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The authors declare that they have no competing interests.
GSB coordinated data collection, interpreted results and draft the questionnaire and the manuscript. MSP performed statistical analyses, interpreted results and helped drafting the manuscript. PB performed data management and presentation. NPE and RB collected initial data, and drafted the initial version of the questionnaire. CR and XO reviewed all versions and coordinated the qualitative assessment. VF oversaw the overall study and helped drafting the manuscript. JLP designed and coordinated the study, interpreted the results and drafted the manuscript. All authors read and approved the final manuscript.
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The SI! Program promotes cardiovascular health through a multilevel school-based intervention on four lifestyle-related components: diet, physical activity, understanding the body and heart, and management of emotions. We report here the development and validation of the KAH (knowledge, attitudes and habits)-questionnaire adapted for elementary school children (6–7 years old) as a tool for the forthcoming evaluation of the SI! Program, where the KAH scoring will be the primary outcome. The efficacy of such an intervention will be based on the improvements in children’s KAH towards a healthy lifestyle.
The questionnaire validation process started with a pool of items proposed by the pedagogical team who developed the SI! Program for elementary school. The questionnaire was finalized by decreasing the number of items from 155 to 48 using expert panels and statistical tests on the responses from 384 children (ages 6–7). A team of specialized psychologists administered the questionnaire at schools providing standard directions for the final administration. The internal consistency was assessed using Cronbach’s α coefficients. Reliability was measured through the split-half method, and problematic items were detected applying the item response theory. Analysis of variance and Tukey’s test of additivity were used for multiple comparisons.
The final KAH-questionnaire for elementary school children should be administered to children individually by trained staff. The 48 items-questionnaire is divided evenly between the 4 components of the intervention, with an overall Cronbach’s α = 0.791 (α = 0.526 for diet, α = 0.537 for physical activity, α = 0.523 for human body and heart, and α = 0.537 for management of emotions).
The KAH-questionnaire is a reliable instrument to assess the efficacy of the SI! Program on instilling healthy lifestyle-related behaviors in elementary school children.