A Pilot Study of a Measure of Parental Trust in Pediatric Emergency Department Care Teams

ObjectiveTo modify and test an existing measure of trust validated in a primary care setting for use in a pediatric emergency department (PED).MethodsThe study population was parents/guardians who brought their child to an urban PED with a chief complaint of abdominal pain or head injury. We used a 2-phase design with modifications resulting from cognitive interviews with 15 participants followed by a field test with 150 participants. We measured usefulness by percent missing responses and ceiling effects. Cronbach's alpha and greatest lower bound measured reliability. As evidence of validity, we calculated a total trust score by summing the item scale values and correlating the score with measures of constructs shown to be positively associated with trust in other settings. We conducted a similar analysis to test a published shortened version of the same scale.ResultsFour items were modified prior to field testing. Ceiling effects for each item ranged from 53% to 67%. Missing data were minimal affecting only 2 items. The modified measure exhibited high reliability (Cronbach's alpha = .88, greatest lower bound = 0.93). Total trust scores ranged from 27 to 50 with mean (standard deviation) = 45.1 (4.9). The trust score exhibited a high positive correlation with communication and overall satisfaction, and moderate correlation with intent to adhere to physician recommendations. The short version of the scale performed similarly.ConclusionsThis study provides evidence that the modified Wake Forest measure of trust is applicable and useful in the PED setting for this patient population.     

Parent Readiness for Hospital Discharge Scale: Psychometrics and Association With Postdischarge Outcomes

IntroductionThe purpose of this study is to validate the Readiness for Hospital Discharge Scale (RHDS) for use with parents of hospitalized children. PedRHDS is a structured tool for a discharge readiness assessment before pediatric discharge.MethodsUsing combined data from four studies with 417 parents, psychometric testing and item reduction proceeded with principal component analysis for factor structure delineation, Cronbach's alpha for reliability estimation, and regression analysis for predictive validity.ResultsA 23-item PedRHDS retained the a priori factor structure. Reliability ranged from 0.73 to 0.85 for the 23-item and 10- and 8-item short scales. PedRHDS (all forms) was associated with postdischarge coping difficulty (explaining 12%–16% of variance) and readmission (odds ratio = 0.71−0.80).DiscussionThe PedRHDS and both short forms (PedRHDS-SF10 and PedRHDS-SF8) are reliable and valid measures of parental discharge readiness that can be used as outcome metrics of hospital care and risk indicators for postdischarge coping difficulty and readmission.     

Development of an instrument to measure parents' preferences and goals for the treatment of attention deficit-hyperactivity disorder

ObjectivesTo describe the development and validation of an instrument to measure parents’ attention deficit–hyperactivity disorder (ADHD) treatment preferences and goals.MethodsParents of children 6 to 12 years of age diagnosed with ADHD in the past 18 months were recruited from 8 primary care sites and an ADHD treatment center (autism excluded). A 16-item medication, 15-item behavior therapy preference scale and a 23-item goal scale, were developed after a review of the literature, 90 parent and clinician semistructured interviews, and input from parent advocates and professional experts were administered to parents. Parent cognitive interviews confirmed item readability, clarity, content, and response range. We conducted an exploratory factor analysis and assessed internal consistency and test-retest reliability and construct and concurrent validity.ResultsWe recruited 237 parents (mean child age 8.1 years, 51% black, 59% from primary care, 61% of children medication naive). Factor analyses identified 4 medication preference subscales (treatment acceptability, feasibility, stigma, and adverse effects, Cronbach’s α 0.74–0.87); 3 behavior therapy subscales (treatment acceptability, feasibility, and adverse effects, α 0.76–0.83); and 3 goal subscales (academic achievement, behavioral compliance, and interpersonal relationships, α 0.83–0.86). The most strongly endorsed goal was academic achievement. The scales demonstrated construct validity, concurrent validity (r = 0.3–0.6) compared with the Treatment Acceptability Questionnaire and Impairment Rating Scale and moderate to excellent test–retest reliability (intraclass coefficient = 0.7–0.9).ConclusionsWe developed a valid and reliable instrument for measuring preferences and goals for ADHD treatment, which may help clinicians more easily comply with new national treatment guidelines for ADHD that emphasize shared decision making.     

Development and Psychometric Evaluation of a Caregiver Survey to Assess Family-Centered Care in the Emergency Department

ObjectiveTo develop and evaluate the psychometric properties of a family caregiver-reported survey that assesses family-centeredness of care in the context of pediatric emergency department (ED) encounters.MethodsWe created a caregiver-reported scale, incorporated content expert feedback, and iteratively revised it based on cognitive interviews with caregivers. We then field tested the scale in a survey with caregivers. We dichotomized items using top-box scoring and obtained a summary score per respondent. Using a sample of 191 caregivers recruited from 9 EDs, we analyzed internal consistency reliability, dimensionality via item response theory modeling, and convergent validity with the ED Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey.ResultsFeedback from the 9 experts led us to remove 4 items. We conducted 16 cognitive interviews and revised the survey in 4 rounds. An 11-item survey was field tested. Mean (standard deviation) respondent 11-item summary score was 77.2 (26.6). We removed 2 items given inconsistent response patterns, poor variability, and poor internal consistency, which increased coefficient alpha from 0.85 to 0.88 for the final scale. A multidimensional model fit the data best, but factor scores correlated strongly with summary scores, suggesting the latter are sufficient for quality improvement and future research. Regarding convergent validity, adjusted partial correlation between our scale's 9-item summary score and the ED CAHPS summary score was 0.75 (95% confidence interval 0.67–0.81).ConclusionsPsychometric analyses demonstrated strong item performance, reliability, and convergent validity for the 9-item scale. This survey can be used to assess family-centered care in the ED for research and quality improvement purposes.     

Construction and validation of a questionnaire on the knowledge of healthy habits and risk factors for cardiovascular disease in schoolchildren

ObjectivesTo develop and analyze the reliability and validity of a questionnaire on the knowledge of healthy habits and risk factors for cardiovascular disease (CARDIOKID) to be used in schoolchildren.MethodsThe study included 145 children aged 7 to 11 years. The measured factors were the knowledge of healthy habits and risk factors for cardiovascular disease. Cronbach's alpha and intra-class correlation coefficient (ICC) were used to verify reliability, and exploratory factor analysis was used to assess the validity of the questionnaire.ResultsThe sample consisted of 60% females and 40% males. In factorial analysis, the Kaiser-Meyer-Olkin (KMO) test result was measures of sampling adequacy (MSA) = 0.81 and Bartlett's test of sphericity was X² = (66) = 458.64 (p < 0.001). In the factorial analysis with varimax rotation, two dimensions were defined. The “healthy habits” dimension was composed of five factors (ICC = 0.87 and α = 0.93) and the “cardiovascular risk factors” dimension was composed of seven factors (ICC = 0.83 and α = 0.91). In the individual factor analysis, Cronbach's alphas were between 0.93 and 0.91. Total variance was 46.87%. There were no significant differences between test and retest applications.ConclusionThe questionnaire presented satisfactory validity and reliability (internal consistency and reproducibility), allowing for its use in children.     

Parents' Perception of Satisfaction With Care From Pediatric Nurse Practitioners Instrument

IntroductionThe purpose of this methodological study was to establish the psychometric properties of the newly developed Parents' Perceptions of Satisfaction with Care from Pediatric Nurse Practitioners (PPSC-PNP) instrument to measure parents' satisfaction with PNP care.MethodThe initial 37-item PPSC-PNP was sent to five expert judges for review. The 28 retained items yielded a content validity index of .81. The PPSC-PNP instrument was completed by two convenience samples of 25 and 91 parents of children younger than 18 years who were recruited from clinical practice settings in Southeastern Pennsylvania.ResultsItems on the PPSC-PNP were evaluated for content validity by Cronbach's α internal consistency reliability coefficients and item-to-total correlations. The final 28-item PPSC-PNP had a Cronbach's α of .98. The scores on the PPSC-PNP indicated that the parents were satisfied with PNP care.DiscussionAlthough several instruments designed to measure patients' satisfaction with nurse practitioner care are reported in the nursing literature, none were found to measure parents' perception of pediatric nurse practitioner care. The newly developed PPSC-PNP is a valid and reliable instrument that can be used as a quality indicator of PNP care.     

Assessment of the severity of infant crying and its impact on parents: Development and validation of the ColiQ Questionnaire in France

ObjectivesThe purpose of this study was to develop and validate a questionnaire that comprehensively assesses symptoms and severity of crying, symptoms suggesting infant functional gastrointestinal discomfort, and its impact on parents’ quality of life: the Infant Colic Questionnaire (ColiQ©). For the first time, parents had access to a web application to follow their infants’ evolving symptoms with a daily questionnaire.MethodsThe ColiQ was developed with a board of clinical experts (physicians and psychologists) based on extensive parent input. A longitudinal, observational study was conducted in France for 3 months. ColiQ assessments were collected online at six different time points. Psychometric testing demonstrated that ColiQ has acceptable psychometric properties (reliability, internal consistency, construct validity, and responsiveness).ResultsThe ColiQ is a 16-question instrument developed in French including ten questions describing symptoms (Infant score) and six questions describing impacts (Parent score). The ColiQ demonstrated good test-retest reliability (ICC > 0.70), internal consistency for both the Symptom and Impact subscale scores (Cronbach's α > 0.70), and construct validity. Responsiveness was good; the ColiQ was able to detect significant improvement in the target population as early as 1 month (p < 0.05). The global ColiQ score discriminated between severity levels (mild, medium, severe).ConclusionsThe ColiQ was developed with input from parents and healthcare professionals and has shown validity, reliably, and responsiveness to change. Parents can use the web application to follow how their infants’ symptoms evolve. The ColiQ can help parents quantify and verbalize their concerns during consultations, and provides an opportunity to facilitate conversations between the physician and parents.     

Performance of the Person Centered Primary Care Measure in Pediatric Continuity Clinic

ObjectiveImprovement efforts in pediatric primary care would benefit from measures that capture families’ holistic experience of the practice. We sought to assess the reliability and validity of the new Person-Centered Primary Care Measure (PCPCM) in a pediatric resident continuity clinic serving low-income families.MethodsWe incorporated the 11-item PCPCM, stems adapted to reflect a parent responding about their child's visit, into a telephone survey of 194 parents presenting for care in October 2019 at a pediatric resident continuity clinic in Cleveland Ohio (64% response rate). We evaluated PCPCM items using factor analysis and Rasch modeling, and assessed associations of the PCPCM with parents’ demographics and perceptions of specific elements of their child's care.ResultsIn this sample of low-income families, the PCPCM had good reliability (Cronbach's alpha 0.85). All items loaded onto a single factor in principal axes factor analysis. Of the 11 aspects of primary care represented in the scale, “shared experience” was most difficult for parents to endorse in Rasch modeling. All 11 items contributed significantly to the total scale score with corrected item-total correlations >0.4. The PCPCM score was independent of socio demographics and was associated with parent's report that their child's clinician spends enough time with them.ConclusionsThe PCPCM performs well in a pediatric continuity clinic setting, warranting consideration for its use as a parsimonious parent-reported measure of what patients and clinicians say matters most in pediatric primary care.     

Cross-Cultural Adaptation,Reliability, and Validity of The Autism Treatment Evaluation Checklist in Persian

Objective

The objectives of the current study were to translate and adapt Autism Treatment Evaluation Checklist (ATEC) into Persian language and to investigate its reliability and validity in an Iranian autistic sample.

Methods

A total sample of 134 children with autism spectrum disorders aged 6-15 years were assigned to the study. The process of cross-cultural adaptation was performed according to international methodological steps as following: translation, back-translation, revision by an expert committee and pretest. A sample of 20 primary caregivers of autistic children were pretested. The content validity of the ATEC was reviewed by the expert committee all through the stages. The construct quality of the questionnaire was evaluated by comparison of the adapted version of the instrument with similar tests assessed similar factors. Moreover, the reliability of the questionnaire was evaluated through stability and homogeneity assessments.

Findings

The results showed good content validity and internal consistency (Cronbach''s alpha: 0.86-0.93). In relation to construct validity, there was significant correlation between ATEC subscales and raw data obtained from Autism Diagnostic Interview-Revised (ADI-R) (r=0.38-0.79). The Intraclass Correlation Coefficient for the test–retest reliability was excellent for all the subscales and also for total scores (ICC: 0.79 - 0.93).

Conclusion

Cross-cultural adaptation of ATEC was successful. The psychometric properties were verified and indicated that the adapted questionnaire is valid and reliable to use in Iranian culture.     

Cross-cultural adaptation and psychometric properties of the Brazilian-Portuguese version of the VSP-A (Vécu et Santé Perçue de l'Adolescent), a health-related quality of life (HRQoL) instrument for adolescents, in a healthy Brazilian population

Background

Health-related quality of life (HRQoL) assessment, encompassing the adolescents' perceptions of their mental, physical, and social health and well-being is increasingly considered an important outcome to be used to identify population health needs and to provide targeted medical care. Although validated instruments are essential for accurately assessing HRQoL outcomes, there are few cross-culturally adapted tools for use in Brazil, and none designed exclusively for use among adolescents. The Vécu et Santé Perçue de l'Adolescent (VSP-A) is a generic, multidimensional self-reported instrument originally developed and validated in France that evaluates HRQoL of ill and healthy adolescents.

Purpose

To cross-culturally adapt and validate the Brazilian-Portuguese version of the VSP-A, a generic HRQoL measure for adolescents originally developed in France.

Methods

The VSP-A was translated following a well-validated forward-backward process leading to the Brazilian version. The psychometric evaluation was conducted in a sample of 446 adolescents (14-18 years) attending 2 public high schools of São Gonçalo City. The adolescents self-reported the Brazilian VSP-A, the validated Psychosomatic Symptom Checklist and socio-demographic information. A retest evaluation was carried out on a sub-sample (n = 195) at a two-week interval. The internal construct validity was assessed through confirmatory factor analysis (CFA), multi-trait scaling analyses, Rasch analysis evaluating unidimensionality of each scale and Cronbach's alpha coefficients. The reproducibility was evaluated by intra-class correlation coefficients (ICC). Zumbo's ordinal logistic regression analysis was used to detect differential item functioning (DIF) between the Brazilian and the French items. External construct validity was investigated testing expected differences between groups using one-way analysis of variance (ANOVA), Mann-Whitney tests and the univariate general regression linear model.

Results

CFA showed an acceptable fit (RMSEA=0.05; CFI=0.93); 94% of scaling success was found for item-internal consistency and 98% for item discriminant validity. The items showed good fit to the Rasch model except 3 items with an INFIT at the upper threshold. Cronbach's Alpha ranged from 0.60 to 0.85. Test-retest reliability was moderate to good (ICC=0.55-0.82). DIF was evidenced in 4 out of 36 items. Expected patterns of differences were confirmed with significantly lower physical, psychological well being and vitality reported by symptomatic adolescents.

Conclusions

Although DIF in few items and responsiveness must be further explored, the Brazilian version of VSP-A demonstrated an acceptable validity and reliability in adolescents attending school and might serve as a starting point for more specific clinical investigations.     

Adolescent Lifestyle Profile-Revised 2: validity and reliability among adolescents in Chile

ObjectiveThe aims of this study were twofold. First, to provide evidence of the validity and reliability of the Adolescent Lifestyle Profile-Revised 2 (ALP-R2) among adolescents in Chile; and second, to examine the relationship between the health-promoting behaviors measured by this scale and several demographic variables.MethodsCross-sectional survey. Students attending grades 9 through 12 from schools representing low-, middle-, and high-income families were included. All schools were in the city of San Felipe, Chile. Students completed the ALP-R2, a fourty-four-item scale aiming to assess health-promoting behaviors. To evaluate validity and reliability, confirmatory factor analysis and omega coefficient calculation were conducted, respectively.ResultsThe sample size was 572 students (82.5% of the eligible population). More males (56.6%) than females (43.4%) participated in the study, and the mean age was 16.4 (SD, 1.3) years. The ALP-R2 had adequate adjustment indicators in the confirmatory factor analysis, which means that the data supports the original theoretical model (seven subscales). The highest internal consistency was obtained for the total scale (Ω = 0.87); and (among the subscales), physical activity (Ω = 0.85) and spiritual health (Ω = 0.78) had the highest reliability.ConclusionsThe ALP-R2 appears to be a valid and reliable instrument to assess health-promoting behaviors among adolescents attending secondary schools.     

Portuguese Children's Sleep Habits Questionnaire - validation and cross-cultural comparison

Objectiveto validate the Portuguese version of the Children's Sleep Habits Questionnaire (CSHQ-PT) and compare it to the versions from other countries.Methodsthe questionnaire was previously adapted to the Portuguese language according to international guidelines. 500 questionnaires were delivered to the parents of a Portuguese community sample of children aged 2 to 10 years old. 370 (74%) valid questionnaires were obtained, 55 children met exclusion criteria and 315 entered in the validation study.Resultsthe CSHQ-PT internal consistency (Cronbach's α) was 0.78 for the total scale and ranged from 0.44 to 0.74 for subscales. The test-retest reliability for subscales (Pearson's correlations, n=58) ranged from 0.59 to 0.85. Our data did not adjust to the original 8 domains structure in Confirmatory Factor Analysis but the Exploratory Factor Analysis extracted 5 factors that have correspondence to CSHQ subscales.Conclusionthe CSHQ-PT evidenced psychometric properties that are comparable to the versions from other countries and adequate for the screening of sleep disturbances in children from 2 to 10 years old.     

Validation of the Family Health Behavior Scale for the Brazilian population

ObjectiveTo validate the Family Health Behavior Scale (FHBS) for Brazilian families.MethodsThe sample included 272 children aged 5 to 12 years old. Caregivers and their healthy answered the FHBS and questions about physical activity. In addition, anthropometric measurements of the children's weight and height were performed, as well as the bioimpedance exam. The scale was translated and the following validities were assessed: content (qualitative analysis and content validity index), construct (factor analysis) and concurrent validity (difference between domains and the total score with the categories of BMI, fat percentage and physical activity). Reliability (Cronbach's alpha, ceiling-floor effect, two-half test, intraclass correlation and Bland – Altman) was also assessed.ResultsFHBS instrument performed well with regard to the psychometric properties in the Brazilian population. The content validity index was 0.987. Fit indices of the factor analysis were considered satisfactory, according to Bartlett's sphericity test (χ 2 = 1927, df = 351; p < 0.001) and the Kaiser-Meyer-Olkin index (KMO = 0.789). Concurrent validity, the differences between the mean of the domains and the total score between the categories of BMI (p = 0.011), percentage of fat (0.004) and physical activity (p < 0.001) were all significant. The reliability results were Cronbach's alpha internal consistency = 0.83, adequate ceiling-floor effect, 0.8105 (0.09 SD) two-half test, 0.626 intraclass correlation (95% CI: 0.406 to 0.777) and Bland – Altman -0.840 (-22.76 to 21.07).ConclusionThe FHBS adapted for the Brazilian population showed evidence of adequate psychometric performance.     

Development of the breast milk expression experience measure

Exclusive breastfeeding provides optimal nutrition through 6 months. Recent research has shown that milk expression may affect breastfeeding duration. A woman's experience with milk expression might mediate the effect of milk expression on breastfeeding duration. The objective of this study was to develop a measure to evaluate women's experiences of expressing milk. Based on the available literature, we developed a brief measure of the Breast Milk Expression Experience (BMEE) assessing three dimensions: (1) social support for milk expression; (2) ease of learning how to express milk; and (3) personal experiences of milk expression. All items used 1–5 Likert scales, with higher scores indicating better experiences. We administered the items immediately after expression to 68 mothers who expressed milk post‐partum. We evaluated this measure for reliability using Cronbach's alpha. Mothers completing the BMEE were 57% primiparous with 75% vaginal births. The BMEE demonstrated appropriate reliability with a Cronbach's alpha of 0.703 for the summary index and 0.719–0.763 for social support, learning experience and personal experience subscales. The BMEE also indicated good predictive validity; of the six mothers who had a mean score <3 on the 11‐item scale post‐partum, two (33.3%) were expressing breast milk at 1 month, compared with 37 (80.4%) of the 46 mothers who had a mean score ≥3 on the 11‐item scale post‐partum (P = 0.012). The BMEE is a promising measure of milk expression experience in this population. Use of this measure may allow improved understanding of women's experiences expressing milk.     

Development and Validation of Age-Specific Resilience Instruments for Early Childhood Assessment: A Taiwan Birth Cohort Study

BackgroundWe sought to develop and validate age-specific instruments for measuring early childhood resilience at ages 3, 5 and 8 in the Taiwan Birth Cohort Study, a national longitudinal study.MethodsUsing data from 18,553 mother-infant pairs, we conducted exploratory factor analysis (EFA) on a simple random half of our sample. We then used the remaining half of these data for confirmatory factor analysis (CFA) to further assess the fit of 3 CFA models (ie, first-order, second-order, and bifactor). Psychometric properties, distributions, and inter-item and inter-factor correlations of each instrument were also evaluated.ResultsEFA and CFA showed that the bifactor model of resilience (which included a general resilience factor and 5 specific factors) had the best fit for all 3 resilience scales, with 19 items at year 3, 18 items at year 5, and 19 items at year 8. All 3 resilience scales showed good psychometric properties, including construct validity, internal consistency, and normal distributions. For predictive validity, we found that in the face of adversity (measured by the High Risk Family Score), individuals with high resilience scores at age 3 had better general health scores at ages 3, 5, and 8 compared to those with low resilience scores.ConclusionsWe describe the development and validation of age-appropriate survey instruments to assess resilience in young children at the population level. These instruments can be used to better understand how resilience can impact child health over time, and to identify key factors that can foster resilience.     

Assessing the Validity of the Baby Pediatric Symptom Checklist Using a Nationally Representative Household Survey

ObjectiveThe Baby Pediatric Symptom Checklist (BPSC) is a screening tool developed for detecting behavioral or emotional concerns among parents of children younger than 18 months. Nationally representative survey data have not yet been used to assess the validity of the BPSC, nor to evaluate its appropriateness for use among children between 18 and 23 months old. The current study assesses the validity of the BPSC using data from the National Health Interview Survey (NHIS).MethodsData from the 2019 NHIS were used to evaluate the 12-item BPSC screening tool among a nationally representative sample of children 2 to 23 months. Confirmatory factor analysis (CFA) and differential item functioning (DIF) were used to assess construct and predictive validity and test how response items differed by selected sociodemographics. Quantile regression was used to calculate 50th, 70th, and 90th percentiles for age-based normative curves of the previously established domains of irritability, inflexibility, and difficulty with routines.ResultsA 3-factor CFA produced comparable results to the original study. Tests of DIF did not reveal any significant effects for the child's sex, race and Hispanic origin, household urbanization level, number of children in family, or respondent type (mother, father, other). In addition, DIF was not found between children aged 2 to 17 months and 18 to 23 months. Age-based normative data were calculated for each subscale.ConclusionsThe use of the BPSC in a nationally representative survey produced findings comparable to those of the original-validation study. The NHIS can be used to track BPSC scores over time at the population-level.     

Preliminary Examination of a New Mental Health Screener in a Pediatric Sample

IntroductionApproximately 80% of children with mental health problems do not receive services. It has been recommended that mental health screening be conducted during pediatric visits (Huffman & Nichols, 2004).MethodsThe Primary Care Mental Health Screener (PCMHS) was designed to screen for DSM-IV disorders (APA, 1994) in children. The PCMHS was completed by 328 parents of 3- to 12-year-olds.ResultsThe long-form showed adequate to excellent internal consistency across three age groups and eight subscales with one exception (depression in preschoolers). Next, data were used to shorten the screener without compromising internal consistency, resulting in a 32-item short-form.DiscussionThe long-form of the PCMHS is a promising mental health screener. The internal consistency of the proposed short-form should be examined with a separate sample. Additional research is needed to improve the reliability of the PCMHS for 3- to 5-year-olds and, in general, to examine the validity of this screener.     

The Baby Pediatric Symptom Checklist: Development and Initial Validation of a New Social/Emotional Screening Instrument for Very Young Children

ObjectiveTo develop and validate the Baby Pediatric Symptom Checklist (BPSC), a brief social/emotional screening instrument for children less than 18 months. The BPSC is modeled after the Pediatric Symptom Checklist (PSC) and is part of the Survey of Wellbeing of Young Children, a comprehensive, freely available screening instrument designed for use in pediatric primary care.MethodBPSC items were developed by a team of experts who reviewed existing assessment instruments and relevant research literature. Scale construction and initial validation were conducted with 205 families from pediatric primary care sites and 54 families from referral clinics. A replication sample of 146 additional families were enrolled from an independent set of primary care practices.ResultsExploratory factor analysis revealed 3 dimensions of the BPSC: irritability, inflexibility, and difficulty with routines. Factor structure was confirmed in the replication sample. Retest reliability and internal reliability were adequate (intraclass correlation coefficient >0.70) across subscales, with the exception of the “irritability” subscale’s internal reliability in the replication sample. Construct validity of the “irritability” and the “difficulty with routines” subscales is supported by correlations with the Parenting Stress Index and the Ages & Stages Questionnaire: Social/Emotional, but the “inflexibility” subscale seems to be distinct from performance on these instruments. Tests of differential item functioning revealed no significant effects for race/ethnicity, child gender, parent education, or family income. Age-based normative data were calculated for each subscale.ConclusionThe BPSC assesses 3 domains of behavior for very young children and shows promise as a social/emotional screening instrument for pediatric primary care.     

Validation d’une version francophone de l’Anorexia Nervosa Stages of Change Questionnaire

BackgroundNumerous authors regard motivation to change as a key feature in the treatment of individuals with anorexia nervosa. Although several questionnaires are available to assess motivation to change, most of them were not intended for adolescents nor individuals with anorexia nervosa. The Anorexia Nervosa Stages of Change Questionnaire (ANSOCQ) was developed to assess motivation to change specifically in individuals with anorexia nervosa. This study aimed to validate a French translation of the ANSOCQ based on the three-factor model identified elsewhere.MethodologyEighty adolescents suffering from anorexia nervosa and two from an eating disorder not otherwise specified were recruited at their arrival in a specialized eating disorder inpatient treatment program. Fifty-two adolescents participated again at the time of their discharge. Respondents completed the ANSOCQ, the University of Rhode Island Change Assessment Scale, a single item derived from the Motivation Stages of Change for Adolescents Recovering from an Eating Disorder, and the Eating Disorder Inventory-3. Cronbach's Alpha, Pearson's and Spearman's correlations, ANOVA and multiple regressions were performed.ResultsThe global scale and subscales of the ANSOCQ demonstrated excellent internal consistency (α ≥ 0.82). The global scale was significantly correlated with both the URICA (r = 0.46) and the MSCARED (r_s = 0.68). Participants’ scores on the three subscales of the ANSOCQ were significantly higher at the end of their hospitalization (ps < 0.05), especially for the Ego-Alien Aspects subscale. Youths’ scores on the Weight Gain subscale were significantly lower than their scores on both Eating, Shape, and Weight Concerns and Ego-Alien Aspects subscales (ps < 0.05). The ANSOCQ subscales significantly explained 52% and 41% of variance on the Eating Disorder Risk Composite Scale and the General Psychological Maladjustment Composite Scale, respectively. Furthermore, while the Weight Gain subscale was uniquely related to the former scale (β = ?0.38), the Eating, Shape, and Weight Concerns subscale was uniquely associated with the latter scale (β = ?0.39).ConclusionThese results support the psychometric qualities of this French translation of the ANSOCQ. Given the differences observed in the present study, the use of the ANSOCQ subscales also seems promising. It is possible that adolescents report higher motivation to change aspects of their difficulties that they recognize more, that are associated with fewer secondary benefits, and that entails greater unwanted repercussions. However, further studies are needed to confirm the factorial structure of the ANSOCQ.     

Adaptation of the Youth Connectedness to Provider scale to assess the relationship between health professionals and adolescent and young adult patients

ObjectiveThe aim was to adapt an instrument that evaluates the relationship between young individuals and health professionals to the Brazilian population, which will be called the Escala de Avaliação de Vínculo entre Jovens e Profissionais de Saúde (Youth Connectedness to Provider scale).MethodThe questionnaire known as the Youth Connectedness to Provider scale consists of seven Likert-like questions. The translation, back-translation, evaluation by ten specialists, and pre-test with 43 adolescents and young adults aged between 10 and 24 years were performed to assess the clarity and reliability of meanings. The content validity index was calculated for each question. Subsequently, the clinical validation was performed with 83 patients aged 10–24 years old and Cronbach's alpha coefficient was calculated.ResultsA content validity index >0.8 (considered satisfactory) was obtained for all items analyzed by experts and adolescents. At the clinical validation, it showed a high internal consistency (Cronbach’s alpha = 0.76). The questions showed a good correlation, except for the question about judgment (Spearman’s rho = 0.03–0.19).ConclusionsThe scale adaptation showed an adequate agreement rate at the translation evaluation and a good reliability index in the questions. This instrument provides information on strengths and topics that require more attention from professionals to improve the relationship with their patients; it can be a valuable parameter in assessing the medical consultation quality.