Validation of a questionnaire to assess stress, tobacco use, physical activity, and dietary supplementation

Diene da Silva Schlickmann; Gabriela Cristina Uebel; Patrícia Molz; Eliane Aparecida  Castro; Caroline dos Santos; Pedro Jose Benito; Silvia Isabel Rech Franke

Diene da Silva Schlickmann Graduate Program in Promotion of Health, Department Health Sciences, University of Santa Cruz do Sul, Santa Cruz do Sul-RS, Brazil.
Gabriela Cristina Uebel Graduate Biomedical Department of Life Sciences University of Santa Cruz do Sul, Santa Cruz do Sul-RS, Brazil
Patrícia Molz Graduate Program in Medicine and Health Sciences, School of Medicine, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre-RS, Brazil.
Eliane Aparecida Castro Universidad Católica de la Santíssima Concepción, Faculty of Education, Department of Sports Sciences and Physycal Conditiononig, Concepción, Chile.
Caroline dos Santos Graduate Program in Promotion of Health, Department Health Sciences, University of Santa Cruz do Sul, Santa Cruz do Sul-RS, Brazil.
Pedro Jose Benito LFE Research Group Universidad Politécnica de Madrid (UPM), Faculty of Physical Activity and Sports Sciences, Department of Health and Human Performance, Madrid Spain Department.
Silvia Isabel Rech Franke Graduate Program in Promotion of Health, Department Health Sciences, University of Santa Cruz do Sul, Santa Cruz do Sul-RS, Brazil.

Keywords: Dietary Supplements, Evaluation Study, Physical Activity, Psychometrics, Validation Study

Abstract

Introduction: Given the large expansion of gyms, reliable instruments are needed to assess and obtain information about the behavior of gym members, and these instruments may be able to assist in the implementation of planning and health promotion strategies in this population. Objective: To develop and validate a questionnaire to assess the lifestyle habits, physical activity, and dietary supplementation of gym members. Materials and Methods: A 44-item questionnaire was developed. The Delphi technique was used for content and appearance validity using the content validity index (CVI). Construct validity was verified by exploratory factor analysis (EFA) in several phases. Reliability analysis was assessed by internal consistency and temporal reproducibility using Cronbach’s alpha and the intraclass correlation coefficient (ICC), respectively. Results: Two rounds of the Delphi technique identified a total CVI of 100%. The final model was composed of eight items, with excellent quality in the EFA adjustment, and distributed into four factors. Internal consistency was adequate in all factors, with ICC 0.997, 0.916, 0.698, and 0.631. Conclusions: This study provides a reliable and valid questionnaire to assess stress, smoking, physical activity, and dietary supplementation of fitness center members.

References

-Amaral, G.G.; Oliveira, V.C.; Azevedo Guimarães, E.A.; Reis, I.A; Fonseca Viegas, S.M.; Pinto, I.C.; Oliveira, M.M. Evaluation of the psychometric properties of the Immunobiological Agent Conservation Assessment Scale. Journal of Nursing Measurement. Vol. 8. 2020. p. 55-65.

-Bailey, R.L.; Gahche, J.J.; Miller, P.E.; Thomas, P.R.; Dwyer, J.T. Why US adults use dietary supplements. JAMA Internal Medicine Vol. 173. Num. 5. 2013 p. 355-361. Available from: https://pubmed.ncbi.nlm.nih.gov/23381623/

-Baumann, F.; Weber, J.; Mahr, D.; Bäumlein, M.; Kerschbaum, M.; Müller, K. Joint awareness in posttraumatic osteoarthritis of the knee: Validation of the forgotten joint score in long term condition after tibial plateau fracture. Health and Quality of Life Outcomes. Vol. 15. Num. 1. 2017. p. 1-7.

-Bellucci, J.A.; Matsuda, L.M. Construção e validação de instrumento para avaliação do Acolhimento com Classificação de Risco. Revista Brasileira de Enfermagem. Vol. 65. 2012. p.751-7.

-Biggs, J.M.; Morgan, J.A.; Lardieri, A.B.; Kishk, O.A.; Klein-Schwartz, W. Abuse and misuse of selected dietary supplements among adolescents: A look at poison center data. The Journal of Pediatric Pharmacology and Therapeutics. Vol. 22. Num. 6. 2017. p. 385-393. Available from: https://pubmed.ncbi.nlm.nih.gov/29290737/

-Campbell, A.; Carins, J.; Rundle-Thiele, S.; Deshpande, S.; Baker, B. Motivators of indiscriminate and unsafe supplement use among young Australians International Journal of Environmental Research and Public Health. Vol. 18. Num. 19. 2021. p. 1-18. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8507933/

-Christie, A.D.; Seery, E.; Kent, J.A. Physical activity, sleep quality, and self-reported fatigue across the adult lifespan. Experimental Gerontology. Vol. 77. 2016. p. 7-11. Disponível em: https://pubmed.ncbi.nlm.nih.gov/26853493/

-Cunha, C.M.; Neto, O.P.A.; Stackfteh R. Main psychometric evaluation methods of measuring instrument’s reliability. Revista de Atenção à Saúde. Vol. 14. 2016. p. 98-103.

-Dart, H.; Nguyen, N.; Colditz, G.A. Physical Activity and Chronic Disease Prevention. In the Young Female Athlete. 2016. p481-514.

-Denovan, A.; Macaskill, A.; Building resilience to stress through leisure activities: A qualitative analysis. Annals of Leisure Research. Vol. 20. Num. 4. 2017. p. 446-466.

-Dubnov-Raz, G.; Lahav, Y.; Constantini, N.W. Non-nutrients in sports nutrition: Fluids, electrolytes, and ergogenic aids. e-SPEN, the European e-Journal of Clinical Nutrition and Metabolism. Vol. 6. Num. 4. 2011. p. e217-e222.

-Echevarría-Guanilo, M.E.; Gonçalves, N.; Romanoski, P.J. Psychometric properties of measurement instruments: Conceptual bases and evaluation methods - part I. Texto e Contexto Enfermagem. Vol. 26. Num 4. 2017. p. 1-12.

-Field, A.; Field, A. Descobrindo a Estatística usando o SPSS. 2nd ed. Porto Alegre. Artmed. 684 p. 2009.

-Gómez-Carmona, PM.; Cervera, V.; Benito, P.J. Design and validation of a socio-emotional questionnaire for youth football players. Revista Internacional de Medicina y Ciencias de la Actividad Física y del Deporte. Vol. 14. Num. 55. 2014. p.545-559. Available from: https://www.redalyc.org/pdf/542/54231902010.pdf

-15-Hair, J.; Black, W. C.; Babin, B. J.; Anderson, R. E.; Tatham, R. L. Multivariate data analysis. 6th (ed.) Prentice-Hall. Upper Saddle River NJ. 2010.

-Hirschbruch, M.D.; Carvalho, J.R. Nutrição Esportiva: uma visão prática. Manole. 2002.

-Jawad, A.H.; Addar, A.M.; Alazzam, A.S.; Alrabieah, F.O.; Al Alsheikh, A.S.; Amer, R.R. Prevalence of dietary supplements use among gymnasium users. Journal of Nutrition and Metabolismo. 2017. Available from: https://www.hindawi.com/journals/jnme/2017/9219361/

-Jung, M.; Lee, S.B.; Kim, J.; Kim, H.J.; Ko, B.S.; Son, B.H. A Mobile Technology for Collecting Patient-Reported Physical Activity and Distress Outcomes: Cross-Sectional Cohort Study. JMIR mHealth and uHealth. Vol. 8. Num. 5. 2020. p. e17320. Disponível em: https://pubmed.ncbi.nlm.nih.gov/32364508/

-Keszei, A.P.; Novak, M.; Streiner, D.L. Introduction to health measurement scales. Journal of psychosomatic research. Vol. 68. Num. 4. 2010. p. 319-323. Available from: https://pubmed.ncbi.nlm.nih.gov/20307697/

-Liz, C.M.; Andrade, A. Qualitative analysis of the reasons to the adhesion and desistance to the practice of resistance exercises in gyms. Revista Brasileira de Ciências do Esporte. Vol. 38. 2016. p. 267-274.

-Malacarne, M.P.; Luiz, S.G.; Amaral, T.R.; Siqueira, M.M. Avaliação de serviços de saúde no campo da Saúde Coletiva: uma sistematização em curso. Revista Brasileira de Pesquisa em Saúde. Vol. 18. Num. 1. 2016. p. 62-67.

-Mendes, K.D.S.; Silveira, R.C.C.P.; Galvão, C.M. Revisão integrativa: método de pesquisa para a incorporação de evidências na saúde e na enfermagem. Texto & contexto-enfermagem. Vol. 17. 2008. p. 758-764.

-Monteiro, G.T.R.; Hora, H.R.M. Pesquisa em Saúde Pública: como desenvolver e validar instrumentos de coleta de dados. Curitiba. Appris. 2014. p. 114.

-Moore, S.C.; Patel, A.V.; Matthews, C.E.; Berrington de Gonzalez, A.; Park, Y.; Katki, H.A. Leisure time physical activity of moderate to vigorous intensity and mortality: a largepooled cohort analysis. PLoS Med. e1001335. 2012. Available from: https://pubmed.ncbi.nlm.nih.gov/23139642/

-Oliveira, M.M.; Oliveira, V.C.; Ferreira, A.P.; Reis, I.A.; Torres, H.D.C.; Amaral, G.G. Validity of an instrument to evaluate the immunobiological cold chain. Avances en Enfermería. Vol. 38. Num. 2. 2020. p. 170-181. Available from: https://pesquisa.bvsalud.org/portal/resource/pt/biblio-1114687

-Oliver, A.S.; León, M.T.M.; Hernández, E.G. Prevalence of protein supplement use at gyms. Nutrición hospitalaria. Vol. 26. Num. 5. 2011. p. 1168-1174. Available from: https://pubmed.ncbi.nlm.nih.gov/22072369/

-Papathanasiou, G.; Papandreou, M.; Galanos, A.; Kortianou, E.; Tsepis, E.; Kalfakakou, V.; Evangelou, A.; Smoking and physical activity interrelations in health science students. Is smoking associated with physical inactivity in young adults. Hellenic Journal Cardiology. Vol. 53. Num. 1. 2012. p. 17-25. Available from: https://pubmed.ncbi.nlm.nih.gov/22275739/

-Pasquali, L. Instrumentação psicológica: fundamentos e práticas. Porto Alegre. Artmed. 560 p. 2009.

-Pedroso, M.; Sartori, R.F.; Roncada, C.; Dias, C.P. Desenvolvimento e validação de um questionário sobre uso do Facebook voltado para praticantes de atividades físicas em academias. Revista Brasileira de Atividade Física & Saúde. Vol. 22. Num. 4. 2017. p. 382-395.

-Penn, L.; Rodrigues, A.; Haste, A.; Marques, M. M.; Budig, K.; Sainsbury, K.; Sniehotta, F. F. NHS Diabetes Prevention Program in England: formative evaluation of the program in early phase implementation. BMJ Open. Vol. 8. Num. 2. 2018. p. e019467. Available from: https://pubmed.ncbi.nlm.nih.gov/29467134/

-Pereira, R.D.M.; Alvim, N.A.T. Delphi technique in dialogue with nurses on acupuncture as a proposed nursing intervention. Escola Anna Nery. Vol. 19. 2015. p. 174-180. Available from: https://www.redalyc.org/pdf/1277/127737750024.pdf

-Pérez, C.A. Prescribing exercise in tobacco smoking cessation therapy. Archivos de Bronconeumología. Vol. 45. Num. 11. 2009. p. 556-560. Available from: https://www.sciencedirect.com/science/article/abs/pii/S1579212909734172

-Polit, D.F.; Yang, F.M. Measurement and the measurement of change China: Wolters Kluwer. 2016. 350 p. 2016.

-Sala, G.; Jopp, D.; Gobet, F.; Ogawa, M.; Ishioka, Y.; Masui, Y. The impact of leisure activities on older adults’ cognitive function, physical function, and mental health. PloS one. Vol. 14. Num. 1. 2019. p. e0225006. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6839878/

-Salin, K.; Kankaanpää, A.; Hirvensalo, M.; Lounassalo, I.; Yan, G.X.; Magnussen, C.G. Smoking and physical activity trajectories from childhood to midlife. International Journal of Environmental Research and Public health. Vol. 16. Num. 2019. p. 1-14. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6466084/

-Silva, T.G.; Molz, P.; Schlickmann, D.S.; Soares, G.M.; Franke, S.I.R. Comparação da composição corporal entre praticantes de academia que fazem ou não uso de suplementos alimentares. Revista Brasileira de Obesidade, Nutrição e Emagrecimento. São Paulo. Vol. 14. Num. 86. 2020. p. 362-369. Available from: http://www.rbone.com.br/index.php/rbone/article/view/1279

-Scaparo, A.F.; Laus, A.M.; Azevedo, A.L.C.S.; Freitas, M.R.I.; Gabriel, C.S.; Chaves, L.D.P. Reflexões sobre a técnica delphi em pesquisa na enfermagem TT- Reflections on the use of delphi technique in research in nursing. Rev Rene. Vol. 13. Num. 1. 2012. p. 242-251. Available from: https://www.redalyc.org/pdf/3240/324027980026.pdf

-Siqueira, J. P.; Azevedo Guimaraes, E. A.; Oliveira, V. J.; Oliveira, Q. H. F.; Amaral, G.; Oliveira, V. C. Knowledge of healthcare professionals on vaccinations for pregnant women: elaboration and. Revista Cuidare. Vol. 11. Num 1. 2020.

-Sjetne, I.S.; Iversen, H.H.; Holmboe, O.; Helgeland, J. Response probabilities and response ‑ mode preferences in a self ‑ administered survey. BMC Research Notes. Vol. 12. Num. 1. 2019. p. 1-4.

-Souza, L.E.P.F.; Silva, L.M.V.; Hartz, Z.M. A Conferência do consenso sobre a imagem objetivo da descentralização da atenção à saúde no Brasil. In Avaliação em saúde dos modelos teóricos à prática na avaliação de programas e sistemas de saúde. p. 102. 2005.

-Tavakol, M.; Dennick, R. Making sense of Cronbach’s alpha. International journal of medical education. Vol. 2. 2011. p.53-55. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4205511/

-Taylor-Piliae, R. E.; Fair, J. M.; Haskell, W. L.; Varady, A. N.; Iribarren, C.; Hlatky, M. A.; Go, A. S.; Fortmann, S. Validation of the Stanford Brief Activity Survey: Examining Psychological Factors and Physical Activity Levels in Older Adults. Journal of Physical Activity and Health. Vol. 7. Num. 1. 2010. p. 87-94. Available from: https://pubmed.ncbi.nlm.nih.gov/20231759/

-Van Gelder, M.M.H.J.; Bretveld, R.W.; Roeleveld, N. Web-based questionnaires: The future in epidemiology? American Journal of Epidemiology. Vol. 172 n. 11. 2010. p. 1292-1298. Available from: https://academic.oup.com/aje/article/172/11/1292/194147

-Wai, J.P.M.; Tsai, M.K.; Lee, J.H.; Lu, P.J.; Kao, C.; Wen, C.P.; Lin, C.L. Encouraging physical activity for smokers: benefits beyond expectation. Tobacco Induced Diseases. Vol. 16. Num. 1. 2018.

-Warburton, D.E.; Bredin, S.S. Health benefits of physical activity: a systematic review of current systematic reviews. Current opinion in cardiology. Vol. 32. Num. 5. 2017 p. 541-556. Available from: https://pubmed.ncbi.nlm.nih.gov/28708630/

-WHO. World Health Organization. Physical activity. 2018. Available from: https://www.who.int/news-room/factsheets/detail/physical-activity. accessed 6/2020.

-Zhang, C.; Qing, N.; Zhang, S. The Impact of Leisure Activities on the Mental Health of Older Adults: The Mediating Effect of Social Support and Perceived Stress. Journal of Healthcare Engineering. 2021. p.1-11. Available from: https://www.hindawi.com/journals/jhe/2021/6264447/

-Zhou, X.Y.; Xu, X.M.; Fan, J.P.; Wang, F.; Wu, S.Y.; Zhang, Z.C. Cross-cultural validation of simplified Chinese version of spine functional index. Health and quality of life outcomes. Vol. 15. Num. 1. 2017. p. 1-9. Available from: https://pubmed.ncbi.nlm.nih.gov/29047361/