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Development and primary validation of the School Health Assessment Tool for Primary Schools (SHAT-PS)

Kazemitabar, Maryam ; Garcia, Danilo LU orcid ; Chukwuorji, John Bosco C. ; Sanmartín, Ricardo ; Lucchese, Franco ; Khoshnood, Kaveh and Cloninger, Kevin M. (2021) In PeerJ 9.
Abstract

Background. School health programs need to target all aspects of physical, psychological, and social well-being. Using a slightly modified version of the COSMIN Risk of Bias checklist, we developed and conducted the first validation of the School Health Assessment Tool for Primary Schools (SHAT-PS). Method. The exploratory sequential mixed method was used in this study. In the first phase, scientific databases were systematically searched to find school health models and instruments and 65 interviews were conducted with school stakeholders. The Colaizzi's method was used to code the qualitative data into themes. Then, a pool of items was created for each theme, rechecked by psychometric experts and then validated for content (i.e.,... (More)

Background. School health programs need to target all aspects of physical, psychological, and social well-being. Using a slightly modified version of the COSMIN Risk of Bias checklist, we developed and conducted the first validation of the School Health Assessment Tool for Primary Schools (SHAT-PS). Method. The exploratory sequential mixed method was used in this study. In the first phase, scientific databases were systematically searched to find school health models and instruments and 65 interviews were conducted with school stakeholders. The Colaizzi's method was used to code the qualitative data into themes. Then, a pool of items was created for each theme, rechecked by psychometric experts and then validated for content (i.e., relevance, clarity, and comprehensiveness) by psychometric experts and individuals of the target population (i.e., school personnel). In the second phase, classical test theory was utilized to analyze the validity and reliability of the resulting items from phase 1 among 400 individuals working at primary schools. Results. The coding of the interviews resulted in ten themes that we labeled based on the theoretical literature: school health policies, community connections, health education, physical activity, health services, nutrition, psychological services, physical environment, equipment and facilities, and school staff's health. The items created for each theme ended up in an initial pool of 76 items. In the final stage of phase 1, 69 items remained after the content validity assessment by experts and school personnel. In phase 2, the SHAT-PS items were tested using maximum likelihood exploratory factor analysis and confirmatory factor analysis. Of the 69 items from phase 1, 22 items were removed due to low factor loadings. The results showed that the 8-factor model was the best solution (chi-square/df = 2.41, CFI = .98, TLI = .97, RMSEA = .06). The discriminant and convergent validity of the SHAT-PS were evaluated as satisfactory and the scale had high internal consistency (Cronbach's alpha for all subscales > .93). The test-retest reliability was satisfactory - the intraclass correlation coefficient pooled was .95 (99% CI [.91-.98]). Moreover, the standard error of measurement resulted in an SEM pooled equal to 4.4. No discrepancy was found between subgroups of gender and subgroups of staffs' positions at schools. Conclusion. The SHAT-PS is a valid and reliable tool that may facilitate school staff, stakeholders and researchers to evaluate the presence of the factors that promote health at primary schools. Nevertheless, in the process of validation, many of the items related to staff's health were eliminated due to poor factor loadings. Obviously, staff health is an important factor in the measurement of school health. Hence, we recommend that the validity and reliability of the SHAT-PS in other cultures should be done using the original 76-item version.

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organization
publishing date
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Contribution to journal
publication status
published
subject
keywords
Assessment and evaluation, COSMIN risk of bias checklist, Factor analysis, Psychometrics, Reliability and validity, School health, Tool development, Well-being
in
PeerJ
volume
9
article number
e12610
publisher
PeerJ
external identifiers
  • scopus:85121837456
  • pmid:34993021
ISSN
2167-8359
DOI
10.7717/peerj.12610
language
English
LU publication?
yes
id
2b9ab670-1f3b-43fb-98c8-e84842266900
date added to LUP
2022-02-03 10:39:29
date last changed
2024-06-04 05:33:52
@article{2b9ab670-1f3b-43fb-98c8-e84842266900,
  abstract     = {{<p>Background. School health programs need to target all aspects of physical, psychological, and social well-being. Using a slightly modified version of the COSMIN Risk of Bias checklist, we developed and conducted the first validation of the School Health Assessment Tool for Primary Schools (SHAT-PS). Method. The exploratory sequential mixed method was used in this study. In the first phase, scientific databases were systematically searched to find school health models and instruments and 65 interviews were conducted with school stakeholders. The Colaizzi's method was used to code the qualitative data into themes. Then, a pool of items was created for each theme, rechecked by psychometric experts and then validated for content (i.e., relevance, clarity, and comprehensiveness) by psychometric experts and individuals of the target population (i.e., school personnel). In the second phase, classical test theory was utilized to analyze the validity and reliability of the resulting items from phase 1 among 400 individuals working at primary schools. Results. The coding of the interviews resulted in ten themes that we labeled based on the theoretical literature: school health policies, community connections, health education, physical activity, health services, nutrition, psychological services, physical environment, equipment and facilities, and school staff's health. The items created for each theme ended up in an initial pool of 76 items. In the final stage of phase 1, 69 items remained after the content validity assessment by experts and school personnel. In phase 2, the SHAT-PS items were tested using maximum likelihood exploratory factor analysis and confirmatory factor analysis. Of the 69 items from phase 1, 22 items were removed due to low factor loadings. The results showed that the 8-factor model was the best solution (chi-square/df = 2.41, CFI = .98, TLI = .97, RMSEA = .06). The discriminant and convergent validity of the SHAT-PS were evaluated as satisfactory and the scale had high internal consistency (Cronbach's alpha for all subscales &gt; .93). The test-retest reliability was satisfactory - the intraclass correlation coefficient pooled was .95 (99% CI [.91-.98]). Moreover, the standard error of measurement resulted in an SEM pooled equal to 4.4. No discrepancy was found between subgroups of gender and subgroups of staffs' positions at schools. Conclusion. The SHAT-PS is a valid and reliable tool that may facilitate school staff, stakeholders and researchers to evaluate the presence of the factors that promote health at primary schools. Nevertheless, in the process of validation, many of the items related to staff's health were eliminated due to poor factor loadings. Obviously, staff health is an important factor in the measurement of school health. Hence, we recommend that the validity and reliability of the SHAT-PS in other cultures should be done using the original 76-item version. </p>}},
  author       = {{Kazemitabar, Maryam and Garcia, Danilo and Chukwuorji, John Bosco C. and Sanmartín, Ricardo and Lucchese, Franco and Khoshnood, Kaveh and Cloninger, Kevin M.}},
  issn         = {{2167-8359}},
  keywords     = {{Assessment and evaluation; COSMIN risk of bias checklist; Factor analysis; Psychometrics; Reliability and validity; School health; Tool development; Well-being}},
  language     = {{eng}},
  publisher    = {{PeerJ}},
  series       = {{PeerJ}},
  title        = {{Development and primary validation of the School Health Assessment Tool for Primary Schools (SHAT-PS)}},
  url          = {{http://dx.doi.org/10.7717/peerj.12610}},
  doi          = {{10.7717/peerj.12610}},
  volume       = {{9}},
  year         = {{2021}},
}