Validation of a social-cognitive theory-based tool for measuring factors influencing obesity prevention behaviors in 4-6 years old children using confirmatory factor analysis (CFA)

Child obesity is one of the main health problems all across the world, which leads to mental and physical health problems. There is no specific tool based on the constructs of social-cognitive theory (SCT) to assess the factors associated with child obesity. The aim of this study was to investigate the validity and confirmatory factor analysis of a SCT-based questionnaire for assessing obesity preventing behaviors among 4-6-year-old children.
This cross-sectional study was conducted to validate a SCT-based instrument for measuring factors affecting obesity prevention behaviors among children aged 4-6 years. 240 preschool children aged 4 to 6 years in Behbahan city, southwest Iran participated in the study. After performing the forward-backward translation method, the face, content, and construct validity of the SCT-based questionnaire were confirmed. The content validity index (CVI) and the content validity ratio (CVR) were used to assess the difficulty, relevancy, and ambiguity of the items, and Confirmatory factor analysis (CFA) was performed to measure the construct validity. Structural Equation Modeling (SEM) was also performed to evaluate the fitness of the model. Reliability of the questionnaire was also measured through Cronbach’s alpha coefficient and Intraclass Correlation Coefficient (ICC). The obesity prevention behaviors used in the model included physical activity, consumption of fruit and vegetable, consumption of sugar-free drinks, and screen.
Results of this study confirmed the acceptable content and face validity of the SCT-based questionnaire. The results of confirmatory factor analysis also confirmed the factor loading of more than 0.3 for all variables; therefore the SCT-based questionnaire had an acceptable validity and reliability.
Since the SCT-based questionnaire had an acceptable validity and reliability, it can be used to assess the obesity prevention behaviors in 4-6-year-old children, and also to design relevant educational interventions.