Development and Psychometric Properties of a Tool Related to the Adoption of Desirable Behaviors in the Consumption of Sugar-sweetened Beverages in Children Based on the Social Cognitive Theory

Consumption of sugar-sweetened beverages is associated with chronic diseases such as diabetes and cardiovascular disorders and other severe negative health consequences and is one of the challenging issues in the field of nutrition in today's societies. This study was conducted with the aim of designing a psychometric questionnaire in relation to the consumption behavior of sugar-sweetened drinks in children.

In this cross-sectional research, 607 students were selected and included in the study by multi-stage cluster sampling from the first-year secondary schools covered by the Urmia Department of Education. Waltz's method was used to design the questionnaire, and based on a targeted review of the literature and questionnaires related to nutrition behavior, an initial questionnaire with 51 items was designed. After confirming the face and content validity of the questionnaire by 15 members of the expert panel, construct validity steps were performed using exploratory factor analysis. Finally, the internal reliability of the questionnaire was determined by calculating Cronbach's alpha.

The first version of the questionnaire was designed with 51 items and all the items were retained in the psychometric process during content validity. The content validity index and ratio were calculated to be higher than 0.79 and 0.6, respectively. Based on the exploratory factor analysis, the number of items in the questionnaire remained at 51, and the dimensions of the questionnaire were categorized into 6 factors: perceived barriers, self-efficacy, self-regulation, social support, preventive behaviors, and reinforcing behaviors, with a predictive power of 56,261 and in repeating the exploratory factor analysis for items with a different nature from other factors, 3 separate factors were identified: the physical health dimension of outcome expectations, negative outcome expectations, and positive outcome expectations with a predictive power of 54.667. The internal reliability of the questionnaire items was accepted and confirmed with Cronbach's alpha coefficient above 0.70.

The final questionnaire with 51 items has the ability to be used by various researchers due to the strength of the factorial structure and suitable psychometric properties.