Background: Health-promoting behaviour is an important concept for health education. Unfortunately, there is a dearth of validated instruments to measure levels of health-promoting behaviour in the Malaysian context. The purpose of this study was to validate a Malay-language version of the Health-Promoting Lifestyle Profile II (HPLP-II) using a confirmatory approach. Methods: Participants were 997 university undergraduate students, with a mean age of 21 years (SD = 1.58). The majority of the participants (80.4%) were female. Health-promoting behaviour was assessed using the 52-item HPLP-II, which measures six components of health-promoting behaviour outcomes. HPLP-II was translated into the Malay language using standard forward and backward translation procedures. Participants then completed the HPLP-II Malay version (HPLP-II-M). Confirmatory factor analysis (CFA) was conducted using Mplus 8.0 software on the six domains of HPLP-II-M model. Results: The CFA result based on the hypothesised measurement model of six factors was aligned with the original HPLP-II, except for two low loading items which were subsequently removed from the CFA analysis. The final CFA measurement model with 50 items resulted in a good fit to the data based on RMSEA and SRMR fit indices (RMSEA = 0.046, 90%CI = 0.045, 0.048, SRMR = 0.062). The construct reliabilities for the HPLP-II-M subscales were acceptable, ranging from 0.737 to 0.878. Conclusion: The HPLP-II-M with six components of health-promoting behaviour outcomes and 50 items was considered valid and reliable for the present Malaysian sample.

Measurement equivalence is often assumed across comparison groups, a pervasive problem related to many self-report instruments. Measurement equivalence, also known as measurement invariance, implies that a measure has the same meaning across different groups of people. In this study, we aimed to examine the measurement and structural invariance among gender of the Malay version of the Physical Activity and Leisure Motivation Scale for Youth (PALMS-Y-M). Seven-hundred-and-eighty-three secondary school students (female = 57.3%, male = 42.7%) with mean age 14.5 years (standard deviation = 1.25) from Kota Bharu, Malaysia, volunteered to participate in this study and completed the PALMS-Y-M, consisting of 28 items with seven subscales. We conducted the confirmatory factor analysis (CFA) and invariance tests on the seven motives of the PALMS-Y-M model. The hypothesized model consisted of 28 observed items and seven latent variables. We used estimator robust to maximum likelihood, MLR to examine the hypothesized measurement and structural invariance. Measurement invariance was tested for three different levels. We first established the configural invariance model, then we compared the metric invariance model and the scalar invariance model with the less restrictive model. Then structural invariance was tested for factor variance, covariance, and means. Findings provided evidence for full measurement and structural invariance of the PALMS-Y-M in males and females. The final CFA model fit the data well for males [comparative fit index (CFI) = 0.922, root mean square error of approximation (RMSEA) = 0.048, standardized root mean residual (SRMR) = 0.050] and females (CFI = 0.922, RMSEA = 0.047, SRMR = 0.053). When invariance of both factor loadings and item intercepts holds in PALMS-Y-M, underlying factors consisting of different motives for participating in PA can be meaningfully compared across gender. Accurate and valid measurement of PALMS-Y-M across comparison groups is crucial for future research that involves examining motives to physical activity in different genders and other socio-cultural variables.

BackgroundEngaging in regular physical activity (PA) has become a worldwide issue for the prevention of numerous chronic diseases; therefore, is important to increase students’ desires to engage in PA by triggering their motivation. The purpose of this study was to examine the relationships between the motives for participating in PA and the amount of PA that secondary Chinese school students in Kelantan undertake.MethodsThe participants consisted of 304 Chinese secondary school students (males = 165, females = 139) with a mean age of 13.55 years old (SD = 0.57) who volunteered to complete three measures, consisting of a demographic information form, the physical activity and leisure motivation scale for youth-Chinese version (PALMS-Y-C) and the Godin leisure-time exercise questionnaire-Chinese version (GLTEQ-C).ResultsThere were significant positive correlations between all the seven PA participation motives with amount of exercise (Enjoyment: r = 0.16, P = 0.010; Mastery: r = 0.23, P < 0.001; Competition: r = 0.21, P = 0.001; Affiliation: r = 0.22, P < 0.001; Psychological condition: r = 0.26, P < 0.001; Appearance: r = 0.20, P = 0.001; Physical condition: r = 0.20, P = 0.001). There were also significant mean differences among sweating exercise frequency categories in all the seven areas of PA participation motives (Enjoyment: P = 0.003, Mastery: P < 0.001, Competition: P = 0.001, Affiliation: P = 0.001, Psychological condition: P = 0.038, Appearance = 0.002, Physical condition: P = 0.004).ConclusionThe present study provided insight into how to promote PA in Kelantan Chinese school-aged children by specifically targeting their motives. Interventions targeting these motives could increase the amount of PA among Kelantan Chinese youths.

BackgroundThe purpose of the study was to compare the motives for participating in physical activity (PA) through the different types of co-curricular activities chosen by health sciences undergraduate students at Universiti Sains Malaysia (USM), Malaysia.MethodsThe participants were university students at USM’s Health Campus, who were invited to volunteer and complete two measures: a demographic form, including the types of co-curricular activities in which the students chose to enrol (sports, uniform and art), and the Physical Activity and Leisure Motivation Scale (PALMS).ResultsA total of 588 university students (female = 79.1%, male = 20.9%) with a mean age of 19.77 (SD = 1.39) participated in the study. The results showed significant differences in the motives of affiliation (P < 0.001), appearance (P = 0.008) and physical condition (P = 0.010) across the types of co-curricular activities in which the students participated. The students who enrolled in sports generally showed higher motives of affiliation, appearance and physical condition for participating in PA than other types of co-curricular activities.ConclusionThe study findings can provide further insights into the motives for participating in PA among health sciences students and encouragement for students to integrate PA into their daily routines.

Abdominal bloating (AB), a common complaint that affects quality of life and disturbs psychological well-being, is largely a behavioral-driven disorder. We aimed to develop and validate a new health belief of bloating (HB-Bloat) scale in the Malay language. The initial item pool was developed based on the theory of planned behavior, empirical literatures, expert review and in-depth interviews. Using the population with bloating (diagnosed based on the Rome IV criteria and pictogram), exploratory and confirmatory factor analytical approaches (EFA and CFA, respectively) were utilized to explore and confirm the domains in the new scale. There were 150 and 323 respondents in the EFA and CFA, respectively. There were 45 items in the initial scale, but it was reduced to 32 items after content validity and pre-testing. In EFA, 17 items with three (3) structure factors (attitude 4 items, subjective norm 7 items, and perceived behavior control 6 items) were identified. Total variance explained by the EFA model was 40.92%. The Cronbach alpha of the three (3) factors ranged from 0.61 to 0.79. With CFA, the three factors model was further tested. Five problematic items were identified and removed. The final measurement model fit the data well (root mean square error of approximation (RMSEA (90% CI) = 0.054 (0.038, 0.070), Comparative Fit Index (CFI) = 0.941, Tucker–Lewis Fit Index (TLI) = 0.924, and standardized root mean squared residual (SRMR) = 0.044). The construct reliability of the final measurement model ranged from 0.76 to 0.84. As a conclusion, the new HB-Bloat scale is a valid and reliable tool for assessment of health beliefs in bloating.

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Background Health management strategies may help patients with abdominal bloating (AB), but there are currently no tools that measure behaviour and awareness. This study aimed to validate and verify the dimensionality of the newly-developed Health Promoting Behaviour for Bloating (HPB-Bloat) scale. Methods Based on previous literature, expert input, and in-depth interviews, we generated new items for the HPB-Bloat. Its content validity was assessed by experts and pre-tested across 30 individuals with AB. Construct validity and dimensionality were first determined using exploratory factor analysis (EFA) and Promax rotation analysis, and then using confirmatory factor analysis (CFA). Results During the development stage, 35 items were generated for the HPB-Bloat, and were maintained following content validity assessment and pre-testing. One hundred and fifty-two participants (mean age of 31.27 years, 68.3% female) and 323 participants (mean age of 27.69 years, 59.4% male) completed the scale for EFA and CFA, respectively. Using EFA, we identified 20 items that we divided into five factors: diet (five items), health awareness (four items), physical activity (three items), stress management (four items), and treatment (four items). The total variance explained by the EFA model was 56.7%. The Cronbach alpha values of the five factors ranged between 0.52 and 0.81. In the CFA model, one problematic latent variable (treatment) was identified and three items were removed. In the final measurement model, four factors and 17 items fit the data well based on several fit indices (root mean square error of approximation (RMSEA) = 0.044 and standardized root mean squared residual (SRMR) = 0.052). The composite reliability of all factors in the final measurement model was above 0.60, indicating acceptable construct reliability. Conclusion The newly developed HPB-Bloat scale is valid and reliable when assessing the awareness of health-promoting behaviours across patients with AB. Further validation is needed across different languages and populations.

Background: Excessive screen time in young children is associated with many harmful consequences including screen dependency. Research has shown a worrying prevalence of media-related dependency among adolescents and pre-school children. There are a few available questionnaires among adolescents but none for pre-school children. This study aimed to design and validate a questionnaire to assess screen dependency among pre-school children aged 4 to 6 years old. Methodology: A cross-sectional two-phase study was carried out to develop the scale. In phase 1, a preliminary parent-report measure questionnaire was developed in Bahasa Malaysia. Later, it was sent to four experts for content validity followed by face validity. In Phase 2, a total of 386 parents of pre-school children aged 4 to 6 years old, split into two samples, were involved in the field study for exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Result: Sample 1 was used to perform EFA to determine the factorial structure of the SDS. All items with a factor loading of >0.4 were included. Sample 2 was used to perform the CFA. RMSEA and CFI analysis showed that the SDS has a good fit and confirms the dimensional structure found via EFA. The final questionnaire consists of 15 items with a 4 factors’ structure and has excellent internal consistency reliability. Conclusions: The Screen Dependency Scale (SDS) is a reliable and valid questionnaire to detect screen dependency among pre-school children aged 4 to 6 years old in Malaysia.