突发公共卫生事件视域下青少年健康素养评价量表编制及在初中生中应用的信效度分析

Development of adolescent health literacy evaluation scale under public health emergencies and its reliability and validity analysis in junior middle school students

目的编制突发公共卫生事件视域下青少年健康素养评价量表(adolescent health literacy evaluation scale under public health emergencies,AHLES-PHE)并检测其在初中生中应用的信效度。方法结合突发公共卫生事件及青少年健康素养特点形成AHLES-PHE初始版,经两轮Delphi专家征询形成AHLES-PHE专家版,对1729名初中生中进行测试,通过项目分析和因子分析(结构效度)形成AHLES-PHE正式版。AHLES-PHE正式版内容效度用专家法和敏感性分析评估,检测其与日常健康信息素养自评问卷(everyday health information literacy,EHIL)关联效度,计算内部一致性信度、奇偶分半信度及重测信度。结果(1)项目分析:AHLES-PHE专家版各条目得分与总分的相关系数在0.420~0.722之间(P<0.01),决断值CR在10.140~66.980之间(P<0.01)。(2)效度分析:探索性因子分析得出45条目和8因子的AHLES-PHE正式版,8因子可解释总变异的61.30%,验证性因子分析模型拟合指标为χ^(2)/df=3.325、RMSEA=0.052、GFI=0.853、CFI=0.912、TLI=0.904、NFI=0.880;敏感性分析Cronbach’sα系数范围为0.957~0.958,AHLES-PHE正式版总分与EHIL总分相关系数r值为0.340(P<0.01)。(3)信度分析:AHLES-PHE正式版总量表的内部一致性Cronbach’sα系数、分半信度Spearman-Brown系数分别为0.958和0.975,总量表的重测信度ICC值为0.753(P<0.01)。结论该研究编制的AHLES-PHE正式版具有较好的信度、结构效度及内容效度,与EHIL关联效度一般,该量表在突发公共卫生事件视域下对初中生健康素养评测有一定的适用性。

Objective To develop and examine the reliability and validity of the adolescent health literacy evaluation scale under public health emergencies(AHLES-PHE)in junior middle school students.Methods The initial version of AHLES-PHE was formed by combining the characteristics of public health emergencies and adolescent health literacy.The expert version of AHLES-PHE was formed by two rounds of Delphi expert consultation.Totally 1729 adolescent students from three junior middle schools in Changzhou City were tested.The formal version of AHLES-PHE was formed through item analysis and factor analysis(structural validity).The content validity of the formal version of AHLES-PHE was evaluated by specialist analysis and sensibility analysis,and its correlation validity with the everyday health information literacy(EHIL)was tested.The internal consistency reliability,parity split-half coefficient and test-retest reliability were calculated.Results(1)Item analysis:the correlation coefficient between the scores of each item and the total score of AHLES-PHE expert version was 0.420 to 0.722(P<0.01),and the CR of decision value was 10.140 to 66.980(P<0.01).(2)Validity analysis:the formal version of AHLES-PHE with 45 items and 8 factors was obtained by exploratory factor analysis.The 8 factors could explain 61.30%of the total variation.The fitting indexes of the confirmatory factor analysis model wereχ^(2)/df=3.325,RMSEA=0.052,GFI=0.853,CFI=0.912,TLI=0.904,NFI=0.880.Sensibility analysis of the formal version of AHLES-PHE showed the Cronbach'sαranged from 0.957 to 0.958.The correlation coefficient between the total score of AHLES-PHE formal version and the total score of EHIL was 0.340(P<0.01).(3)Reliability analysis:the Cronbach'sαcoefficient and parity split-half coefficient of the formal version of AHLES-PHE were 0.958 and 0.975,respectively.The test-retest reliability of the formal version of AHLES-PHE was 0.753(P<0.01).Conclusion The formal version of AHLES-PHE developed in this study has good reliability,structural validity and content validity,and the correlation validity with EHIL is common.This scale has a certain degree of applicability to the assessment of health literacy for junior middle school students under public health emergencies.