200 patients. The first phase of the study allowed the development of a 19-items questionnaire, the Psychological Predictors of Therapeutic success in Diabetes (PPTD) questionnaire. Validation analyses showed that the questionnaire was able to predict therapeutic success. Patients with HbA1c ≤7% (53 mmol/mol) at follow-up showed higher test scores than those with HbA1c >7% [31.0 (26.2; 35.0) vs 28.0 (23.0; 32.0); p = 0.016]. The attainment and maintenance of therapeutic goals in patients with type 2 diabetes depend on a wide range of factors. The PPTD is an attempt at condensing the complexity of psychological factors affecting glycemic control in a simple and easy-to-use self-reported questionnaire, which can be used in wide-scale research.

Does assessment type matter? A measurement invariance analysis of online and paper and pencil assessment of the Community Assessment of Psychic Experiences (CAPE)

Background

The psychometric properties of an online test are not necessarily identical to its paper and pencil original. The aim of this study is to test whether the factor structure of the Community Assessment of Psychic Experiences (CAPE) is measurement invariant with respect to online vs. paper and pencil assessment.

Method

The factor structure of CAPE items assessed by paper and pencil (N = 796) was compared with the factor structure of CAPE items assessed by the Internet (N = 21,590) using formal tests for Measurement Invariance (MI). The effect size was calculated by estimating the Signed Item Difference in the Sample (SIDS) index and the Signed Test Difference in the Sample (STDS) for a hypothetical subject who scores 2 standard deviations above average on the latent dimensions.

Results

The more restricted Metric Invariance model showed a significantly worse fit compared to the less restricted Configural Invariance model (χ²(23) = 152.75, p<0.001). However, the SIDS indices appear to be small, with an average of −0.11. A STDS of −4.80 indicates that Internet sample members who score 2 standard deviations above average would be expected to score 4.80 points lower on the CAPE total scale (ranging from 42 to 114 points) than would members of the Paper sample with the same latent trait score.

Conclusions

Our findings did not support measurement invariance with respect to assessment method. Because of the small effect sizes, the measurement differences between the online assessed CAPE and its paper and pencil original can be neglected without major consequences for research purposes. However, a person with a high vulnerability for psychotic symptoms would score 4.80 points lower on the total scale if the CAPE is assessed online compared to paper and pencil assessment. Therefore, for clinical purposes, one should be cautious with online assessment of the CAPE.

A poverty-related quality of life questionnaire can help to detect health inequalities in emergency departments

OBJECTIVES

This study aimed to develop a self-administered, multidimensional, poverty-related quality of life (PQoL) questionnaire for individuals seeking care in emergency departments (EDs): the PQoL-17.

STUDY DESIGN AND SETTING

The development of the PQoL was undertaken in three steps: item generation, item reduction, and validation. The content of the PQoL was derived from 80 interviews with patients seeking care in EDs. Using item response and classical test theories, item reduction was performed in 3 EDs on 300 patients and validation was completed in 10 EDs on 619 patients.

RESULTS

The PQoL contains 17 items describing seven dimensions (self-esteem/vitality, psychological well-being, relationships with family, relationships with friends, autonomy, physical well-being/access to care, and future perception). The seven-factor structure accounted for 75.1% of the total variance. This model showed a good fit (indices from the LISREL model: root mean square error of approximation, 0.055; comparative fit index, 0.97; general fit index, 0.96; standardized root mean square residual, 0.058). Each item achieved the 0.40 standard for item internal consistency, and Cronbach α coefficients were >0.70. Significant associations with socioeconomic and clinical indicators showed good discriminant and external validity. Infit statistics ranged from 0.82 to 1.16.

CONCLUSION

The PQoL-17 presents satisfactory psychometric properties and can be completed quickly, thereby fulfilling the goal of brevity sought in EDs.

Psychometrics of the preschooler physical activity parenting practices instrument among a Latino sample

BACKGROUND

Latino preschoolers (3-5 year old children) have among the highest rates of obesity. Low levels of physical activity (PA) are a risk factor for obesity. Characterizing what Latino parents do to encourage or discourage their preschooler to be physically active can help inform interventions to increase their PA. The objective was therefore to develop and assess the psychometrics of a new instrument: the Preschooler Physical Activity Parenting Practices (PPAPP) among a Latino sample, to assess parenting practices used to encourage or discourage PA among preschool-aged children.

METHODS

Cross-sectional study of 240 Latino parents who reported the frequency of using PA parenting practices. 95% of respondents were mothers; 42% had more than a high school education. Child mean age was 4.5 (±0.9) years (52% male). Test-retest reliability was assessed in 20%, 2 weeks later. We assessed the fit of a priori models using Confirmatory factor analyses (CFA). In a separate sub-sample (35%), preschool-aged children wore accelerometers to assess associations with their PA and PPAPP subscales.

RESULTS

The a-priori models showed poor fit to the data. A modified factor structure for encouraging PPAPP had one multiple-item scale: engagement (15 items), and two single-items (have outdoor toys; not enroll in sport-reverse coded). The final factor structure for discouraging PPAPP had 4 subscales: promote inactive transport (3 items), promote screen time (3 items), psychological control (4 items) and restricting for safety (4 items). Test-retest reliability (ICC) for the two scales ranged from 0.56-0.85. Cronbach's alphas ranged from 0.5-0.9. Several sub-factors correlated in the expected direction with children's objectively measured PA.

CONCLUSION

The final models for encouraging and discouraging PPAPP had moderate to good fit, with moderate to excellent test-retest reliabilities. The PPAPP should be further evaluated to better assess its associations with children's PA and offers a new tool for measuring PPAPP among Latino families with preschool-aged children.