Background
Methods
Participants and design
Procedure and ethical considerations
Measurements
The original Adolescent Health Promotion (AHP) scale
Socio-demographic information
Statistical analysis
Confirmatory factor analysis
Discriminant validity
Results
Characteristics of the participants
CFA results for the calibration sample
Global model fit | Calibration sample (40 items) | Calibration sample (24 items) | Calibration sample (21 items) | Validation sample (21 items) |
---|---|---|---|---|
Absolute fit index | ||||
GFI | .81 | .93 | .95 | .92 |
AGFI | .78 | .91 | .93 | .90 |
SRMR | .064 | .041 | .036 | .046 |
RMSEA | .059 | .037 | .028 | .051 |
Relative fit index | ||||
NFI | .75 | .88 | .93 | .90 |
NNFI | .82 | .95 | .98 | .93 |
CFI | .84 | .96 | .98 | .94 |
Parsimony fit index | ||||
PNFI | .70 | .77 | .77 | .74 |
PCFI | .78 | .82 | .81 | .78 |
LR χ2/df
| 2.43 | 1.56 | 1.31 | 2.07 |
CFA results for the validation sample and test of cross-validation
Calibration sample | Validation sample | |||
---|---|---|---|---|
Construct/Item |
Mean
|
SD
|
Mean
|
SD
|
Nutrition
| ||||
Item 2 | 2.94 | 0.86 | 2.97 | 0.95 |
Item 3 | 3.41 | 1.07 | 3.40 | 1.04 |
Item 5 | 3.49 | 1.10 | 3.44 | 1.10 |
Social support
| ||||
Item 7 | 3.45 | 1.10 | 3.28 | 1.13 |
Item 8 | 3.62 | 1.06 | 3.47 | 1.13 |
Item 9 | 3.58 | 1.15 | 3.53 | 1.23 |
Item 12 | 3.96 | 1.00 | 3.92 | 1.03 |
Health responsibility
| ||||
Item 14 | 3.60 | 1.27 | 3.62 | 1.27 |
Item 15 | 3.18 | 1.29 | 3.19 | 1.31 |
Item 16 | 2.73 | 1.18 | 2.64 | 1.22 |
Item 17 | 2.67 | 1.23 | 2.57 | 1.24 |
Life appreciation
| ||||
Item 24 | 3.69 | 1.11 | 3.67 | 1.14 |
Item 26 | 3.33 | 1.07 | 3.27 | 1.11 |
Item 27 | 3.92 | 1.08 | 3.86 | 1.08 |
Item 28 | 3.69 | 1.22 | 3.61 | 1.21 |
Exercise
| ||||
Item 31 | 3.57 | 1.28 | 3.47 | 1.26 |
Item 33 | 3.04 | 1.24 | 3.12 | 1.28 |
Item 34 | 2.83 | 1.05 | 2.86 | 1.07 |
Stress management
| ||||
Item 36 | 3.26 | 1.27 | 3.20 | 1.30 |
Item 39 | 3.17 | 1.18 | 3.20 | 1.24 |
Item 40 | 3.59 | 1.12 | 3.58 | 1.16 |
Model and invariance level |
Δ
df
|
Δχ2
|
Pvalue |
ΔNFI |
ΔIFI |
ΔRFI |
ΔNNFI |
ΔCFI |
---|---|---|---|---|---|---|---|---|
Assuming model unconstrained to be correct | ||||||||
Unconstrained | – | – | – | – | – | – | – | – |
Measurement weights | 21 | 14.2 | .862 | .002 | .002 | -.004 | -.004 | .001 |
Structural covariance | 36 | 34.9 | .519 | .006 | .006 | -.004 | -.005 | <.001 |
Measurement residual | 57 | 57.3 | .463 | .009 | .010 | -.006 | -.007 | <.001 |
Assuming model measurement weights to be correct | ||||||||
Structural covariance | 15 | 20.8 | .145 | .003 | .003 | -.001 | -.001 | -.001 |
Measurement residual | 36 | 43.2 | .192 | .007 | .007 | -.003 | -.003 | -.001 |
Assuming model structural covariance to be correct | ||||||||
Measurement residuals | 21 | 22.4 | .377 | .004 | .004 | -.002 | -.002 | <.001 |
Discriminant validity
The absence or presence of outcomes | Per 1 unit decrease of health promoting behaviors with presence of outcomes | |||
---|---|---|---|---|
Outcomes/AHP-SF subscales | Absence | Presence | OR (95% CI) |
P
|
Overweight/obese (23.0%, 187/814) | ||||
Nutrition | 3.29 ± 0.79 | 3.22 ± 0.80 | 1.13 (0.92–1.38) | 0.260 |
Social support | 3.65 ± 0.88 | 3.42 ± 0.95 | 1.32 (1.11–1.58) | 0.002 |
Health responsibility | 3.04 ± 0.94 | 2.98 ± 0.86 | 1.07 (0.90–1.28) | 0.459 |
Life appreciation | 3.67 ± 0.89 | 3.49 ± 0.90 | 1.24 (1.04–1.49) | 0.018 |
Exercise | 3.18 ± 0.93 | 3.03 ± 0.92 | 1.20 (1.01–1.44) | 0.039 |
Stress management | 3.35 ± 0.91 | 3.26 ± 0.89 | 1.11 (0.93–1.33) | 0.243 |
Total AHP-SF | 3.38 ± 0.66 | 3.24 ± 0.68 | 1.35 (1.06–1.73) | 0.016 |
Number of breakfast per week <5 (70.6%, 575/814) | ||||
Nutrition | 3.47 ± 0.81 | 3.20 ± 0.77 | 1.55 (1.27–1.90) | <0.001 |
Social support | 3.67 ± 0.87 | 3.57 ± 0.91 | 1.13 (0.95–1.35) | 0.155 |
Health responsibility | 3.14 ± 0.93 | 2.98 ± 0.90 | 1.21 (1.02–1.43) | 0.031 |
Life appreciation | 3.72 ± 0.85 | 3.60 ± 0.91 | 1.17 (0.98–1.39) | 0.085 |
Exercise | 3.26 ± 0.91 | 3.10 ± 0.93 | 1.20 (1.02–1.43) | 0.031 |
Stress management | 3.44 ± 0.90 | 3.29 ± 0.90 | 1.22 (1.02–1.45) | 0.028 |
Total AHP-SF | 3.46 ± 0.66 | 3.30 ± 0.66 | 1.43 (1.13–1.81) | 0.003 |
TV and playing computer games ≧4 hours per day (27.0%, 220/814) | ||||
Nutrition | 3.37 ± 0.77 | 3.02 ± 0.79 | 1.78 (1.45–2.19) | <0.001 |
Social support | 3.69 ± 0.86 | 3.37 ± 0.96 | 1.49 (1.25–1.77) | <0.001 |
Health responsibility | 3.13 ± 0.89 | 2.76 ± 0.94 | 1.57 (1.32–1.88) | <0.001 |
Life appreciation | 3.71 ± 0.88 | 3.44 ± 0.91 | 1.40 (1.18–1.67) | <0.001 |
Exercise | 3.26 ± 0.89 | 2.86 ± 0.98 | 1.59 (1.34–1.90) | <0.001 |
Stress management | 3.44 ± 0.87 | 3.06 ± 0.94 | 1.59 (1.34–1.90) | <0.001 |
Total AHP-SF | 3.44 ± 0.64 | 3.10 ± 0.68 | 2.23 (1.74–2.85) | <0.001 |
Discussion
Nutrition | 21. Make an effort to choose foods without preservatives (e.g., additives on food).a
|
1. I eat three meals daily.a
| Life appreciation |
2. I choose foods without too much oil. | 22. Make an effort to like myself.a
|
3. Include dietary fiber (e.g. fruits or vegetables). | 23. Make an effort to feel happy and content.a
|
4. Drink at least 1500 cc of water daily (or 6–8 cups).a
| 24. I usually think positively. |
5. Each meal includes five food groups (e.g. bread, meat, milk, fruit, vegetable) | 25. Make an effort to understand my strengths, weaknesses and accept them.a
|
6. Eat breakfast daily.a
| 26. Make an attempt to correct my defects. |
Social support | 27. Make an effort to know what’s important for me. |
7. I speak up & share my feelings with others. | 28. Make an effort to feel interesting and challenged every day. |
8. I care about other people. | 29. Make an effort to believe that my life has purpose.a
|
9. I talk about my concerns with others. | Exercise |
10. Make an effort to smile or laugh every day.a
| 30. Perform stretching exercise daily.a
|
11. Enjoy keeping in touch with relatives.a
| 31. Exercise rigorously 30 minutes at least 3 times per week. |
12. Make an effort to have good friendships. | 32. Participate in physical fitness class at school weekly.a
|
13. Talk about my troubles to others.a
| 33. Warm up before rigorous exercise. |
Health responsibility | 34. Make an effort to stand or sit up straight. |
14. Read food labels when I shop. | Stress management |
15. I watch my weight. | 35. Make an effort to spend time daily for relaxation.a
|
16. Discuss my health concerns with a doctor or nurse. | 36. Make an effort to determine the source of my stress. |
17. Observe my body at least monthly. | 37. Make an effort to watch my mood changes.a
|
18. Brush my teeth and use dental floss after meals.a
| 38. Sleep for 6–8 hours each night.a
|
19. Wash hands before meals.a
| 39. Make schedules and set priorities. |
20. Read health information.a
| 40. I try not to lose control when things happen that are unfair. |