Validation and Reliability of Lifestyle Instruments for Indonesian Adolescents with Hypertension Family History: A Rasch Model

Abstract

BACKGROUND: There are lifestyle changes among adolescents in this modern era, such as less physical activities, because many activities can be carried out using modern technology, unhealthy food habits such as eating junk food, canned food and beverages, and preserved fruits and vegetables, poor sleeping habits, stress, and smoking behavior. These lifestyles are harmful and lead to cardiometabolic diseases such as obesity and hypertension, especially in adolescents with hypertension history in the family.

AIM: This study aimed to assess the validation and reliability of healthy lifestyle instruments for Indonesian adolescents with a family history of hypertension.

METHODS: This study is a survey research conducted from July 2021 to February 2022 in South Sumatera, Indonesia. The subjects were adolescents with a family history of hypertension and recruited using purposive random sampling. Adolescents aged 10–18 years old who returned signed parental consent forms, gave written assent to participate, and completed the questionnaire were included in the study. The questionnaire was consisted of three sections, Section I contained internal factors, Section II related to external factors, and Section III related to healthy lifestyle. The study was approved by the Research Ethics Committee Universitas Padjadjaran Bandung. Winsteps software was used to analyze the validity, reliability, unidimentionality, and rating scale.

RESULTS: Obtained 103 valid question items with OUTFIT values 0.5 < mean square < 1.5; −2.0 < ZSTD < 2.0; and the point measure correlation (Pt Mean Corr) value is in the range of 0.32 < Pt Measure Corr < 0.85. The reliability value of respondents and instruments is 0.88, with a ’Cronbach’s alpha value of 0.95. The raw variance explained by the measured value is 72.3%, and all unexplained variance values are <15%.

CONCLUSIONS: Healthy lifestyle instruments are valid and reliable, so it is feasible to measure the healthy lifestyle of Indonesian adolescents with a family history of hypertension. This instrument can measure the success of a program or intervention in changing a lifestyle in adolescents at risk of developing hypertension, especially adolescents with a family history of hypertension. We suggest further research involving more participants in a broader area. We hope the healthy lifestyle instruments can be used in a standardized manner for all regions of Indonesia.