Structural validity of a brief scale adapted to measure adolescent spiritual health

Abstract

Spiritual health is established as an important protective health asset in child populations. Measurement and assessment of this elusive concept are, however, challenging. Brief and age-appropriate instruments are required for surveys and related population health research. One longstanding model describing child spirituality suggests that scales and measures consider four standard domains describing connections to self, others, nature, and the transcendent. In this validation study, we tested the structural validity and internal consistency of a brief, literacy-level appropriate instrument for adolescents that was based on prior adaptations of this model. The 2018 cross-national study population included 47,180 children aged 11–15 years from 9 countries. Based upon theory, factor pattern matrices, and Scree plots, the exploratory factor analysis best supported the four-factor model, with items organized according to the original four domains. Internal consistency of the items was acceptable (alpha>.7) to good (alpha>.8) within domains, again within each of the 9 countries. The confirmatory factor analysis again supported the four-factor model (by country, SRMR: 0.020 to 0.042; and AGFI and NFI fit: >0.98). Model fit indices for the four-factor model were improved compared with its unidimensional version. Moving forward, our analysis establishes the structural validity and internal consistency of this adapted brief spiritual health instrument to be used in surveys of adolescents.

Connections associated with a healthy spirituality: are these unrecognized intermediary determinants that shape health inequities in Canadian young people?

“…On the other hand, the strengths of this analysis include the robust nature of our sample, which is nationally representative and includes young people at formative ages from across our country. Additionally, measures used in our analysis have strong histories in terms of validity and reliability in child populations e.g., [ 13 , 15 , 17 – 20 ], and historical use in our 50 + country international research network e.g., [ 13 – 15 , 19 , 22 , 24 ]. Finally, our statistical analysis was framed using an established theoretical framework [ 1 , 2 ], and our core hypothesis was novel and builds on a strong base of theory and an initial cross-sectional analysis (Michaelson et al, Establishing spirituality as an intermediary determinant of health among 42,843 children from eight countries, In review).…”

“…Participants answered 10 questions in four domains with response options following a 5-point scale ranging from 0- “not at all important” to 4- “very important” [ 13 ]. Individual items described how important it was for them to: “feel that your life has meaning or purpose”; “experience joy (pleasure, happiness) in life” (the “connections to self” domain); “be kind to other people”; “be forgiving of others”; “show respect for other people” (connections to others); “feel connected to nature”; “care for the natural environment” (connections to nature); and “meditate or pray”; “feel a connection to a higher spiritual power”; “feel a sense of belonging to something greater than yourself” (connections to the transcendent).…”

“…Summary scores were obtained for each domain. Cronbach alpha coefficients describing the internal consistencies of the overall scale and sub-scales in the four domains were acceptable (all > 0.7), and confirmatory factor analysis shows that these items fit the underlying latent constructs being summarized and that the module was best analyzed by domain [ 13 ].…”

“…We examined a range of seven health outcomes to examine for consistent effects, in support of eventual causal inference. We also performed analyses by domain of spirituality, as influenced by past psychometric analyses [ 13 ]. Our goals were to broaden understanding of the novel ways that systemic inequities may arise in child populations, and to provide new etiological evidence to support the contention that spirituality is an unrecognized determinant of health, worthy of focused attention.…”

Do Spiritual Health Connections Protect Adolescents When They Are Bullied: A National Study of 12,593 Young Canadians

“…Students answered using a series of items describing the connections using a 5-point Likert-type scale ranging from 1 (“ not at all important ”) to 5 (“ very important ”). Consistent with confirmatory factor analyses that demonstrate that a four-domain model best represents spiritual health measures ( Shaver et al, 2020 ), we created ordinal scores for each domain by summing corresponding domain items (score range 0–8 for self and nature, 0–12 for others and transcendent). We then transformed each domain into a binary variable consisting of “high” (cut point of scores >5 for self and nature, scores >9 for others and transcendent) versus “low” connections.…”