Editorial: an author's checklist for measure development and validation manuscripts

The Gender Minority Stress and Resilience Measure: Psychometric Validity of an Adolescent Extension

OBJECTIVE

Minority stress contributes to several physical and psychological problems in sexual and gender minorities but is largely understudied in transgender/gender-nonconforming (TGNC) individuals, particularly TGNC adolescents. The availability of psychometrically sound measures of adolescent minority stress can help improve assessment and treatment planning in this area. This original research study examined whether an existing measure of TGNC-related minority stress and resilience among adults could retain construct and psychometric validity when administered to TGNC adolescents.

METHODS

Respondents were 258 TGNC adolescents, aged 12 -17.99 years (M=15.1, SD=1.4), majority white/European American (70.2%) and assigned female at birth (71.7%) seeking care in an interdisciplinary gender-health clinic within a pediatric academic medical center in the Midwestern United States. Respondents completed a battery of clinical measures as standard of care, including the Gender Minority Stress and Resilience Measure, measures of anxiety and depression symptoms, and parental support.

RESULTS

Findings indicated that minor adaptation of the existing adult measure resulted in high internal consistency and construct validity across 9 subscales assessing domains of minority stress and resilience in this sample of TGNC adolescents.

CONCLUSIONS

This study provides evidence of the factor structure, reliability and validity of an adolescent extension of the Gender Minority Stress and Resilience measure (GMSR-A). These findings demonstrate the clinical utility of the GMSR-A, a tool that can help increase understanding of minority stress and resilience phenomena experienced by TGNC adolescents.

Validation of the Spanish Version of the Psychosocial Assessment Tool (PAT) in Pediatric Cancer

Objective

Family psychosocial risk screening is an important initial step in delivering evidence-based care and in addressing health disparities. There is currently no validated measure of family psychosocial risk in Spanish. The Psychosocial Assessment Tool (PAT) is a brief parent report screener based on the trilevel Pediatric Preventative Psychosocial Risk Model (PPPHM; Universal, Targeted, and Clinical). The current article validates a Spanish version of the PAT (Version 3.0) in pediatric oncology.

Method

Spanish-speaking Hispanic primary caregivers of 79 children newly diagnosed with cancer participated in this 4-institution multisite investigation, completing Spanish versions of the PAT and validation measures using REDCap.

Results

Over 60% of the sample had a high school or lower level of education and they primarily identified as Hispanic in terms of acculturation. Internal consistency for the total score (KR20 = 0.76) and the Social Support, Child Problems, Sibling Problems, and Family Problems subscales was strong (KR20 = 0.69-0.79). Stress Reactions, Family Structure, and Family Beliefs subscales were lower (KR20 = 0.43-0.55). Moderate to strong correlations with the criteria measures provided validation for the total and subscale scores. Nearly two-thirds of the sample scored in the Targeted or Clinical range of the PPPHM. The PAT was successful in identifying clinical cases.

Conclusions

The Spanish version of the PAT can be used with families of children newly diagnosed with cancer. Elevated psychosocial risks were found and warrant particular attention in providing psychosocial care attentive to the needs of Spanish-speaking families.

Screening for Family Psychosocial Risk in Pediatric Cancer: Validation of the Psychosocial Assessment Tool (PAT) Version 3

Objective

Family psychosocial risk screening is an important initial step in delivering evidence-based care. The Psychosocial Assessment Tool (PAT) is a brief parent report screener based on the trilevel Pediatric Psychosocial Preventative Health Model (PPPHM; Universal, Targeted, Clinical). The current article validates a revised PAT (version 3.0) in pediatric oncology that includes new items (for families of younger patients; clinically relevant risk items) and applicable to broad health literacy levels (a 4th grade reading level).

Methods

Primary caregivers of 394 children newly diagnosed with cancer participated in this multisite investigation, completing the PAT and validation measures using REDCap.

Results

The original structure of the PAT, with seven subscales (Family Structure, Social Support, Child Problems, Sibling Problems, Family Problems, Stress Reactions, and Family Beliefs) was supported using a confirmatory factor analysis. Internal consistency for the total score (Kuder-Richardson 20 coefficient [KR20] = 0.81) and the subscales (KR20 = 0.59-0.85) was moderate to strong. Moderate to strong correlations with the criteria measures provided validation for the total and subscale scores. The validation measures varied significantly, as expected, across the three levels of the PPPHM. Receiver operating characteristic (ROC) analyses showed that the PAT total and subscale scores can discriminate families above and below clinical thresholds.

Conclusions

Results reinforce the psychometric properties of this approach for screening of family psychosocial risk. The PAT provides an evidence-based screener that identifies families at three levels of risk and can provide the basis for further evaluation and treatment of children with cancer and their families.

Development and Content Validation of the Transition Readiness Inventory Item Pool for Adolescent and Young Adult Survivors of Childhood Cancer

Objective

The development of the Transition Readiness Inventory (TRI) item pool for adolescent and young adult childhood cancer survivors is described, aiming to both advance transition research and provide an example of the application of NIH Patient Reported Outcomes Information System methods.

Methods

Using rigorous measurement development methods including mixed methods, patient and parent versions of the TRI item pool were created based on the Social-ecological Model of Adolescent and young adult Readiness for Transition (SMART).

Results

Each stage informed development and refinement of the item pool. Content validity ratings and cognitive interviews resulted in 81 content valid items for the patient version and 85 items for the parent version.

Conclusions

TRI represents the first multi-informant, rigorously developed transition readiness item pool that comprehensively measures the social-ecological components of transition readiness. Discussion includes clinical implications, the application of TRI and the methods to develop the item pool to other populations, and next steps for further validation and refinement.

The Diabetes Strengths and Resilience Measure for Adolescents With Type 1 Diabetes (DSTAR-Teen): Validation of a New, Brief Self-Report Measure

Objective

Despite the challenges of managing type 1 diabetes, many adolescents achieve optimal outcomes. A validated measure of diabetes-specific strengths is needed to measure adaptive behaviors and attitudes associated with overcoming challenges and achieving "resilient" outcomes.

Methods

Baseline data from 260 adolescents (age 14-18 years, M = 15.7 ± 1.1, 60% female, 33% Non-Caucasian, M A1c = 9.1 ± 1.9%) and caregivers in a behavioral intervention trial were analyzed to evaluate psychometric properties of the 12-item self-report Diabetes Strengths and Resilience measure for adolescents (DSTAR-Teen). Reliability and validity were examined in relation to measures of related constructs, regimen adherence, and glycemic outcomes, and confirmatory factor analysis was conducted.

Results

Reliability was good (internal consistency: α = .89; item-total correlations: r range = .55-.78). Significant correlations demonstrated construct and criterion validity. A two-factor structure reflecting intrapersonal and interpersonal processes fit the data better than a one-factor solution.

Conclusions

The DSTAR-Teen has strong psychometric properties, captures adaptive aspects of adolescents' diabetes management (i.e., "strengths"), and is related to clinical outcomes.

The Development and Initial Validation of the Irrational Performance Beliefs Inventory (iPBI)

Abstract. The growing use of Rational Emotive Behavior Therapy (REBT) in performance contexts (e.g., business, sport) has highlighted the absence of a contextually valid and reliable measure of irrational beliefs. This paper reports the development and initial validation of the Irrational Performance Beliefs Inventory (iPBI). The iPBI was developed to provide a validated measure of the four core irrational beliefs of REBT theory. Item development was completed in three stages comprising two expert panels and one novice panel, reducing and refining 176 items to 133. Then, exploratory and confirmatory factor analyses were used to refine the measure and reduce the number of items. A total of 665 business professionals completed the 133-item scale, alongside an established measure of irrational beliefs and a measure of negative emotion. A 28-item measure was developed (the iPBI) that showed an acceptable fit to the four-factor REBT structure. The iPBI correlated well with the established irrational beliefs measure, and with anxiety, depression, and anger, demonstrating concurrent and predictive validity. Further validation efforts are required to assess the validity and reliability of the iPBI in alternative samples in other performance-related contexts.

Measurement in pediatric epilepsy self-management: A critical review

Given the paucity of information available regarding self-management, the aims of this paper are to synthesize the literature on factors associated with and measures to assess self-management in pediatric epilepsy.

INCLUSION CRITERIA

youth birth to 18 years with a seizure disorder or an epilepsy diagnosis and/or their caregivers, published 1985-2014 in English, and conducted in countries with a very high human development index. The review was conducted in 6 phases: (1) identification of bibliographical search criteria and databases; (2) abstract assessment; (3) full article review; (4) organization of final citations into categories; (5) identification of predictors, potential mediators/moderators, and outcomes associated with self-management factors and categorization of factors as influences, processes, or behaviors across individual, family, community, and health care domains; and (6) critique of self-management instrument studies. Twenty-five studies that evaluated factors associated with self-management were identified. Individual and family-focused factors were the most commonly studied predictors of self-management, with psychosocial care needs and self-efficacy for seizure management identified as key factors associated with pediatric epilepsy self-management. Few studies have included mediator and moderator analyses. Measures of adherence were the most commonly used outcome. There has been a predominant focus on pediatric epilepsy influences and processes that are modifiable in nature, potentially at the expense of evidence for the role of community and health systems in pediatric epilepsy self-management. The 6 self-management instrument tools reported scientific rationale and good psychometric properties. Results highlight several key modifiable cognitive and behavioral targets for skills development: adherence, self-efficacy for seizure management, attitudes toward epilepsy, and family variables. Moving forward, a comprehensive pediatric epilepsy self-management model, well-validated measures of self-management behaviors, mediator/moderator designs to examine the complex relationships between predictors and pediatric epilepsy self-management outcomes, and studies examining the community and health care domains of self-management are necessary.

Development of Health-Related Quality of Life Instruments for Young Children With Disorders of Sex Development (DSD) and Their Parents

Objective

Research in disorders of sex development (DSD) is hindered by a lack of standardized measures sensitive to the experiences of affected children and families. We developed and evaluated parent proxy (children 2-6 years) and parent self-report (children ≤6 years) health-related quality of life (HRQoL) instruments for DSD.

Methods

Items were derived from focus groups and open-ended interviews. Clarity and comprehensiveness were assessed with cognitive interviews. Psychometric properties were examined in a field survey of 94 families.

Results

Measures demonstrated adequate to good psychometrics, including internal consistency, test-retest reliability, convergent validity, and ability to detect known-group differences. Parents reported greatest stress on Early Experiences , Surgery , and Future Concerns scales.

Conclusions

These instruments identify patients' and families' needs, monitor health and quality of life status, and can evaluate clinical interventions. Findings highlight the need for improved psychosocial support during the diagnostic period, better parent-provider communication, and shared decision-making. HRQoL measures are needed for older youth.

Measures of fidelity of delivery of, and engagement with, complex, face-to-face health behaviour change interventions: A systematic review of measure quality

PURPOSE

Understanding the effectiveness of complex, face-to-face health behaviour change interventions requires high-quality measures to assess fidelity of delivery and engagement. This systematic review aimed to (1) identify the types of measures used to monitor fidelity of delivery of, and engagement with, complex, face-to-face health behaviour change interventions and (2) describe the reporting of psychometric and implementation qualities.

METHODS

Electronic databases were searched, systematic reviews and reference lists were hand-searched, and 21 experts were contacted to identify articles. Studies that quantitatively measured fidelity of delivery of, and/or engagement with, a complex, face-to-face health behaviour change intervention for adults were included. Data on interventions, measures, and psychometric and implementation qualities were extracted and synthesized using narrative analysis.

RESULTS

Sixty-six studies were included: 24 measured both fidelity of delivery and engagement, 20 measured fidelity of delivery, and 22 measured engagement. Measures of fidelity of delivery included observation (n = 17; 38.6%), self-report (n = 15; 34%), quantitatively rated qualitative interviews (n = 1; 2.3%), or multiple measures (n = 11; 25%). Measures of engagement included self-report (n = 18; 39.1%), intervention records (n = 11; 24%), or multiple measures (n = 17; 37%). Fifty-one studies (77%) reported at least one psychometric or implementation quality; 49 studies (74.2%) reported at least one psychometric quality, and 17 studies (25.8%) reported at least one implementation quality.

CONCLUSION

Fewer than half of the reviewed studies measured both fidelity of delivery of, and engagement with complex, face-to-face health behaviour change interventions. More studies reported psychometric qualities than implementation qualities. Interpretation of intervention outcomes from fidelity of delivery and engagement measurements may be limited due to a lack of reporting of psychometric and implementation qualities. Statement of contribution What is already known on this subject? Evidence of fidelity and engagement is needed to understand effectiveness of complex interventions Evidence of fidelity and engagement are rarely reported High-quality measures are needed to measure fidelity and engagement What does this study add? Evidence that indicators of quality of measures are reported in some studies Evidence that psychometric qualities are reported more frequently than implementation qualities A recommendation for intervention evaluations to report indicators of quality of fidelity and engagement measures.

Identifying "Hitting Bottom" Among Individuals with Alcohol Problems: Development and Evaluation of the Noteworthy Aspects of Drinking Important to Recovery (NADIR)

BACKGROUND

Alcohol use disorder (AUD) is a costly public health concern; yet, many individuals with AUD never receive formal treatment. Prior studies have identified that "hitting bottom" may be an important factor in seeking treatment for AUD) and the notion that "hitting bottom" is necessary for recovery is commonly portrayed in the popular media. Yet, "hitting bottom" has never been formally operationalized.

OBJECTIVES

The present article aimed to operationalize "hitting bottom."

METHODS

A multiphase process was used to develop a measure of hitting bottom among individuals experiencing alcohol problems: The Noteworthy Aspects of Drinking Important to Recovery (NADIR). Psychometric evaluation of the measure was conducted using online data collected from individuals who identified as moderate to heavy drinkers (N = 597).

RESULTS

The NADIR included five lower-order dimensions and one higher-order dimension ("hitting bottom"), had strong concurrent validity with measures of alcohol use severity and alcohol-related problems, and was found to have excellent internal consistency reliability (α > 0.90). An overall summary score on the NADIR of 50+ (factor scores>0) differentiated individuals who had previously sought treatment for AUD and reported more excessive alcohol use compared to those with no treatment history and lower levels of alcohol use. Thus, the NADIR with a cutoff of 50 may be a good starting point for future researchers to test as a method to identify individuals who have hit bottom. Conclusions/Importance: The NADIR provides a viable operational definition of hitting bottom. Future research should evaluate the predictive validity of the NADIR.

Validation of a Brief Insomnia Severity Measure in Youth Clinically Referred for Sleep Evaluation

Objectives

Evaluate psychometric properties of the Pediatric Insomnia Severity Index (PISI), a brief measure of insomnia severity.

Methods

Clinically referred youth ( n = 462; 283 males, 179 females, mean age = 7.28 ± 2.05 years) and their caregiver(s) completed sleep evaluation including the PISI, Children's Sleep Habits Questionnaire, and sleep disorders inventory for students. Tests of reliability and validity and confirmatory factor analysis (CFA) were conducted to assess PISI psychometric properties. Exploratory analyses were conducted to examine insomnia severity by insomnia diagnosis.

Results

Measures of internal consistency for the PISI factor scores varied. CFA indicated that a two-factor model had optimal fit relative to a single-factor solution. Overall, convergent and discriminant validity of PISI factors were supported. Insomnia severity varied by diagnosis.

Conclusions

Findings provide preliminary support for the reliability and validity of the PISI within a large pediatric sample and for its clinical utility as a brief measure of insomnia severity.

Reliability and validity of the Beliefs About Medication Scale in pediatric inflammatory bowel disease

Low adherence is a pervasive issue among youth with inflammatory bowel diseases (IBD), yet our understanding of perceived adherence barriers is hampered by a lack of validated instruments. This study sought to address this by evaluating the reliability and predictive validity of the Beliefs About Medication Scale (BAMS) among youth with IBD. Seventy-six youth (ages 11-18) with IBD who were prescribed a daily oral IBD medication completed baseline ratings of perceived adherence barriers via the BAMS. Parents provided information about patient demographic and disease factors. Subjective medication adherence was assessed via the medication adherence measure. Objective medication adherence was assessed via Medication Event Monitoring System (MEMS) Track Caps. BAMS subscales demonstrated adequate internal consistency ( αs = .78-.90) and test-retest reliability ( rs = .64-.79). BAMS subscales reliably distinguished between adherent and low adherent groups, though intent to adhere (IA) was the only independent predictor of adherence status. The BAMS holds promise as a tool for assessing adherence barriers among adolescents with IBD. IA may be of particular value in identifying adolescents at risk for low adherence.

Psychometric Properties of the Psychosocial Assessment Tool-Chronic Pain Version in Families of Children With Headache

Children with headache disorders are at increased psychosocial risk, and no validated screening measures exist to succinctly assess for risk. This study examined the psychometric properties of the Psychosocial Assessment Tool-Chronic Pain, a previously adapted screening measure of risk, in a retrospective sample of families of children diagnosed with headaches. Participants included 127 children and caregivers presenting for behavioral health evaluation of headache. Children and their primary caregivers completed several psychosocial assessment measures. Internal consistency for the Psychosocial Assessment Tool-Chronic Pain total score was high (α = 0.80), and all subscale scores had moderate to high internal consistency (α = 0.597-0.88), with the exception of the caregiver beliefs subscale (α = 0.443). The total score and the majority of subscale scores on the Psychosocial Assessment Tool-Chronic Pain were correlated with caregiver- and child-reported scores on study measures. The results demonstrate that the Psychosocial Assessment Tool-Chronic Pain has adequate psychometric properties, and because of the brief administration time, ease of scoring, and accessibility of the measure, it is a promising measure of screening for psychosocial risk in this population.

Examination of the relationship between social support and treatment outcomes in mothers referred by Child Protective Services utilizing the Significant Other Support Scale

Supportive social networks may play an important role in recovery for mothers within the umbrella of Child Protective Services (CPS). However, investigators have yet to assess how the quality of significant other support assists family-based treatment. In this study the influence of significant others was examined in the family-based treatment of 38 mothers who were referred for behavioral treatment by CPS. The Significant Other Support Scale (SOSS) was empirically developed, and subsequently utilized to assess the extent to which participants' significant others were perceived by treatment providers to support the participants' goals during treatment sessions. Results indicated that SOSS scores (but not participant and significant other session attendance) were associated with lower participant child abuse potential and drug use frequency at the conclusion of treatment. There was no relationship found between SOSS scores and participant session attendance. However, there was a positive correlation between SOSS scores and significant other session attendance (r = .489, p < .01). The results of this study suggest the quality of significant other support during treatment sessions in this population of mothers may be more important to improving treatment outcomes than session attendance per se. Future directions are discussed in light of the results.

Further Psychometric Evaluation of the Child Disgust Scale

This study evaluated the psychometric properties of the Child Disgust Scale (CDS) among 457 youth (ages 8-17, M = 14.77 ± 1.98 years) initiating residential treatment for obsessive-compulsive disorder and anxiety disorders. Confirmatory factor analysis supported a bifactor model with two distinct factors of Disgust Avoidance and Disgust Affect, in addition to an overall General Disgust factor. Strong internal consistency was observed for the CDS total and factor scores. In addition, CDS scores demonstrated generally modest and positive correlations with child-reported obsessive-compulsive and anxiety symptoms, weaker correlations with parent-reported anxiety and child-rated impairment, and non-significant correlations with parent-rated impairment. Findings suggest that the CDS displays strong psychometric properties and is developmentally appropriate for use in pediatric clinical populations with obsessive-compulsive and anxiety disorders.

Accumulation of Content Validation Evidence for the Critical Thinking Self-Assessment Scale

Background/Purpose: Critical thinking skills (CTS) are essential for nurses; assessing students’ acquisition of these skills is a mandate of nursing curricula. This study aimed to develop a self-assessment instrument of critical thinking skills (Critical Thinking Self-Assessment Scale [CTSAS]) for students’ self-monitoring. Methods: An initial pool of 196 items across 6 core cognitive skills and 16 subskills were generated using the American Philosophical Association definition of CTS. Experts’ content review of the items and their ratings provided evidence of content relevance using the item-level content validity index (I-CVI) and Aiken’s content validity coefficient (VIk). Results: 115 items were retained (range of I-CVI values = .70 to .94 and range of VIkvalues = .69–.95; significant atp< .05). Conclusion: The CTSAS is the first CTS instrument designed specifically for self-assessment purposes.

Development and psychometric evaluation of the Military Suicide Attitudes Questionnaire (MSAQ)

BACKGROUND

To date, a culturally-sensitive psychological instrument has not been developed to evaluate military attitudes toward suicide. Understanding these attitudes can inform suicide prevention research, clinical practice, and policy. We aimed to develop such an instrument and to evaluate its psychometric properties using an active-duty military sample.

METHODS

A team of military personnel, suicidologists, and researchers assisted with item development. A cross-sectional design was used to evaluate the psychometric properties of the Military Suicide Attitudes Questionnaire (MSAQ) via an online survey battery. Exploratory and confirmatory factor analyses were conducted.

RESULTS

A total of 317 military service members met eligibility criteria and completed the online surveys. A four-factor model that explained 46.4% of the variance was identified: (1) Individual-Based Rejection versus Acceptance; (2) Psychache versus Pathological; (3) Unit-Based Rejection versus Acceptance; (4) Moral versus Immoral. The MSAQ demonstrated high partial validity and test-retest reliability.

LIMITATIONS

The study used a convenience sample and did not control for social desirability.

CONCLUSIONS

The newly developed MSAQ is a promising measure that fills a notable gap in the assessment of suicide attitudes within the United States military. The MSAQ has the potential for future use in evaluating suicide prevention and stigma reduction programs within the Department of Defense. Additionally, the MSAQ may serve as a useful tool for leadership in the evaluation of command climates. In clinical settings, the MSAQ could be used along with other cognitive and attitudinal measures to track suicidal patients' attitude towards suicide over the course of treatment.

Adaptation of the State-Trait Inventory for Cognitive and Somatic Anxiety for Use in Children: A Preliminary Analysis

OBJECTIVE

Anxiety has both state/trait and cognitive/somatic dimensions, and these distinctions may be particularly relevant for children with medical problems. This two-part study adapted the State-Trait Inventory for Cognitive and Somatic Anxiety (STICSA) and confirmed its factor structure in a sample of children in a primary care clinic.

METHODS

STICSA items were adapted for reading level and piloted in a small group of children. Next, 250 children (12.3 ± 2.7 years) completed the adapted version, the STICSA-C.

RESULTS

Separate confirmatory factor analyses conducted on the State and Trait forms of the STICSA-C confirmed the two-factor structure of the original measure (i.e., cognitive and somatic anxiety) and suggested an improved parsimonious model.

CONCLUSIONS

Support was found for use of the STICSA-C as a reasonably good internally consistent measure for assessing cognitive and somatic anxiety in pediatric samples. Further investigation of its reliability and validity with replication in pediatric populations is warranted.

The Mood Rhythm Instrument: development and preliminary report

OBJECTIVE

To describe the initial steps in the development and validation of a new self-reported instrument designed to assess daily rhythms of mood symptoms, namely, the Mood Rhythm Instrument.

METHODS

A multidisciplinary group of experts took part in systematic meetings to plan the construction of the instrument. Clarity of items, their relevance to evaluation of mood states, and the consistency of findings in relation to the available evidence on the biological basis of mood disorders were investigated. The internal consistency of the questionnaire was evaluated through Cronbach's alpha.

RESULTS

All of the items proposed in a first version were well rated in terms of clarity. The items more frequently rated as "rhythmic" were related to the somatic symptoms of mood. Their peaks in 24 hours were more frequent in the morning. The items associated with affective symptoms of mood were rated as less rhythmic, and their peak in 24 hours occurred more frequently in the afternoon and evening. Males and females behaved more similarly with respect to somatic than behavioral-affective items. The second version of the Mood Rhythm Instrument had a Cronbach's alpha of 0.73.

CONCLUSION

The proposed Mood Rhythm Instrument may be able to detect individual rhythms of cognitive and behavioral measures associated with mood states. Validation in larger samples and against objective measures of rhythms, such as actigraphy, is warranted.

An Evaluation of the Children's Report of Sleep Patterns Using Confirmatory and Exploratory Factor Analytic Approaches

OBJECTIVE

To explore the psychometric properties of the Children's Report of Sleep Patterns (CRSP) in school-aged children by conducting a factor analysis of the Sleepiness Scale and the Sleep Disturbances Scales.

METHODS

Participants included 155 children from two elementary schools (Mage = 9.82) who completed the self-report CRSP. A confirmatory factor analysis (CFA) was conducted using the originally hypothesized structure. A subsequent exploratory factor analysis (EFA) was conducted to determine an alternative factor structure.

RESULTS

CFA revealed that the hypothesized factor structure was not supported. The EFA produced an alternative six-factor solution, which supports the conceptualization of three new scales, Restless Legs Report, Sleep Initiation, and Sleep Maintenance/Night Wakings.

CONCLUSION

The revised measure adds increased specificity with scales related to insomnia and restless leg symptoms. Researchers and clinicians interested in using the CRSP should continue to assess its validity by exploring the relationship between the measure and objective measures of sleep behavior.

Self-Management and Transition Readiness Assessment: Development, Reliability, and Factor Structure of the STARx Questionnaire

INTRODUCTION

The Self-Management and Transition to Adulthood with Rx=Treatment (STARx) Questionnaire was developed to collect information on self-management and health care transition (HCT) skills, via self-report, in a broad population of adolescents and young adults (AYAs) with chronic conditions.

METHODS

Over several iterations, the STARx questionnaire was created with AYA, family, and health provider input. The development and pilot testing of the STARx Questionnaire took place with the assistance of 1219 AYAs with different chronic health conditions, in multiple institutions and settings over three phases: item development, pilot testing, reliability and factor structuring.

RESULTS

The three development phases resulted in a final version of the STARx Questionnaire. The exploratory factor analysis of the third version of the 18-item STARx identified six factors that accounted for about 65% of the variance: Medication management, Provider communication, Engagement during appointments, Disease knowledge, Adult health responsibilities, and Resource utilization. Reliability estimates revealed good internal consistency and temporal stability, with the alpha coefficient for the overall scale being .80. The STARx was developmentally sensitive, with older patients scoring significantly higher on nearly every factor than younger patients.

CONCLUSION

The STARx Questionnaire is a reliable, self-report tool with adequate internal consistency, temporal stability, and a strong, multidimensional factor structure. It provides another assessment strategy to measure self-management and transition skills in AYAs with chronic conditions.

Development and validation of the Peer Interaction Macro-Coding System Scales (PIMS): a new tool for observational measurement of social competence in youth with spina bifida

Many children with chronic health conditions encounter enduring difficulties in their peer interactions and friendships. This study aimed to create and validate scales derived from an observational coding system (i.e., Peer Interaction Macro-Coding System, or PIMS) in a sample of children with spina bifida and their peers. Participants were 106 target child-peer dyads who completed a battery of questionnaires and interviews and were videotaped performing 4 interaction tasks, which were then coded across multiple domains of social functioning. Five scales (i.e., Control, Prosocial Skills, Positive Affect, Conflict, and Dyadic Cohesion) were rationally derived based on a review of the literature and a panel of experts. Internal consistency and interrater reliability at the scale level were good to excellent for all 5 scales. Interscale correlations were in the low-to-moderate range for 4 of the scales, although the Dyadic Cohesion Scale was highly correlated with two other scales and was subsequently dropped. Convergent validity and discriminant validity were established by examining the 4 remaining scales in association with comparable questionnaire and interview data. The 4 PIMS scales appear to be reliable and valid measures of social competence and may enhance future multimethod research efforts aimed at learning more about peer interactions and overall social competence.

Life stress as a determinant of emotional well-being: development and validation of a Spanish-Language Checklist of Stressful Life Events

Objectives: To develop a screening instrument for investigating the prevalence and impact of stressful life events in Spanish-speaking Peruvian adults. Background: Researchers have demonstrated the causal connection between life stress and psychosocial and physical complaints. The need for contextually relevant and updated instruments has been also addressed. Methods: A sequential exploratory design combined qualitative and quantitative information from two studies: first, the content validity of 20 severe stressors (N = 46); then, a criterion-related validity process with affective symptoms as criteria (Hopkins Symptom Checklist (HSCL-25), N = 844). Results: 93% of the participants reported one to eight life events (X = 3.93, Mdn = 3, SD = 7.77). Events increase significantly until 60 years of age (Mdn = 6). Adults born in inland regions (Mdn = 4) or with secondary or technical education (Mdn = 5) reported significantly more stressors than participants born in Lima or with higher education. There are no differences by gender. Four-step hierarchical models showed that life stress is the best unique predictor (β) of HSCL anxiety, depression and general distress (p < .001). Age and gender are significant for the three criteria (p < .01, p < .001); lower education and unemployment are significant unique predictors of general distress and depression (p < .01; p < .05). Previously, the two-factor structure of the HSCL-25 was verified (Satorra-Bentler chi-square, root-mean-square error of approximation = 0.059; standardized root-mean-square residual = 0.055). Conclusion: The Spanish-Language Checklist of Stressful Life Events is a valid instrument to identify adults with significant levels of life stress and possible risk for mental and physical health (clinical utility).

The validation of a scale to measure cognitive development in Chinese preschool children

The present study aimed to evaluate the reliability and validity of the cognitive sub-test of the Preschool Developmental Assessment Scale (PDAS) for Hong Kong Chinese children. Participants included 378 children (189 boys and 189 girls) aged 3-6 years old, with 324 children with typical development and 54 children with developmental disabilities. They were administered the cognitive sub-test of the PDAS and the Wechsler Preschool and Primary Scale of Intelligence - Revised (WPPSI-R). The PDAS cognitive sub-test total scores correlated positively with the WPPSI-R scores. It could differentiate children from different age groups, with younger children attaining significantly lower scores than older children. The sub-test could also differentiate children with typical development from those with developmental disabilities, with the latter attaining significantly lower scores. The sensitivity and specificity were around 80%. Internal consistency (KR-20) was .93 and test-retest reliability was .81. The cognitive sub-test of the PDAS was found to be a promising screening tool for the identification of preschool children with developmental disabilities.

Validation of a questionnaire to measure mastery motivation among Chinese preschool children

The aim of this study was to validate a questionnaire on mastery motivation (task and effort) for use with Chinese preschool children in Hong Kong. A parent version and a teacher version were developed and evaluated. Participants included 457 children (230 boys and 227 girls) aged four and five years old, their preschool teachers and their parents. Further, 44 children (39 boys and 5 girls) with developmental disabilities were recruited. The children were assessed on the cognitive sub-test of the Preschool Development Assessment Scale (PDAS). Their parents completed the task and effort motivation scales, as well as the Strengths and Difficulties Questionnaire (SDQ). Their teachers also completed the task and effort motivation scales. Rasch analysis results provided support for the unidimensionality of the parent and teacher versions of the two motivation scales. The parent and teacher versions of the two motivation scales correlated positively with the PDAS cognitive sub-test and the SDQ prosocial scale scores, and negatively with the SDQ total problem behavior scores. Children with developmental disabilities were assigned lower scores by their teachers and parents on the two motivation scales, compared with children with typical development. Reliability (Cronbach's Alpha) of the parent and teacher versions of the two motivation scales were above .70. The results suggested that the task and effort motivation scales were promising instruments for the assessment of motivation among Chinese preschool children.

Validation of a questionnaire on behaviour academic competence among Chinese preschool children

The aim of this study was to validate a questionnaire on academic competence behaviour for use with Chinese preschool children in Hong Kong. A parent version and a teacher version were developed and evaluated. The participants included 457 children (230 boys and 227 girls) aged four and five years old, their preschool teachers and their parents. Besides, 44 children (39 boys and 5 girls) with developmental disabilities were recruited. The children were assessed on the cognitive domain of the Preschool Development Assessment Scale (PDAS). Their parents completed a questionnaire on academic competence behaviour, as well as the Strength and Difficulty Scale (SDQ). Their teachers completed the questionnaire on academic competence behaviour. Rasch analysis results provided support for the unidimensionality of the parent and teacher versions of the scale, with one item deleted. The parent and teacher versions of the revised scale correlated positively with the cognitive domain of the PDAS and the prosocial scale of the SDQ and negatively with SDQ total problem behaviour score. Children with developmental delay were assigned lower scores by their parents and teachers, compared with preschool children, on the revised versions of the academic competence behaviour scale. Reliability estimates (Cronbach's alpha) of the parent and teacher versions of this revised scale were above .80. The results suggested that the two versions of academic competence behaviour scales were promising instruments for the assessment of academic competence behaviour among Chinese preschool children.

Assessment of anxiety in older adults: a systematic review of commonly used measures

OBJECTIVES

The authors set out to systematically review the research literature in order to identify the anxiety measures most commonly used in the assessment of older adults. Once identified, the literature was reviewed to determine the extent to which these instruments had age-relevant norms and psychometric data supporting their use with older adults.

METHOD

Literature searches were conducted in PsycINFO and PubMed to identify research articles in which anxiety measures were completed by older adults. After screening for suitability, a total of 213 articles were reviewed to determine the most commonly used anxiety measures with older adults to examine the psychometric properties of these instruments and to evaluate whether the instruments are appropriate for use with older adults.

RESULTS

A total of 91 different anxiety measures were used in the 213 included articles. Twelve anxiety measures were most commonly used in the literature and of those three were specifically developed for older adults.

CONCLUSIONS

Of the most commonly used measures, the majority lacked sufficient evidence to warrant their use with older adults. Based on psychometric evidence, three measures (Beck Anxiety Inventory, Penn State Worry Questionnaire, and Geriatric Mental Status Examination) showed psychometric properties sufficient to justify the use of these instruments when assessing anxiety in older adults. In addition, two measures developed specifically for older adults (Worry Scale and Geriatric Anxiety Inventory) were also found to be appropriate for use with older adults.

The factor structure of traumatic stress in parents of children with cancer: a longitudinal analysis*

OBJECTIVES

To determine the factor structure of posttraumatic stress symptoms (PTSS) and assess its stability over time among parents of children diagnosed with cancer.

METHODS

Parents of children with cancer included in a longitudinal study completed the posttraumatic stress disorder (PTSD) Checklist-Civilian Version 2 weeks (n = 249) and 2 (n = 234) and 4 (n = 203) months after their child's diagnosis. Confirmatory factor analysis (CFA) was used to assess 3 models of the underlying dimensions of PTSD and invariance tests were used to assess stability over time.

RESULTS

A longitudinal CFA with the factors reexperiencing, avoidance, dysphoria, and hyperarousal provided best fit to the data. Invariance testing suggested that the pattern and size of loadings were equivalent across the three assessments. Discussions Findings tentatively suggest that PTSS among parents of children with cancer consist of four factors. Implications for research and clinical practice are discussed.

The Development and Evaluation of a Measure Assessing School Nurses' Perceived Barriers to Addressing Pediatric Obesity

School nurses represent an important resource for addressing pediatric obesity and weight-related health. However, school nurses perceive numerous barriers that prevent them from addressing the weight-related health of students. The current study developed and tested a new, comprehensive measure of nurses' perceptions of 10 types of barriers to addressing pediatric weight in a nationally representative sample of 214 school nurses. The measure was developed in the context of Bronfenbrenner’s (1979) ecological systems theory and includes subscales assessing nurses' perceptions of skills-based, job-related, and societal barriers. Confirmatory factor analyses (CFAs) provided evidence for the validity of the measure, including the three barrier subscales. In addition, the subscales demonstrated adequate internal consistencies. Results indicate that school nurses perceive barriers to addressing weight-related health on multiple ecological levels, which may inform intervention or continuing education efforts. Future pediatric weight programs that involve school nurses might consider using the measure to assess nurses' perceptions of barriers.