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Self-efficacy (or the belief in one’s ability to effect change) often moderates the relationship between education, interest, and actions in evaluations of training programs that prepare community-based investigators in the clinical and translational sciences workforce. Such evaluations, however, tend to emphasize individual-level attitudes when there are also community- or organizational-level outcomes impacted. Methods: This study uses a novel sequential, explanatory mixed-methods design to explore multiple levels of self-efficacy (or self-awareness of personal growth in leadership) in the Clinical Scholars program, an equity-centered leadership development program for mid- to later-career healthcare professionals. Our design involves: (1) bivariate correlations and confirmatory factor analysis of self-assessed competencies across all program participants to identify emergent combinations of competencies, which informed (2) more nuanced thematic coding of participants’ stories of most significant change in their personal and professional lives, as a result of the program. Results: In unpacking their accounts of personal leadership styles (that aligned with our quantitative analyses of competencies), we found that participants demonstrated multiple competencies simultaneously. Specifically, they employed emotionally intelligent learning and consensus-building dialogue to manage conflict for interpersonal impact. Additionally, they used this combination of skills to unite diverse stakeholders under a shared vision in order to lead and manage organizational change where all colleagues’ contributions were valued. Conclusion: Together, these methods extend our understanding of personal growth in leadership as an outcome of the program in terms of individual- and organizational-level impacts, using representative quantitative self-assessments to categorize rich qualitative descriptions.
Informal digital learning of English (IDLE) is a promising way of learning English that has received growing attention in recent years. It has positive effects on English as a foreign language (EFL) learners and also creates valuable opportunities for EFL teachers to improve their teaching skills. However, there has been a lack of a valid and reliable scale to measure IDLE among teachers in EFL contexts. To address this lacuna, this study aims to develop and validate a scale to measure IDLE for EFL teachers in Iran. For this purpose, a nine-step rigorous validation procedure was undertaken: administering pilot interviews; creating the first item pool; running expert judgment; running interviews and think-aloud protocol; running the pilot study; performing exploratory factor analysis, Cronbach’s alpha, and confirmatory factor analysis; creating the second item pool; conducting expert reviews; and performing translation and translation quality check. Findings yielded a 41-item scale with six subscales: IDLE-enhanced benefits (12 items), IDLE practice (five items), support from others (nine items), authentic L2 experience (three items), resources and cognition (four items), and frequency and device (eight items). The scale demonstrated satisfactory psychometric properties such that it can be used for research and educational purposes in future.
Caribbean health research has overwhelmingly employed measures developed elsewhere and rarely includes evaluation of psychometric properties. Established measures are important for research and practice. Particularly, measures of stress and coping are needed. Stressors experienced by Caribbean people are multifactorial, as emerging climate threats interact with existing complex and vulnerable socioeconomic environments. In the early COVID-19 pandemic, our team developed an online survey to assess the well-being of health professions students across university campuses in four Caribbean countries. This survey included the Perceived Stress Scale, 10-item version (PSS-10) and the Brief Resilient Coping Scale (BRCS). The participants were 1,519 health professions students (1,144 females, 372 males). We evaluated the psychometric qualities of the measures, including internal consistency, concurrent validity by correlating both measures, and configural invariance using confirmatory factor analysis (CFA). Both scales had good internal consistency, with omega values of 0.91 for the PSS-10 and 0.81 for the BRCS. CFA suggested a two-factor structure of the PSS-10 and unidimensional structure of the BRCS. These findings support further use of these measures in Caribbean populations. However, the sampling strategy limits generalizability. Further research evaluating these and other measures in the Caribbean is desirable.
Exposure to adversity in childhood is a risk factor for lifetime mental health problems. Altered pace of biological aging, as measured through pubertal timing, is one potential explanatory pathway for this risk. This study examined whether pubertal timing mediated the association between adversity (threat and deprivation) and adolescent mental health problems (internalizing and externalizing), and whether this was moderated by sex.
Methods
Aims were examined using the Adolescent Brain and Cognitive Development study, a large community sample from the United States. Data were used from three timepoints across the ages of 9–14 years. Latent scores from confirmatory factor analysis operationalized exposure to threat and deprivation. Bayesian mixed-effects regression models tested whether pubertal timing in early adolescence mediated the relationship between adversity exposure and later internalizing and externalizing problems. Sex was examined as a potential moderator of this pathway.
Results
Both threat and deprivation were associated with later internalizing and externalizing symptoms. Threat, but not deprivation, was associated with earlier pubertal timing, which mediated the association of threat with internalizing and externalizing problems. Sex differences were only observed in the direct association between adversity and internalizing problems, but no such differences were present for mediating pathways.
Conclusions
Adversity exposure had similar associations with the pace of biological aging (as indexed by pubertal timing) and mental health problems in males and females. However, the association of adversity on pubertal timing appears to depend on the dimension of adversity experienced, with only threat conferring risk of earlier pubertal timing.
The current study evaluated the Kiswahili version of General Health Questionnaire (GHQ-12) in a Kenyan context comprising of women exposed to gender-based violence. Participants were randomly drawn from community sampling using household screening methods in peri-urban areas in Nairobi. A total of 1,394 participants with varying levels of literacy (years of education: mean [M] = 9.42; standard deviation [SD] = 3.73) and aged between 18 and 89 years were recruited for the study. The observed factor structure of the GHQ-12 was evaluated using six most tested models querying the dimensionality of the instrument insofar as the impacts of positive and negative wording effects in driving multidimensionality. Results from the confirmatory factor analysis supported a bifactor model, consisting of a general distress factor and two separate factors representing common variance due to the positive and negative wording of items. Overall, the findings support the use of the Kiswahili version of the GHQ-12 as a unidimensional construct with method-specific variance owing to wording effects. Importantly, GHQ-12 responses from a sample of Kenyan women with relatively low levels of literacy are congruent with the factor structure observed in other cross-cultural settings in low- and-middle-income countries.
Floods are the most frequent natural disasters with a significant share of their mortality. Preparedness is capable of decreasing the mortality of floods by at least 50%. This paper aims to present the psychometric properties of a scale developed to evaluate the behavior of preparedness to floods in Sudan and similar settings.
Methods:
In this methodological scale development study, experts assessed the content validity of the items of the developed scale. Data were collected from key persons of 413 households living in neighborhoods affected by the 2018 floods in Kassala City in Sudan. A pre-tested questionnaire of sociodemographic data and the Flood Preparedness Behavior Scale (FPBS) were distributed to the participants’ houses and recollected. Construct validity of the scale was checked using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Internal consistency of the scale was checked using Cronbach’s alpha. Test-retest reliability was assessed by Pearson’s correlation coefficient. Item analyses and tests of significance of the difference in the mean scores of the highest and lowest score groups were carried out to ensure discriminatory power of the scale items.
Results:
Experts agreed on the scale items. Construct validity of the scale was achieved using EFA by removing 34 items and retaining 25 items that were structured in three factors, named as: measures to be done before, during, and after a flood. Confirmatory factor analysis confirmed the construct obtained by EFA. The loadings of the items on their factors in both EFA and CFA were all > 0.3 with significant associations and acceptable fit indices obtained from CFA. The three factors were found to be reliable in terms of internal consistency (Cronbach’s alpha coefficients for all factors were > 0.7) and test-retest reliability coefficient. In item analysis, the corrected total item correlations for all the items were > 0.3, and significant differences in the means of the highest and lowest score groups indicated good item discrimination power.
Conclusion:
The developed 25 items scale is an instrument which produces valid and reliable measures of preparedness behavior for floods in Sudan and similar settings.
COVID-19 carriers experience psychological stresses and mental health issues such as varying degrees of stigma. The Social Impact Scale (SIS) can be used to measure the stigmatisation of COVID-19 carriers who experience such problems.
Aims
To evaluate the reliability and validity of the Chinese version of the SIS, and the association between stigma and depression among asymptomatic COVID-19 carriers in Shanghai, China.
Method
A total of 1283 asymptomatic COVID-19 carriers from Shanghai Ruijin Jiahe Fangcang Shelter Hospital were recruited, with a mean age of 39.64 ± 11.14 years (59.6% male). Participants completed questionnaires, including baseline information and psychological measurements, the SIS and Self-Rating Depression Scale. The psychometrics of the SIS and its association with depression were examined through exploratory factor analysis, confirmatory factor analysis and receiver operating characteristic analysis.
Results
The average participant SIS score was 42.66 ± 14.61 (range: 24–96) years. Analyses suggested the model had four factors: social rejection, financial insecurity, internalised shame and social isolation. The model fit statistics of the four-factor SIS were 0.913 for the comparative fit index, 0.902 for the Tucker–Lewis index and 0.088 for root-mean-square error of approximation. Standard estimated factor loadings ranged from 0.509 to 0.836. After controlling for demographic characteristics, the total score of the 23-item SIS predicted depression (odds ratio: 1.087, 95% CI 1.061–1.115; area under the curve: 0.84, 95% CI 0.788–0.892).
Conclusions
The Chinese version of the SIS showed good psychometric properties and can be used to assess the level of perceived stigma experienced by asymptomatic COVID-19 carriers.
This study examined various factors influencing protective actions among persons with disabilities exposed to the December 10–11, 2021, tornado outbreak in the US Midwest and Southeastern regions.
Methods:
Survey administration occurred 5 months following the tornado outbreak and included a total of 209 persons with disabilities who lived in one of the counties impacted by tornado warnings. Structural equation modeling was used to examine the direct and indirect effects of hypothesized predictors impacting protective behavioral actions.
Results:
Results found that persons with disabilities who had access to more tornado warning sources increased their protective actions, and tornado risk perception further mediated the relationship between warning information sources and protective actions. In addition, results found that persons with disabilities who encountered more situational barriers in their physical and social environment were found to have a decrease in protective action, and having more situational resources was found to contribute to the ability to take protective action.
Conclusions:
The current study’s results highlight the need for policies and practices that provide additional physical and social resources for persons with disabilities to seek protection during tornado threats.
People with post-traumatic stress disorder (PTSD) exhibit negative cognitions, predictive of PTSD severity. The Post-Traumatic Cognitions Inventory (PTCI) is a widely used instrument measuring trauma-related cognitions and beliefs with three subscales: negative thoughts of self (SELF), negative cognitions about the world (WORLD), and self-blame (BLAME).
Aims:
The current study attempted to validate the use of the PTCI in people with serious mental illness (SMI), who have greater exposure to trauma and elevated rates of PTSD, using confirmatory factor analysis (CFA) and examining convergent and divergent correlations with relevant constructs.
Method:
Participants were 432 individuals with SMI and co-occurring PTSD diagnosis based on the Clinician Administered PTSD Scale, who completed PTCI and other clinical ratings.
Results:
CFAs provided adequate support for Foa’s three-factor model (SELF, WORLD, BLAME), and adequate support for Sexton’s four-factor model that also included a COPE subscale. Both models achieved measurement invariance at configural, metric and scalar levels for three diagnostic groups: schizophrenia, bipolar and major depression, as well as for ethnicity (White vs Black), and gender (male vs female). Validity of both models was supported by significant correlations between PTCI subscales, and self-reported and clinician assessed PTSD symptoms and associated symptoms.
Conclusions:
Findings provide support for the psychometric properties of the PTCI and the conceptualization of Sexton’s four-factor and Foa’s three-factor models of PTCI among individuals diagnosed with SMI (Foa et al., 1999).
In this chapter, we review the quantitative measurement of critical consciousness that has emerged within developmental and applied research over the last few decades. We provide a brief history and offer an overview of the current status of critical consciousness measurement. We also introduce four “phases” of critical consciousness measurement, which we refer to as (1) proxy measurement; (2) scale development; (3) scale expansion and (re)specification; and (4) scale refinement and adaptation. Due to their central role in critical consciousness measurement, we pay particular attention to instruments appearing in phase two, the scale development phase. After summarizing each phase, we identify opportunities for advancement and innovation in critical consciousness measurement and point to important new directions for measurement work in this area of scholarship – many of which are addressed more extensively in subsequent chapters of this volume.
Different dietary indexes are proposed to investigate adherence to the Mediterranean diet (MD). However, they are based on different methodologies, and limited research has compared them to each other, particularly in non-Mediterranean populations. We aimed to compare five indexes intended to measure adherence to the MD. The sample was composed of adults and older adults (n 1187) from 2015 ISA-Nutrition, a cross-sectional population-based study in São Paulo, SP, Brazil. Dietary data obtained through two 24-h dietary recalls (24HDR) from which the Mediterranean diet scale (MDS), Mediterranean diet Score (MedDietscore), Mediterranean dietary pattern (MDP), Mediterranean Adequacy Index (MAI) and Mediterranean-Style Dietary Pattern Score (MSDPS) were calculated. The correlations and agreements between them were analysed by Spearman's correlation and linearly weighted Cohen's Kappa coefficients, respectively. Confirmatory factor analyses (CFAs) were applied to investigate their convergent validity. The highest correlations were found between MDP and MAI (r = 0⋅76; 95% CI 0⋅74–0⋅79) and between MDP and MDS (r = 0⋅72; 95% CI 0⋅69–0⋅75). The greatest agreements observed were moderate, between MDP v. MAI (κ = 0⋅57, P < 0⋅001) and MDP v. MDS (κ = 0⋅48, P < 0⋅001). The goodness-of-fit of CFA for MedDietscore (RMSEA = 0⋅033, 90% CI 0⋅02–0⋅042; SRMR = 0⋅042) and MSDPS (RMSEA = 0⋅028, 90% CI 0⋅019–0⋅037; SRMR = 0⋅031) had acceptable values for absolute fit indices. Vegetables, olive oil, MUFA:SFA ratio and cereals with legumes were more relevant to characterise the MD (factor loadings ≥0⋅50). The MDS, MAI and MDP classified the population similarly, but the MedDietscore showed better performances in evaluating adherence to the MD. These results provided guidance for the most appropriate Mediterranean dietary index to be applied in non-Mediterranean populations.
The present study identified dietary patterns (DP) and analyse their association with household composition. This is a cross-sectional school-based study, with a nationally representative sample of Brazilian adolescent students, aged 11–19 years, with data from National School Health Survey (n 102 072). Food consumption was obtained through the weekly frequency of consumption of food markers, and the confirmatory factor analysis was applied to examine the latent variables ‘Healthy’ (beans, legumes/vegetables and fresh fruit/fruit salad) and ‘Unhealthy’ (ultra-processed foods, sweets, soft drinks and snacks) DP. The association between household composition and DP was estimated considering lives with both parents as reference category. Among adolescents aged 11–14 years, adherence to healthy DP was lower for boys who lived only with mother (β = –2·1), and boys (β = –4·9) and girls (β = –4·5) who lived without any parents. Adherence to unhealthy DP was higher among boys (β = 7·6) and girls (β = 6·0) who lived only with mother, and boys (β = 4·6) and girls (β = 5·3) who lived only with father. For older adolescents (aged 15–19 years), adherence to the unhealthy DP was higher among boys who lived only with mother (β = 3·9) or only with father (β = 5·3) and girls who lived only with mother (β = 6·3). Adherence to healthy DP was lower among girls who lived only with father (β = –9·0). Thus, adolescents who lived in single-parent households had lower adherence to healthy DP and greater adherence to unhealthy DP. Among younger adolescents of both sexes, living without any parent contributed to lower adherence to healthy DP.
To evaluate the construct validity of the NIH Toolbox Cognitive Battery (NIH TB-CB) in the healthy oldest-old (85+ years old).
Method:
Our sample from the McKnight Brain Aging Registry consists of 179 individuals, 85 to 99 years of age, screened for memory, neurological, and psychiatric disorders. Using previous research methods on a sample of 85 + y/o adults, we conducted confirmatory factor analyses on models of NIH TB-CB and same domain standard neuropsychological measures. We hypothesized the five-factor model (Reading, Vocabulary, Memory, Working Memory, and Executive/Speed) would have the best fit, consistent with younger populations. We assessed confirmatory and discriminant validity. We also evaluated demographic and computer use predictors of NIH TB-CB composite scores.
Results:
Findings suggest the six-factor model (Vocabulary, Reading, Memory, Working Memory, Executive, and Speed) had a better fit than alternative models. NIH TB-CB tests had good convergent and discriminant validity, though tests in the executive functioning domain had high inter-correlations with other cognitive domains. Computer use was strongly associated with higher NIH TB-CB overall and fluid cognition composite scores.
Conclusion:
The NIH TB-CB is a valid assessment for the oldest-old samples, with relatively weak validity in the domain of executive functioning. Computer use’s impact on composite scores could be due to the executive demands of learning to use a tablet. Strong relationships of executive function with other cognitive domains could be due to cognitive dedifferentiation. Overall, the NIH TB-CB could be useful for testing cognition in the oldest-old and the impact of aging on cognition in older populations.
The Inventory of Academic Sources of Stress in Medical Education (IASSME) evaluates the presence and intensity of the main sources of academic stress for Portuguese Medicine students in five dimensions: Course demands/CD, Human demands/HD, Lifestyle/LS, Academic competition/AC, and Academic adjustment/AA.
Objectives
To further validate the ISSME using Confirmatory Factor Analysis and to analyze the psychometric properties of a new version including additional sources of stress.
Methods
Participants were 666 Portuguese medicine (82.6%) and dentistry (17.4%) students (81.8% girls); they answered an online survey including the ISSME and other validated questionnaires: Maslach Burnout Inventory – Students Survey (MBI-SS) and Depression Anxiety and Stress Scales (DASS).
Results
Confirmatory Factor Analysis showed that the second order model composed of five factors (the original structure by Loureiro et al. 2008), but excluding item 11 (loading=.371), presented good fit indexes (χ2/df=3.274; RMSEA=.0581, p<.001; CFI=.917; TLI=.904, GFI=.919). The Cronbach’s alfas were α=.897 for the total and from α=.669 (F2-HD) to α=.859 (F1-CD) for the dimensions. The expanded version, including two additional items related to lack of interest in medicine/dentistry (F6, α=.543) and two additional COVID-19 stress-related-items (F7, α=.744) also showed acceptable fit indexes (χ2/df=3.513; RMSEA=.061, p<.001; CFI=.88.; TLI=.866, GFI=.892). This new version’s α was of .896. Pearson correlations between ISSME and the other measures were significant (p<.01) and high: >.55 with DASS and >.50 with MBI-SS. Girls presented significantly higher ISSME scores. F6 score was significantly higher in dentistry students.
Conclusions
This further validation study underlines that IASSME presents good validity (construct and convergent) and reliability.
This study was conducted to determine the validity and reliability of the Turkish version of the Sustainable and Healthy Eating (SHE) Behaviors Scale. The original scale included eight factors and thirty-four items related to the SHE behaviors of adults. The research was carried out in three stages with a total of 586 participants aged 19 to 50 years. The Cronbach alpha coefficient was used to evaluate internal consistency reliability and the test–retest method was applied. Exploratory factor analysis (EFA) was performed to determine the factor structure. The model obtained with EFA was evaluated with confirmatory factor analysis (CFA). The Cronbachαcoefficient of the scale was found to be excellent at 0·912, and the intra-class correlation coefficient was found to be good at 0·832 using the test–retest method. Considering the suitability of the data for factor analysis, the Kaiser–Meier–Olkin coefficient was 0·859, and the significance level of the Bartlett test of sphericity was less than 0·05 (χ2=3·803,25; P < 0·05). As a result of EFA, the items of the scale were found to be distributed in seven factor dimensions. The factor loadings of the items were between 0·516 and 0·890, and the factors explained 67 % of the variance. Considering the fit indices obtained as a result of the analysis of this model with CFA, it was seen that the model had an acceptable fit (χ2/sd = 2·593, comparative fit index = 0·915, Tucker–Lewis index=0·902, standardised root mean square error = 0·0754 and root mean square error of approximation = 0·067). In conclusion, the Turkish version of the SHE Behaviors Scale has credible reliability and construct validity to assess the sustainable and healthy eating behaviours of the Turkish adult population.
The Connor–Davidson Resilience Scale (CD-RISC) and the Brief Resilience Scale (BRS) are two scales widely used to measure resilience. Although both scales seek to assess an individual's ability to recover from and adapt to disruptions or stressful events, they can capture different aspects of resilience. While the CD-RISC focuses on resources that can help individuals to recover from and adapt to disruptions or stressful events, the BRS directly measures one's ability to bounce back or be resilient. The aim of this study is to better understand resilience through empirically examining the differences between the CD-RISC and the BRS.
Method
Samples (a pooled sample N = 448 and two subsamples N = 202 and 246) consisting of undergraduate students from Taiwan were used. Confirmatory factor analysis (CFA) was performed to examine the relationship between the CD-RISC and BRS. Regression analysis was conducted to examine predictive effects of the CD-RISC and BRS on depression and life satisfaction.
Result
The results of CFA using different samples consistently show that the CD-RISC and the BRS are highly correlated but still distinct. The results of regression analyses using different samples also consistently show that the CD-RISC and the BRS have unique predictive effects regarding depression and life satisfaction.
Conclusions
The research findings suggest that the CD-RISC and the BRS capture different aspects of resilience. For future research on resilience, researchers should pay closer attention to the differences between these scales and choose the one that most closely fits their research purpose.
Both original Big Three Perfectionism Scale (BTPS; Smith et al. 2016), and the Portuguese version validated with a sample of university students (Lino et al. 2018) evaluates three second-order factors (rigid, self-oriented and narcissistic perfectionism) and ten facets.
Objectives
To confirm the BTPS three-factors-ten-dimensions’ structure in a sample of Portuguese adults from the general population.
Methods
A sample of 467 adults (70.7% females; Mean age=38.44±12.27; range: 25-82) answered the BTPS Portuguese version and other validated perfectionism measures (Multidimensional Perfectionism Scales from Frost and Hewitt & Flett; Self-Presentation Perfectionism Scale). To study the temporal stability a sub-sample of 132 participants completed the BTPS again after approximately five weeks. SPSS and AMOS software was used.
Results
The second order model presented an acceptable fit (X²/df=3.115; TLI=.811; CFI=.825; RMSEA=.067). There was also evidence of a general factor comprising all the 45 items (X²/df=3.127; TLI=.809; CFI=.823; [JA1] RMSEA=.068). The Cronbach alphas of the three factors ranged from a=.88 to a=.92; and facets had a>.70 showing a total of a=.94. Total and dimensional scores showed significant positive and moderate to high correlations with the other perfectionism measures and their test-retest correlation coefficients were r=.85 (p<0.001).
Conclusions
This study confirms the validity and reliability of the Portuguese BTPS underlying three-factors structure. Additionally, we found, for the first time, that BTPS can also be validly and reliably used to measure a global perfectionism construct. It is our intention to develop a shorter version the Portuguese BTPS in the near future.
Although the Eating Disorder Examination Questionnaire (EDEQ; Fairburn et al. 2008) is the most used instrument worldwide for the assessment of eating disorders symptoms, its factorial structure considerably varies, which limits its construct validity. Using exploratory factor analisys in data from a sample of overweight women, our group found a three-factors structure of the EDEQ Portuguese version (Peixoto et al. 2013), Although it was in accordance with other psychometric studies (eg. Peterson et al 2007), it was different from the original matrix. Further investigation regarding its factor structure has been conducted, with studies supporting a modified seven-item-three-factors structure (dietary restraint, shape/weight overvaluation, body dissatisfaction) with improved psychometric properties (Grilo et al. 2013, 2015), including with Portuguese samples (Machado et al. 2018; Santos et al. 2019).
Objectives
To analyze if the EDEQ version composed of seven items and three factors is replicated in a Portuguese sample of overweight women.
Methods
The EDEQ was administered to an outpatient sample of 276 women (Mean age= 43.85±11.89 years; Mean BMI=32.82±5.43 Kg/height2) attending a weight loss treatment consultation in a public hospital.
Results
Confirmatory factor analysis (CFA) revealed an adequate fit of the EDEQ-7 second order model with three dimensions (χ2/df=1.5497; RMSEA=.0452, CFI=.9955, TLI=.9914, GFI=.xxx; p<.001). The EDEQ7 Cronbach’s alphas for the total and its dimensions were α<.70.
Conclusions
Given its good psychometric properties, the overlap of the measurement model with those found with different samples and the reduced number of items, the EDEQ7 will be very useful both in research and clinical settings with/for overweight women.
The present study aimed to assess the relative validity and reliability of a modified Food and Nutrition Literacy (M-FNLIT) questionnaire in primary school children in the city of Mashhad. The study was conducted in four phases. In the first step, the content and face validity of the questionnaire were evaluated by Delphi consensus as well as interviewing the students. Then, construct validity was examined using Confirmatory Factor Analysis (CFA). The internal consistency and reliability of the questionnaire were also assessed using Cronbach α and Intraclass Correlation Coefficient (ICC), respectively. Finally, a receiver operating characteristic analysis was performed to detect the cut-off scores of the M-FNLIT scale. Findings of two rounds of Delphi showed satisfactory levels of Content Validity Ratio: 0·72 and 0·92, Content Validity Index (CVI): 0·92 and 0·98, respectively. The results of CFA for domains and subscales of the M-FNLIT questionnaire including cognitive domain (understanding food and nutrition information and nutritional health knowledge) and skill domain (functional, food choice, interactive, and critical skills) indicated acceptable fit indices. M-FNLIT subscale-specific Cronbach α values ranged between 0·68 and 0·8 and ICC was 0·95 (95 % CI 0·93, 96). The final questionnaire included forty items (thirty-six Likert-type and four true-false items). FNLIT scores were categorized as low (≤ 58), medium (> 58–< 81), and high (≥ 81). The M-FNLIT questionnaire has a good level of validity and reliability to measure food and nutrition literacy in primary school children. The questionnaire can be applied in the evaluation of nutritional interventions in this age group.
The aim was to analyze the psychometric properties of the Spanish version of the Gain in Alzheimer Care Instrument (GAIN), providing validity evidence based on its internal structure, reliability, item analysis, and relationships with other variables. A sample of 113 informal caregivers of people with dementia completed the GAIN, along with questionnaires assessing burden, general mental health, stress, anxiety, depression, and life satisfaction. Confirmatory factor analysis showed a single-factor structure with adequate fit indices. Reliability of GAIN scores was satisfactory, with McDonald’s omega equal to .91. Items yielded adequate homogeneity indices. Validity evidence based on relationships with other variables was provided by positive correlations between GAIN scores and life satisfaction, and negative correlations with burden, general mental health problems, stress, anxiety, and depression. All these correlations were statistically significant, and most of them were of moderate magnitude. The Spanish version of the GAIN has a single-factor structure and satisfactory psychometric properties. It is quick and easy to apply and given the association between GAIN scores and other variables, it may be used to provide information about a caregiver’s psychological health status.