Development And Psychometric Analysis Of The Multidimensional Sub-health Questionnaire Of Adolescents

Objective The objective of this study was to develop a specific multidimensional sub-health questionnaire for Chinese adolescents with the guidance of the research of the establishment and application of the sub-health multidimensional evaluation method for adolescents, one of the National Key Technologies R&D Programs(863 plan).Methods The sub-health of adolescents was manifested as physical sub-health, psychology sub-health and social adapted sub-health based on the health definition of WHO. The original questionnaire contained 101 items which was developed according to literature, focus group discussions (FGD) and Delphi technique. A total of 6 468 students were selected from two middle schools in Ma Anshan and one college in Hefei for a pilot study. Seventy one items were retained in Multidimensional Sub-health Questionnaire of Adolescents (MSQA) in the end by t-test, correlate analysis, exploratory factor analysis and so on.A total of 7 104 middle school students and college students from freshmen to juniors were selected by cluster sampling. MSQA was used to evaluate sub-health and internal consistency reliability of the questionnaire was assessed by determining the Cronbach's alpha coefficient and split-half reliability coefficient. Factor analysis was applied to assess construct validity. Test-retest stability was evaluated using Pearson correlations among 128 students from middle schools and colleges during two weeks interval. Criterion-related validity was valuated using Pearson correlations between MSQA scores and other concurrently administered psychosocial scales (i.e., SCL-90 and CMI.) among 85 students. A total of 413 freshmen in one college and 1 337 grade one and grade three high school students were selected for investigation of MSQA. The freshmen were retested three months later and paried-sampled t-test and Chi-square test were used to analyze the difference and independent-samples t-test and Chi-squared test were applied for high school students.Results MSQA was developed with 71 items, 32 items on physical sub-health and 39 items on psychology sub-health, including six dimensions, such as lack of physical energy, emotional problems, conduct problems and so on. The test-retest reliability coefficient, Cronbach'sаcoefficient and split-half reliability coefficient were 0.868, 0.958 and 0.942, respectively. The criterion-related validity based on SCL-90 and CMI were 0.636 and 0.649, respectively. The results of exploratory factor analysis showed that 14 factors were extracted and the cumulative common variance explained by the 14 factors was 53.7%. Factor 1 was about emotional problems and it expaining 26.3% of the total variance. Total-to-dimension correlations ranged from 0.653 to 0.927 and total-to-item correlations ranged from 0.284 to 0.717. MSQA could be used to discriminate the status of sub-health between freshmen living in school for one month and that for four months and between high school students in grade one and that in grade three.Conclusion MSQA is reliable, valid and sensitive. The questionnaire describes the status of adolescents'sub-health comprehensively and accurately. It could be served as a sub-healthy evaluation instrument and be popularized in larger numbers of young people.