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

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)....

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Autores principales: Kazemitabar, Maryam, Garcia, Danilo, Chukwuorji, JohnBosco C., Sanmartín, Ricardo, Lucchese, Franco, Khoshnood, Kaveh, Cloninger, Kevin M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: PeerJ Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8675247/
https://www.ncbi.nlm.nih.gov/pubmed/34993021
http://dx.doi.org/10.7717/peerj.12610
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author Kazemitabar, Maryam
Garcia, Danilo
Chukwuorji, JohnBosco C.
Sanmartín, Ricardo
Lucchese, Franco
Khoshnood, Kaveh
Cloninger, Kevin M.
author_facet Kazemitabar, Maryam
Garcia, Danilo
Chukwuorji, JohnBosco C.
Sanmartín, Ricardo
Lucchese, Franco
Khoshnood, Kaveh
Cloninger, Kevin M.
author_sort Kazemitabar, Maryam
collection PubMed
description 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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spelling pubmed-86752472022-01-05 Development and primary validation of the School Health Assessment Tool for Primary Schools (SHAT-PS) Kazemitabar, Maryam Garcia, Danilo Chukwuorji, JohnBosco C. Sanmartín, Ricardo Lucchese, Franco Khoshnood, Kaveh Cloninger, Kevin M. PeerJ Global Health 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. PeerJ Inc. 2021-12-13 /pmc/articles/PMC8675247/ /pubmed/34993021 http://dx.doi.org/10.7717/peerj.12610 Text en ©2021 Kazemitabar et al. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, reproduction and adaptation in any medium and for any purpose provided that it is properly attributed. For attribution, the original author(s), title, publication source (PeerJ) and either DOI or URL of the article must be cited.
spellingShingle Global Health
Kazemitabar, Maryam
Garcia, Danilo
Chukwuorji, JohnBosco C.
Sanmartín, Ricardo
Lucchese, Franco
Khoshnood, Kaveh
Cloninger, Kevin M.
Development and primary validation of the School Health Assessment Tool for Primary Schools (SHAT-PS)
title Development and primary validation of the School Health Assessment Tool for Primary Schools (SHAT-PS)
title_full Development and primary validation of the School Health Assessment Tool for Primary Schools (SHAT-PS)
title_fullStr Development and primary validation of the School Health Assessment Tool for Primary Schools (SHAT-PS)
title_full_unstemmed Development and primary validation of the School Health Assessment Tool for Primary Schools (SHAT-PS)
title_short Development and primary validation of the School Health Assessment Tool for Primary Schools (SHAT-PS)
title_sort development and primary validation of the school health assessment tool for primary schools (shat-ps)
topic Global Health
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8675247/
https://www.ncbi.nlm.nih.gov/pubmed/34993021
http://dx.doi.org/10.7717/peerj.12610
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