Development Of Children’s Spinal And Vision Health Questionnaire And Its Reliability And Validity Test

PurposeDevelop the "Children’s Spine and Vision Health Questionnaire"(CSVHQ),and test the reliability and validity of the questionnaire to accurately reflect the spine health and vision health status of children aged 6-12,and enrich the means of evaluating spine and vision health.Methods(1)Questionnaire development: A research team was set up to review data on children’s spine and vision health through literature searches,and to summarize and analyze existing questionnaires at home and abroad to form the initial structure of the questionnaire,which included spine health aspects and vision health aspects in the main body,and pain,psychological,daily activities,and nutrition related to spine health or vision health in the rest of the contents.Interview outlines were developed based on the initial structure of the questionnaire,and semi-structured interviews with parents were conducted from March to August 2022.All interview data were coded and analyzed using NVivo 11 software,and entries were compiled to form a pool of entries for the questionnaire.From December 2022 to January 2023,38 experts in related fields were invited to form an expert group to conduct two rounds of Delphi method expert consultation.The dimensions and entries were adjusted according to the entry retention criteria(mean value (?) >3.50 or full score ratio K>0.20)and expert revision opinions to form a pre-survey version of the questionnaire.In February 2023,a pre-survey was conducted using the pre-survey questionnaire in an elementary school in Chengdu,Sichuan Province,China,with one class included in each of grades 1-6.Seven item analysis methods(frequency analysis,coefficient of variation,decisive value,correlation coefficient,retest reliability,Cronbach’s alpha coefficient,and factor analysis)were used to comprehensively screen the items of the questionnaire(removing items with <7/10 items of screening indicators that met the retention criteria)to form the official version of the questionnaire.(2)Questionnaire reliability and validity test: A formal survey was conducted in March 2023 using the official version of the questionnaire in one elementary school each in Shandong Province and Sichuan Province,China.The structural validity,internal consistency reliability,and retest reliability of the questionnaire were examined and the final version of the questionnaire was obtained.Results(1)Questionnaire development: A total of 33 interviewees were included,and the average age of the interviewees’ children was 9.76±1.35 years old,with an age range of6-12 years.The interview data were coded to form 129 code numbers,23 meaningful categories,and 5 core categories,and a questionnaire entry pool containing 5dimensions and 33 items was formed after deletion,merging,and modification.A total of 20 experts participated in the correspondence survey,and the participation rate of experts was 71.43%,and the recovery rates of the two rounds of questionnaires were100% and 85%,respectively,with the high motivation of experts;the expert authority coefficient was 0.765,with high authority of experts;all entries met the retention criteria,with a high concentration of experts’ opinions;the Kendall’ W coefficient in the second round increased to 0.179(P<0.001),and the coordination of experts’ opinions were better;the pre-survey questionnaire with 5 dimensions and 21 entries was finally adjusted according to the revision.A total of 338 questionnaires were collected in the pre-survey,of which 333 were valid,with a valid response rate of 98.5%.The average age of students was 9.43±1.82 years old,and the age range was 6-12 years old.(2)Questionnaire reliability and validity test: A total of 762 questionnaires were collected in the formal survey,of which 754 were valid,with a valid response rate of99.0%.The average age of students was 9.23±1.80 years old,and the age range was 6-12 years old.The cumulative contribution of the questionnaire was 50.085%,the Cronbach’s alpha coefficient of the total questionnaire was 0.792,and the retest reliability of the total questionnaire was 0.785 in 59 retest surveys.the final version of the questionnaire contained 3 dimensions and 13 items with acceptable internal consistency reliability,retest reliability,and structural validity.ConclusionsThe CSVHQ has good reliability and validity and can be used as an assessment tool to reflect the spine and vision health status of children aged 6-12 years.The questionnaire is completed by both the child and the parent,and scores range from 13-65,with lower scores indicating poorer spinal and visual health.