Development and validation of a lifetime exposure questionnaire for use among Chinese populations.
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ABSTRACT:
SUBMITTER: Wu S
PROVIDER: S-EPMC3786302 | biostudies-literature | 2013 Sep
REPOSITORIES: biostudies-literature
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Development and validation of a lifetime exposure questionnaire for use among Chinese populations.
Wu ShengHui S Ho Suzanne C SC Lam Tsz-ping TP Woo Jean J Yuen P Y PY Qin Ling L Ku Susanna S
Scientific reports 20130930
The sunlight exposure questionnaire for use in the Chinese population was constructed based on extensive literature review and item suitability for measuring life-time exposure. The content validity index (CVI) was derived from ratings by, an expert panel to assess the item content and relevance. 650 population-based Chinese women completed the sunlight exposure questionnaire through telephone interview. To assess the questionnaire reliability, 94 women were re-interviewed after 2 weeks. 98.4% o ...[more]
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Project description:BackgroundWith a high prevalence of noise-induced hearing loss (NIHL), the noise survey tools for identifying individuals with high risk of NIHL are still limited. This study was aimed to translate and develop a Chinese version of noise exposure questionnaire (C-NEQ), and validate its reliability and reproducibility.MethodsThis study was conducted from May 2020 to March 2021 in China. The questionnaire was translated from the original NEQ and adapted into Chinese culture using the method according to the International Test Committee. Content validity was evaluated by our expert group. Construct validity and reliability of the C-NEQ was determined through estimating the confirmatory factor analysis and Cronbach's alpha in a cross-sectional analysis among 641 Chinese speaking adults, respectively. The retest reproducibility of the C-NEQ was analyzed by using the intra-group correlation coefficient (ICC) in a follow-up analysis among 151 participants.ResultsThe C-NEQ comprises ten items covering four domains: occupational, housework, transport and recreational noise exposure. The annual noise exposure (ANE) was calculated as the protocol of original NEQ. A total of 641 adult participants (aged 26.9 ± 10.1 years, 53.4% males) completed the C-NEQ. The average time for completing the C-NEQ was 4.4 ± 3.0 min. Content validity indicated high relevance of the C-NEQ. The confirmatory factor analysis indices illustrated that the items of the C-NEQ were suitable with the data in the study. For the internal reliability, the Cronbach's α coefficients of the total items and four domains (occupational, housework, transport, and recreational noise exposure) were 0.799, 0.959, 0.837, 0.825, and 0.803, respectively. Among them, 151 participants (aged 36.1 ± 11.1 years, 65.6% males) completed the retest of the C-NEQ 1 month after the first test. The ICC value of total ANEs between the first test and the second test was 0.911 (P < 0.001).ConclusionsIn this study, we have validated the C-NEQ with adequate reliability and reproducibility for quantifying an individual's annual daily noise exposure, which provides an effective fast-screen tool for researches and clinics to identify those individuals with high risks of NIHL within the short time duration (no more than five minutes) among Chinese population.
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Project description:AbstractPatient feedback can provide insights to assess and improve the quality of healthcare. This study aimed to develop a measure of surgical inpatient satisfaction and comfort and examine its acceptability, validity, and reliability among discharged surgical patients.This multicenter, descriptive, cross-sectional study was conducted at three tertiary hospitals in Shaanxi Province, China. A random sample of patients admitted to the surgical inpatient departments of the three hospitals between November and December 2018 was recruited. An analysis was conducted on the acceptability, validity, and reliability of a newly developed measure of satisfaction with surgical inpatient services.A total of 1582 out of 1805 (87.6%) eligible patients completed the questionnaire (average time taken = 17.1 ± 10.3 minutes), which indicated high acceptability. Sociodemographic differences between the participants and non-participants were not significant. Using factor analysis, the following 7 dimensions (number of items: 65, variance explained: 68.0%) were identified: medical care (19 items), nursing care (15 items), environment and logistics (11 items), postoperative and hospitalization experiences (11 items), feeling nervous and afraid (4 items), operating room services (3 items), and visiting (2 items). The latent structure of the assessment was examined and validated using exploratory and confirmatory factor analyses, respectively. All item loadings were >0.4. All dimensions demonstrated satisfactory internal consistency (Cronbach's alphas = 0.83-0.96) and test-retest reliability (intra-class correlation coefficients = 0.77-0.96).The Chinese Surgical Inpatient Satisfaction and Comfort Questionnaire has strong psychometric properties and can be used to assess patient satisfaction with public hospital surgical inpatient services in China. A distinguishing feature of this questionnaire is the inclusion of a subscale that assesses comfort as a dimension of patient satisfaction. Such instruments can be used to identify the factors that should be addressed to improve the quality of patient care. Further research is needed to determine the role of assessment in quality improvement.
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Project description:In the context of building Child-Friendly Cities in China, child-friendly school environments are considered as having a profound impact on children's development and growth. This study presents the development and validation of the Child-Friendly School Environment Questionnaire for assessing a child-friendly school environment. Utilizing open-ended questions and interviews, an initial questionnaire on the child-friendly school environment was compiled. An exploratory factor analysis of the preliminary test results with 696 primary school children in grades three to six was conducted to refine the questionnaire into a formal 19-item questionnaire. Subsequently, a confirmatory factor analysis was performed to analyze the evaluation results of 807 primary school children in grades three to six. The results indicated that a child-friendly school environment is a multi-dimensional construct encompassing Environment Friendly, Teaching Friendly, Peer Friendly, and Children Participation, with good reliability and validity. The promising outcomes of this study suggest that the Child-Friendly School Environment Questionnaire can be widely used as a powerful evaluation tool for the child-friendly school education practice in the future.
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Project description:ObjectiveThis study aimed to develop and validate a risk scoring system to identify high-risk individuals carrying malignant lesions in stomach for tailored gastric cancer screening.MethodsA gastric cancer risk scoring system (GC-RSS) was developed based on questionnaire-based predictors for gastric cancer derived from systematic literature review. To assess the capability of this system for discrimination, risk scores for 8,214 and 7,235 outpatient subjects accepting endoscopic examination in two endoscopy centers, and 32,630 participants in a community-based cohort in China were calculated to plot receiver operating characteristic curves and generate area under the curve (AUC). To evaluate the performance of GC-RSS, the screening proportion, sensitivity and detection rate ratio compared to universal screening were used under different risk score cutoff values.ResultsGC-RSS comprised nine predictors including advanced age, male gender, low body mass index (<18.5 kg/m2), family history of gastric cancer, cigarette smoking, consumption of alcohol, preference for salty food, irregularity of meals and consumption of preserved food. This tool performed well in determining the risk of malignant gastric lesions with AUCs of 0.763, 0.706 and 0.696 in three validation sets. When subjects with risk scores ≥5 were evaluated with endoscopy, nearly 50% of these endoscopies could be saved with a detection rate of over 1.5 times achieved. When the cutoff was set at 8, only about 10% of subjects with the highest risk would be offered endoscopy, and detection rates for gastric cancer could be increased 2-4 fold compared to universal screening.ConclusionsAn effective questionnaire-based GC-RSS was developed and validated. This tool may play an important role in establishing a tailored screening strategy for gastric cancer in China.
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Project description:BackgroundExisting predictive outcomes models for type 2 diabetes developed and validated in historical European populations may not be applicable for East Asian populations due to differences in the epidemiology and complications. Despite the continuum of risk across the spectrum of risk factor values, existing models are typically limited to diabetes alone and ignore the progression from prediabetes to diabetes. The objective of this study is to develop and externally validate a patient-level simulation model for prediabetes and type 2 diabetes in the East Asian population for predicting lifetime health outcomes.Methods and findingsWe developed a health outcomes model from a population-based cohort of individuals with prediabetes or type 2 diabetes: Hong Kong Clinical Management System (CMS, 97,628 participants) from 2006 to 2017. The Chinese Hong Kong Integrated Modeling and Evaluation (CHIME) simulation model comprises of 13 risk equations to predict mortality, micro- and macrovascular complications, and development of diabetes. Risk equations were derived using parametric proportional hazard models. External validation of the CHIME model was assessed in the China Health and Retirement Longitudinal Study (CHARLS, 4,567 participants) from 2011 to 2018 for mortality, ischemic heart disease, cerebrovascular disease, renal failure, cataract, and development of diabetes; and against 80 observed endpoints from 9 published trials using 100,000 simulated individuals per trial. The CHIME model was compared to United Kingdom Prospective Diabetes Study Outcomes Model 2 (UKPDS-OM2) and Risk Equations for Complications Of type 2 Diabetes (RECODe) by assessing model discrimination (C-statistics), calibration slope/intercept, root mean square percentage error (RMSPE), and R2. CHIME risk equations had C-statistics for discrimination from 0.636 to 0.813 internally and 0.702 to 0.770 externally for diabetes participants. Calibration slopes between deciles of expected and observed risk in CMS ranged from 0.680 to 1.333 for mortality, myocardial infarction, ischemic heart disease, retinopathy, neuropathy, ulcer of the skin, cataract, renal failure, and heart failure; 0.591 for peripheral vascular disease; 1.599 for cerebrovascular disease; and 2.247 for amputation; and in CHARLS outcomes from 0.709 to 1.035. CHIME had better discrimination and calibration than UKPDS-OM2 in CMS (C-statistics 0.548 to 0.772, slopes 0.130 to 3.846) and CHARLS (C-statistics 0.514 to 0.750, slopes -0.589 to 11.411); and small improvements in discrimination and better calibration than RECODe in CMS (C-statistics 0.615 to 0.793, slopes 0.138 to 1.514). Predictive error was smaller for CHIME in CMS (RSMPE 3.53% versus 10.82% for UKPDS-OM2 and 11.16% for RECODe) and CHARLS (RSMPE 4.49% versus 14.80% for UKPDS-OM2). Calibration performance of CHIME was generally better for trials with Asian participants (RMSPE 0.48% to 3.66%) than for non-Asian trials (RMPSE 0.81% to 8.50%). Main limitations include the limited number of outcomes recorded in the CHARLS cohort, and the generalizability of simulated cohorts derived from trial participants.ConclusionsOur study shows that the CHIME model is a new validated tool for predicting progression of diabetes and its outcomes, particularly among Chinese and East Asian populations that has been lacking thus far. The CHIME model can be used by health service planners and policy makers to develop population-level strategies, for example, setting HbA1c and lipid targets, to optimize health outcomes.
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Project description:BACKGROUND:Evidence-based practice (EBP) education or training are considered fundamental to building and strengthening an EBP culture, as well as to encouraging evidence-based academic and clinical practice in the nursing community. However, few valid and reliable instruments are available for the assessment of EBP teaching and learning in clinical nurses in China. Translation, reliability, and validity testing of the English Evidence-Based Practice Profile Questionnaire (EBP2Q), which has strong psychometric properties, may encourage evaluation and promote the implementation of EBP in Mainland China. METHODS:Based on established guidelines for the development of questionnaires, the English EBP2Q was translated and cross-culturally adapted. The Chinese version of the EBP2Q (EBP2Q-C) was validated using a sample of 543 nurses. Structural validity was evaluated through exploratory factor analysis and confirmatory factor analysis, and the questionnaire was tested for convergent and criterion validity. The internal consistency and test-retest reliability were also evaluated. RESULTS:The content validity index demonstrated good content validity (?0.98). An eight-factor structure was obtained in the exploratory factor analysis, and verified by a three-order factor model from the confirmatory factor analysis (?2/df?=?2.001; RMSEA?=?0.065; SRMR?=?0.077; and CFI?=?0.884). The Spearman's rank correlation analysis of the EBP2Q-C with the Evidence-Based Practice Questionnaire showed moderate correlations for Practice (0.58) and Confidence (0.68) and a low correlation for Sympathy (0.32). Criterion validity was demonstrated by significant differences in terms of nurses' highest education, present position, EBP training, involvement in research programs, and level of understanding of English. Both the overall Cronbach's ? and the Cronbach's ? for the domains exceeded 0.70. The intraclass correlation coefficients for the domains ranged between 0.75 and 0.96, indicating satisfactory repeatability. CONCLUSIONS:Except for the convergent validity of the Sympathy domain, the EBP2Q-C provided evidence of validity and reliability. Therefore, it can be applied in EBP education or training assessment in Mainland China.
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Project description:A noted decrease in adolescent physical activity in the past decade has resulted in an increase in health risks. Sport orientation correlates closely with physical activity. A sufficient assessment scale that measures an individual's sport orientation is important to measure an adolescent's physical inactivity. The purpose of this study was to develop and validate a short version of the Sport Orientation Questionnaire for Chinese Adolescents (SOQ-CA). Based on Gill's SOQ and previous literature, an initial 30-item questionnaire was developed to create the original SOQ-CA. A five-point Likert scale was used to measure by self-report. In this study, three surveys were conducted. Volunteer participants completed 1,235 valid questionnaires. The data of the first collection sample (n = 486) were split randomly into two groups, sample 1 (n = 150) used for exploratory factor analysis (EFA) and sample 2 (n = 336) for confirmatory factor analysis (CFA). The data of the second (n = 377) and third (n = 372) collection samples were used to perform test-retest reliability, internal consistency, and CFA of the SOQ-CA. The SOQ-CA obtained good reliability and validity through both EFA and CFA. The development of the SOQ-CA provides an opportunity to develop further theories and practices regarding the assessment of both sport motivation and individual achievement orientation. The application of the SOQ-CA in China would be significant for monitoring the development of adolescent physical activity and aiding in the implementation of policies.
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Project description:BackgroundThis study aimed to develop and validate the Food and Nutrition Literacy Questionnaire for Chinese School-age Children (FNLQ-SC).MethodsA comprehensive literature review and qualitative study were initially performed to identify the dimensions and core components of food and nutrition literacy. A cross-sectional survey of 4359 school-age children was conducted, and junior middle school students were used to analyze the reliability and validity of the questionnaire (n = 2452). The reliability of the questionnaire was determined by internal consistency, the construct validity was assessed by exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), and the content validity was assessed by the Pearson correlation coefficient.ResultsFrom the literature review and qualitative methods, 19 core components of the FNLQ-SC were developed, including one dimension of food and nutrition knowledge and understanding, and four skill dimensions (ability of access, selection, preparing food and healthy eating). The overall FNLQ-SC questionnaire had acceptable internal consistency (Cronbach's α = 0.698). The EFA of skill components extracted 5 factors that were included in the conceptual framework in a slightly different model, and the cumulative contribution of variance accounted for 50.60% of the overall variance. The CFA of skill components showed an acceptable fit in general and the root mean square error of approximation (RMSEA) was 0.070 (between 0.50 to 0.80). The communality was greater than 0.20 for all components. The Pearson correlation coefficients between each dimension and the overall questionnaire ranged from 0.370 to 0.877. The average FNLQ-SC score of all 4395 participants was 61.91 ± 9.22, and the score for the knowledge and understanding dimension was higher than that for the skill dimensions. Multiple linear regression analysis indicated that not only social demographic characteristics (being a girl, being an only child, living someplace other than at school, having an urban registered permanent residence status, being from an affluent family, and being cared for by parents/grandparents with a higher education level) but also the home food environment were predictors of food and nutrition literacy in school-age children (R2 = 0.226, F = 81.401, P<0.05).ConclusionThe Food and Nutrition Literacy Questionnaire (FNLQ-SC) developed here had good reliability, and it can potentially be a useful instrument for assessing food and nutrition literacy among Chinese school-age children.
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Project description:BackgroundVarious hypertension predictive models have been developed worldwide; however, there is no existing predictive model for hypertension among Chinese rural populations.MethodsThis is a 6-year population-based prospective cohort in rural areas of China. Data was collected in 2007-2008 (baseline survey) and 2013-2014 (follow-up survey) from 8319 participants ranging in age from 35 to 74 years old. Specified gender hypertension predictive models were established based on multivariate Cox regression, Artificial Neural Network (ANN), Naive Bayes Classifier (NBC), and Classification and Regression Tree (CART) in the training set. External validation was conducted in the testing set. The estimated models were assessed by discrimination and calibration, respectively.ResultsDuring the follow-up period, 432 men and 604 women developed hypertension in the training set. Assessment for established models in men suggested men office-based model (M1) was better than others. C-index of M1 model in the testing set was 0.771 (95% confidence Interval (CI) = 0.750, 0.791), and calibration χ2 = 6.3057 (P = 0.7090). In women, women office-based model (W1) and ANN were better than the other models assessed. The C-indexes for the W1 model and the ANN model in the testing set were 0.765 (95% CI = 0.746, 0.783) and 0.756 (95% CI = 0.737, 0.775) and the calibrations χ2 were 6.7832 (P = 0.1478) and 4.7447 (P = 0.3145), respectively.ConclusionsNot all machine-learning models performed better than the traditional Cox regression models. The W1 and ANN models for women and M1 model for men have better predictive performance which could potentially be recommended for predicting hypertension risk among rural populations.
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Project description:BACKGROUND:A valid and efficient stress measure is important for clinical and community settings. The objectives of this study were to translate the English version of the Perceived Stress Questionnaire (PSQ) into Chinese and to assess the psychometric properties of the Chinese version of the PSQ (C-PSQ). The C-PSQ evaluates subjective experiences of stress instead of a specific and objective status. METHODS:Forward translations and back translations were used to translate the PSQ into Chinese. We used the C-PSQ to survey 2798 medical students and workers at three study sites in China from 2015 to 2017. Applying Rasch analysis (RA) and factor analysis (FA), we examined the measurement properties of the C-PSQ. Data were analyzed using the Rasch model for item fit, local dependence (LD), differential item functioning (DIF), unidimensionality, separation and reliability, response forms and person-item map. We first optimized the item selection in the Chinese version to maximize its psychometric quality. Second, we used cross-validation, by exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), to determine the best fitting model in comparison to the different variants. Measurement invariance (MI) was tested using multi-group CFA across subgroups (medical students vs. medical workers). We evaluated validity of the C-PSQ using the criterion instruments, such as the Chinese version of the Perceived Stress Scale (PSS-10), the Short Form-8 Health Survey (SF-8) and the Goldberg Anxiety and Depression Scale (GADS). Reliability was assessed using internal consistency (Cronbach's alpha, Guttman's lambda-2, and McDonald's omegas) and reproducibility (test-retest correlation and intraclass correlation coefficient, [ICC]). RESULTS:Infit and/or outfit values indicated that all items fitted the Rasch model. Three item pairs presented local dependency (residual correlations >?0.30). Ten items showed DIF. Dimensionality instruction suggested that eight items should be deleted. One item showed low discrimination. Thirteen items from the original PSQ were retained in the C-PSQ adaptation (i.e. C-PSQ-13). We tested and verified four feasible models to perform EFA. Built on the EFA models, the optimal CFA model included two first-order factors (i.e. constraint and imbalance) and a second-order factor (i.e., perceived stress). The first-order model had acceptable goodness of fit (Normed Chi-square?=?8.489, TLI?=?0.957, CFI?=?0.965, WRMR?=?1.637, RMSEA [90% CI]?=?0.078 [0.072, 0.084]). The second-order model showed identical model fit. Person separation index (PSI) and person reliability (PR) were 2.42 and 0.85, respectively. Response forms were adequate, item difficulty matched respondents' ability levels, and unidimensionality was found in the two factors. Multi-group CFA showed validity of the optimal model. Concurrent validity of the C-PSQ-13 was 0.777, -?0.595 and 0.584 (Spearman correlation, P <?0.001, the same hereinafter) for the Chinese version of the PSS-10, SF-8, and GADS. For reliability analyses, internal consistency of the C-PSQ-13 was 0.878 (Cronbach's alpha), 0.880 (Guttman's lambda-2), and 0.880 (McDonald's omegas); test-retest correlation and ICC were 0.782 and 0.805 in a 2-day interval, respectively. CONCLUSION:The C-PSQ-13 shows good metric characteristics for most indicators, which could contribute to stress research given its validity and economy. This study also contributes to the evidence based regarding between-group factorial structure analysis.
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