Journal of Education and Health Promotion

Abstract BACKGROUND: During clinical practicum, nursing students are subjected to stressors that can
affect their well‑being, academic performance, and technical skills. The purpose of this study was to
evaluate the psychometric properties of the Arabic version of the Perceived Stress Scale of Clinical
Practicum (PSS‑CP) in a sample of Moroccan nursing students.
MATERIALS AND METHODS: In this study, a translation and back‑translation method and
comparisons were made with the original version. The study population consisted of 215 nursing
students. The construct validity of PSS‑CP was measured using exploratory (EFA) and confirmatory
factor analysis (CFA). Convergent validity was demonstrated by correlation with the Arabic version
of the Depression, Anxiety, and Stress Scale (DASS‑21). For reliability, Cronbach’s alpha and test–
re‑test reliability (with a 10‑day interval) were used. Data were analyzed using IBM SPSS Statistics
V. 23.0 (SPSS) and AMOS V.21.0 (SPSS) software.
RESULTS: The results showed that the PSS‑CP is a reliable and valid scale with good internal
consistency and test–re‑test reliability. In terms of convergent validity, the PSS‑CP showed a positive
and significant correlation with the DASS‑21 scale items. The results of this study led to a two‑factor
model consisting of 29 items.
CONCLUSION: The PSS‑CP is a valid and reliable instrument for assessing clinical stressors among
nursing students in Morocco.

Abstract BACKGROUND: Assessment of the patient safety competency is necessary for the growth of nursing
and safe care profession as well as evaluation of the nurses’ educational needs. The present study
was conducted to determine psychometric properties of the Persian version of the patient safety
competency self‑evaluation (PSCSE) tool in Iranian psychiatric wards.
MATERIALS AND METHODS: All nurses (n = 209) working in two psychiatric hospitals of Kerman,
Iran, were included in the present cross‑sectional study using census method. This tool contains 41
items: six items are related to knowledge, 14 items deal with attitude, and 21 items are about skill
dimension. Psychometric properties of the questionnaire including its content and face validity were
also examined. The factor structure of the questionnaire was evaluated using exploratory factor
analysis. The internal consistency and reliability were assessed by test–retest method with an interval
of 14 days. Cronbach’s alpha and corrected item‑total correlation were used to measure reliability.
RESULTS: The content validity index was 0.65 and the content validity ratio was 0.89. Item 14 was
removed from the skill domain because it was not related to the psychiatric ward. According to the
results of factor analysis, there was a significant relationship between the questions and the relevant
factors. The correlation coefficient for test–retest with 14 days interval was intraclass correlation
coefficient = 0.92 for the whole instrument and 0.89, 0.89, and 0.92 for the domains of knowledge,
attitude, and skill, respectively. The internal consistency coefficient (Cronbach’s alpha) of the whole
tool was 0.95 and 0.95, 0.79, and 0.95 for the domains of knowledge, attitude, and skill, respectively.
Finally, PSCSE Questionnaire was obtained with 40 items in dimensions of knowledge (6 items),
attitude (14 items), and skills (20 items).
CONCLUSION: Persian version of the nurses’ competency tool in ensuring patient safety in psychiatric
wards has acceptable psychometric characteristics.

Abstract BACKGROUND: Online learning self‑efficacy is considered a major contributor to academic success. 
The present study was conducted to assess the psychometric properties of the Persian version of 
the Online Learning Self‑Efficacy Scale.
MATERIALS AND METHODS: A cross‑sectional study was conducted on 211 medical students at 
Kerman University of Medical Sciences in 2021 who were selected through the convenience method. 
Data were collected using a two‑part self‑administered online questionnaire containing demographic 
information and the Persian version of the Online Learning Self‑Efficacy Scale (OLSES). Forward and 
back‑translation methods were used to provide the Persian version of OLSES. Internal consistency 
of the Persian version was determined by the Cronbach alpha coefficient in a pilot study. Exploratory 
and confirmatory factor analyses were conducted using SPSS version 20.0 and LISREL version 8.80.
RESULTS: The mean of the participants’ age was 21.40 ± 2.52 years, and most of them (56.4%) 
were female. The Cronbach alpha coefficient was determined as 0.74, 0.90, 0.75, and 0.89 for 
learning, time management, technology use subscales, and the whole scale, respectively. Exploratory 
factors analysis revealed the justifiability of factor analysis. In confirmatory factor analysis, most of 
the goodness of fit indices had an acceptable level.
CONCLUSIONS: Our study found that the Persian version of OLSES had good psychometric 
properties and can be used as a simple, valid, and reliable tool to assess students’ self‑efficacy 
related to the e‑learning environment.

Abstract BACKGROUND: Effective clinical teaching is crucially important for patient care in future. Therefore, 
proper clinical training is essential to make physicians capable of delivering high‑quality health care.
MATERIALS AND METHODS: The present study was a cross‑sectional research. After translating 
the questionnaire into Persian, it was distributed among medical students in the clinical years of 
medical education in teaching hospitals affiliated to Ahvaz Jundishapur University of Medical Sciences 
in 2018. The System for Evaluation of Teaching Qualities (SETQ) has 25 questions in a 6‑scale 
Likert scale that evaluates clinical tutors in five dimensions of teaching and learning environment, 
professional attitude toward students, transferring of goals, evaluation of students, feedback, and 
promoting self‑directed learning. Instrument reliability was assessed by calculating the Cronbach’s 
alpha coefficient, whereas questionnaire content validity was evaluated by relative content validity 
ratio (CVR) and content validity index (CVI). To evaluate the structural validity, an exploratory factor 
analysis was conducted.
RESULTS: The SETQ was completed by 127 medical students. Cronbach’s alpha coefficient of the 
total questionnaire was estimated as 0.908. The factor analysis showed that the questionnaire was 
composed of six factors, explaining 66.14% of the total variance. The CVI and CVR indices of the 
individual items were also acceptable.
CONCLUSION: The findings of our study showed that the Persian version of SETQ questionnaire had 
the acceptable reliability and validity to be used in assessing clinical tutors in different hospitals in Iran.

Abstract BACKGROUND: In the coronavirus disease 2019 pandemic era, clinical programs and mandatory 
hands‑on activities have been supplanted by remote teaching to maintain the fundamental capabilities 
of medical training and to furnish medical students with quality education. Nonetheless, the satisfaction 
of faculty members with this training method in the current pandemic has yet to be assessed. The 
aim of this study was to design a Persian questionnaire with appropriate validity and reliability on 
cardiology professors’ satisfaction level with virtual education.
MATERIALS AND METHODS: In this cross‑sectional study, a questionnaire was devised drawing 
upon scientific sources and Iranian medical educators’ expertise. Seventeen faculty members 
in various specialties evaluated the questionnaire concerning face and content validity. Content 
validity was assessed through the calculation of the content validity ratio (CVR) (values >0.62 
were considered acceptable) and the content validity index (CVI) (values >0.79 were considered 
acceptable), construct validity was evaluated through principal component factor analysis by the 
Kaiser–Meyer–Olkin (KMO) statistic and Bartlett’s sphericity test, internal reliability was measured 
through the calculation of Cronbach’s alpha coefficient, and consistency was appraised through the 
use of test‑retest reliability at two different time points.
RESULTS: The questionnaire had a reliability rate of 95%, indicating high internal validity. Concerning 
test‑retest reliability, the intraclass correlation coefficient was 0.96 (P < 0.001), demonstrating relatively 
good stability. The CVI was 0.81, and the CVR was 0.85. The KMO measure of sampling adequacy 
was 0.954, indicating the acceptability of the degree of common variance among the all items.
CONCLUSIONS: This Persian questionnaire on virtual education aimed at cardiology faculty members 
in the current pandemic with its low question count and appropriate domains had high reliability 
and validity. By knowing the level of professors’ satisfaction with the new method of education, it 
is possible to take steps to better provide specialized medical education to cardiology residents.

Abstract BACKGROUND: This study aimed to investigate the psychometric properties of children’s
somatization inventory (CSI‑24) in a sample of Iranian school adolescents.
MATERIALS AND METHODS: In this study, after translating and back‑translating CSI‑24,
comparisons were made with the original version. The study population consisted of 394 school
adolescents. Cronbach’s alpha method was used to examine the reliability of the scale. Furthermore,
the correlation of the scale with the Symptom Checklist‑90‑Revised was evaluated to determine its
criterion validity, using Pearson’s correlation coefficient. Exploratory and confirmatory factor analysis
methods were applied for construct validity.
RESULTS: Investigation of the psychometric properties of the Iranian version of CSI‑24 showed its
high reliability and confirmatory factor analysis results show the model’s satisfactory fitting.
CONCLUSION: The Persian version of CSI‑24 is a useful self‑report tool for evaluating the physical
complaints of Iranian school adolescents aged between 12 and 18 years.

Abstract BACKGROUND: It has been realized by senior researchers that interest in biostatistics is very poor
among medical professionals. Knowledge of biostatistics plays an important role in medical research.
Studies conducted about knowledge, attitude toward biostatistics by many researchers, but there were
no works about factors in relation to it. Considering this gap, we tried to develop a new instrument.
MATERIALS AND METHODS: Item generation and questionnaire formation were done using focus
group discussion involving seven experts from different departments of medical colleges. Face validity
and content validity and pilot testing were carried out step by step. In estimating reliability, internal
consistency measured after collecting data from 66 study participants. Data were collected through
self‑administered paper‑based questionnaire where response in each item was in five‑point Likert
scale. Cronbach’s alpha for reliability analysis was used.
RESULTS: In first stage, item generation through FGD, then face validity was assessed by senior
faculties. Content validity was checked by Aiken’s V index. In initial stages, with six items, Cronbach’s
alpha was 0.805. Scale mean and variance were 24.24 and 27.26. After final reliability testing, it
became 0.866 with four items where scale mean and variance came to 15.85 and 16.38.
CONCLUSION: All the six items were important factors. Reliability improved when knowledge in
statistics in higher secondary level and biostatistics classes in PG course were eliminated as factors.
More qualitative research is needed for better understanding of this concept.

Abstract BACKGROUND: Demanding careers like medicine requires a lot of motivation and the Academic
Motivation Scale (AMS) developed by Vallerand et al. (1992) is an instrument to measure motivation.
This study evaluated the validity and reliability of AMS among medical students in the Middle East.
MATERIALS AND METHODS: This was a methodological research utilizing a convenient sampling
technique. AMS scale comprising 28 items subdivided into seven subscales was administered to 900
students (281 students returned the filled AMS). Data were analyzed using the descriptive statistics,
one‑way ANOVA, and t‑tests. Exploratory factor analysis and Cronbach’s alpha were used to evaluate
the validity and reliability of the scale, respectively.
RESULTS: There was a statistically significant difference between both genders in overall
scores (P = 0.015*), two subscales, namely “Identified Regulation” (P =0.017*) and “Stimulating
Experience” (P = 0.015*), with females showing higher value. Second‑year students (n = 91) had
significantly higher score (10.9 ± 4.1) for “Amotivation” (P =.001*) and first‑year students (n = 48)
had significantly higher score (16.2 ± 3.0) for “Achievement” subscale (P =.014*). P < 0.05
was considered statistically significant with 95% confidence interval. No statistically significant
difference was observed between the groups based on nationality or age. Bartlett’s test of
sphericity was significant (Chi‑square: 2988.010; df = 278; P < 0.001). Kaiser–Meyer–Olkin
was 0.890. Principal component analysis with varimax rotation extracted seven factors
corresponding to the original items of AMS questionnaire. All subscales correlated positively
except “amotivation.” Structural equation modeling revealed the relation between observed
and unobserved variables.
DISCUSSION: This study demonstrated that AMS is valid and reliable for application among Middle
East medical students, without needing any modification. AMS has widespread application in medical
education as it impacts learning outcomes.
CONCLUSION: This study demonstrated that AMS is valid and reliable for application among the
Middle East students without needing any modification.

Abstract BACKGROUND: The coronavirus disease 2019 (COVID‑19) pandemic has prompted the further
virtualization of medical education. The satisfaction level of specific users such as cardiology residents
with virtual education can augment its quality; hence, the significance of a valid and reliable questionnaire
to obtain feedback is needed. This study aimed to design and measure validity and reliability of a
satisfaction questionnaire for virtual education of cardiology residents during COVID‑19 pandemic.
MATERIALS AND METHODS: In this cross‑sectional study, a self‑administered questionnaire
was developed by the faculty members of Rajaie Cardiovascular Medical and Research Center.
Reliability was tested utilizing Cronbach’s alpha  and intercorrelation which was tested using Pearson’s
correlation coefficient test (ICC). Factor analysis was done by the Kaiser–Meyer–Olkin measure of
sampling adequacy and Bartlett’s sphericity test. The statistical analyses were performed with the
SPSS software version 22.
RESULTS: The face validity index was determined via an assessment of the relevance, clarity, and
simplicity of each item, and values >0.79 were accepted. The total Cronbach’s alpha coefficient was
calculated 0.93. Concerning test–retest reliability, the correlation between two rounds of evaluation
was >80 (P > 0.001) and ICC was 0.99 (P = 0.001). The content validity evaluation yielded an index of
0.95 and a ratio of 0.91. The principal component factor analysis, conducted to investigate construct
validity, generated four domains.
CONCLUSIONS: The study results confirmed the validity and reliability of the designed questionnaire
to evaluate the level of satisfaction of cardiology residents with virtual learning in COVID‑19 pandemic.

Abstract BACKGROUND: Cardiovascular diseases are among progressive diseases that begin in childhood
and are manifested mainly in adulthood. This study was assessed the validity and reliability testing
of the Persian version of the Perceived Health Competence Scale (PHCS) among patients with
cardiovascular diseases referred to Shahid Rajaie Heart center in Tehran, Iran.
METHODS: In this cross‑sectional study, a convenience sample of 700 patients with cardiovascular
diseases referring to Shahid Rajaie Heart center in Tehran were recruited (response rate = 100%;
n = 700). Content validity was established using translation and back‑translation procedure and getting
views of the expert panel. The content validity of the questionnaire was measured using content
validity ratio (CVR) and content validity index (CVI). Reliability was ascertained using Cronbach’s
alpha. The stability was confirmed using intra‑class correlation coefficients.
RESULTS: In this study, CVI = 0.81 and CVR = 0.72 were calculated. Scale reliability was sufficient
(α = 0.78; range = 0.73–0.77). Furthermore, reliability based on the stability of the whole scale was
0.75.
CONCLUSIONS: The PHCS‑Persian confirmed as a valid and reliable instrument to measure
perceived health competence. The PHCS‑Persian scale could be a useful, comprehensive, and
culturally sensitive scale for assessing perceived health competence.

Abstract BACKGROUND: Nurses’ knowledge and Experience with Health Literacy can affect the treatment
process, improving the quality of health care and effectively communicating with all clients. Evaluation
of nurses’ knowledge and experience requires a reliable instrument. This study aimed to translate
cross‑cultural adaptation and testing of Health Literacy Knowledge and Experience Survey (HL‑KES).
MATERIALS AND METHODS: This cross‑sectional methodological study was done during 2018–2019.
The study was carried out in two stages: the first phase was designed to obtain a translation and
cross‑cultural equivalent of the (HL‑KES), based on the World Health Organization (2018) and the
Sousa and Rojjanasrirat (2011) Guidelines in six steps: preparation, forward translation, reconciliation,
back translation, back translation review and pretesting and cognitive debriefing of the translated
questionnaires. The second phase was conducted to evaluate the psychometric properties of the
questionnaire.
RESULTS: The content validity index and content validity ratio values of all items were >0.62 and
0.79, respectively. Based on the Kuder–Richardson formula, the reliability of the knowledge dimension
was reported as 0.7. Furthermore, split‑half coefficient for inter‑rather reliability and test–retest were
0.76 and 0.96, respectively. The reliability of their experiences with the HL‑KES was measured using
Cronbach’s alpha, in which it was 0.82.
CONCLUSIONS: The Persian version of the instrument for assessing nurses’ knowledge and
experience with health literacy had good validity and reliability. It is recommended that it should be
used in educational, clinical environments, and also in future research studies.

Abstract INTRODUCTION: Aging and chronic diseases associated with nutrition are increasing in the world;
therefore, access to a tool for assessing nutritional literacy in the elderly is necessary. Therefore,
the present study was carried out with the aim of psychometric evaluation of nutritional literacy in
the elderly.
MATERIALS AND METHODS: This study was carried out to psychometric testing of the Nutrition
Literacy Scale (NLS), through the validity and reliability of the tool in 280 elderly people (60 years of
age and older) in Tehran. The validity of this tool was determined through the methods of translation,
face and content and reliability of the tool through the methods of test–retest and internal consistency.
Finally, the tool was analyzed using SPSS software version 16.
RESULTS: In this study, content validity index (CVI) was calculated for each item; CVI average
was 0.86.5. To determine the reliability of the tool, interclass correlation coefficient was calculated
by measuring the instrument’s stability, and it was 0.92. Exploratory factor analysis confirmed the
existence of six factors in the questionnaire, which was named nutritional information, healthy
nutrition, calorie intake, organic foods, saturated fats, and unit size, which explains 43% of the total
variance. Furthermore, in the internal consistency assessment, the questionnaire was completed
by 280 elderly people, and the Cronbach’s α coefficient was 0.80.
CONCLUSION: Based on the results obtained in the reliability and validity assessment, NLS in
Iranian elderly has a desirable reliability and validity. This questionnaire has been translated into
Persian for the first time. The results of this study provide a standard tool for assessing nutritional
literacy status in Persian language communities.

Abstract INTRODUCTION: As an important factor in the quality of nursing care, cultural competence of nurses
should be assessed to improve the quality of care provided. Nursing care is sensitive to culture;
therefore, it is necessary to design a tool for evaluation of cultural competence. In this regard, the
present study intended to develop a cultural competence questionnaire for Iranian nurses.
MATERIALS AND METHODS: In this methodological study, 350 nurses working in all educational
hospitals affiliated to Tabriz University of Medical Sciences were selected through convenience
sampling. Questions related to cultural care were selected by experts of this field, and a questionnaire
was designed and its validity and reliability were examined.
RESULTS: A 20‑item questionnaire was developed which assessed the three areas of learning and
education, awareness and knowledge, and skills. Cronbach’s alpha of the whole questionnaire was
0.912, and its validity based on the Kaiser–Mayer–Olkin Index was 0.891.
CONCLUSION: This study provides proper evidence regarding the strength of factor structure and
the reliability of the developed questionnaire; therefore, it can be considered as a scientific tool for
research, educational, and practical purposes in Iranian nurses.

Abstract BACKGROUND: The content of the mass media is a suitable tool for making changes to the society.
One of the most read news in the mass media is nutritional information. The goal of this study is to
assess the scientific authenticity of such information published in Iranian popular magazines.
MATERIALS AND METHODS: This study is a qualitative study (content analysis) and uses
bibliographic approach. A researcher‑designed checklist is used as data gathering tool, and the
statistical population included the messages obtained from the printed material in 173 volumes
of 8 Iranian popular magazines. 10 most frequent messages were identified, and their scientific
authenticity was investigated using Pubmed and IranMedex databases. The SPSS Software
version 24 (IBM Corporation, Armonk, New York, USA) was applied in the analysis of this work.
RESULTS: The findings indicated that preventive trends had the highest (86.8%) and the treatments
had the lowest (4.2%) frequency. Concerning the type of cancer, more than half (51.2%) of the
conclusions were about cancer. Regarding authorship, 68% of articles were author signed, but the
profession of 66.4% of the authors was not clear. Regarding references, only 25.4% of the articles
had validated references.
CONCLUSION: It is revealed that 70% of the “nutrition information” related to cancer which was
published in the popular magazines during 2012, considered to be acceptable according to scientific
medical information sources. Although in some cases, the amount of evidence is not sufficient.
Finally, it could be deduced that the nutrition information published in the Iranian popular magazines
are still credible.

Abstract AIM: To translate OHIP‑14 into Hindi and test its psychometric properties among school teacher
community.
METHODS: The OHIP‑14 was translated to OHIP‑14‑H using WHO recommended translation
protocol. During pre‑testing, an expert panel assessed content validity of the questionnaire. Face
validity was assessed on a sample of 10 individuals. The OHIP‑14‑H was administered on a random
sample of 170 primary school teachers. Internal consistency and test‑retest reliability were assessed
using Cronbach’s alpha and Intra‑class correlation coefficient (ICC) respectively, with 2 weeks
interval. Predictive validity was tested by comparing OHIP‑14‑H scores with clinical parameters.
The concurrent validity was assessed using self‑reported oral health and discriminant validity was
ascertained through negative association with sociodemographic variables.
RESULTS: The mean OHIP‑14‑H score was 9.57 (S.D = 4.58). ICC and Cronbach’s alpha
for OHIP‑14‑H was 0.96 and 0.92 respectively. Concurrent validity using binomial regression
model indicated that good (OR = 0.56, 95% CI = 0.55 – 4.47) and moderate (OR = 0.25, 95%
CI = 0.17 – 1.87) OHIP‑14‑H scores were negative but significant risk indicators of poor self reported
oral health (P < 0.009). Significant predictive validity was observed between OHIP‑14‑H scores and
clinical parameters (P < 0.000).
CONCLUSION: Translated and culturally adapted OHIP‑14‑H indicates good reliability and validity
among primary school teachers.

Abstract BACKGROUND: This study was aimed at developing and studying the scale of self‑efficacy in
adherence to treatment in Iranian patients with hypertension.
METHODS: A mix‑method study was conducted on the two stages: in the first phase, a qualitative
study was done using content analysis through deep and semi‑structured interviews. After data
analysis, the draft of tool was prepared. Items in the draft were selected based on the extracted
concepts. In the second phase, validity and reliability of the instrument were implemented using a
quantitative study. The prepared instrument in the first phase was studied among 612 participants. To
test the construct validity and internal consistency, exploratory factor analysis and Cronbach’s alpha
were used, respectively. To study the validity of the final scale, the average score of self‑efficacy in
patients with controlled hypertension were compared with patients with uncontrolled hypertension.
RESULTS: In overall, 16 patients were interviewed. Twenty‑six items were developed to assess
different concepts of self‑efficacy. Concept‑related items were extracted from interviews to study
the face validity of the tool from patient’s point of view. Four items were deleted because scored
0.79 in content validity. The mean of questionnaire content validity was 0.85. Items were collected
in two factors with an eigenvalue >1. Four items were deleted with load factor <0.4. Reliability was
0.84 for the entire instrument.
CONCLUSION: Self‑efficacy scale in patients with hypertension is a valid and reliable instrument that
can effectively evaluate the self‑efficacy in medication adherence in the management of hypertension.

Abstract Introduction: The rate of caesarean delivery is increasing worldwide. Maternal beliefs may be
influential on the mode of delivery. This study aimed to validate pregnant women’s preferences
for mode of delivery questionnaire among pregnant women. Materials and Methods: This was
a cross‑sectional study which was done in Ahvaz Public and Private Health Care Centers. A total
of 342 low‑risk pregnant women were included in a study conducted in spring 2011 in Ahvaz,
Iran. After careful consideration and performing content and face validity, a 62‑item measure
was developed and subjects completed the questionnaire. Reliability was estimated using
internal consistency and validity was assessed by performing face, content and structure and
discriminate validity. Data were analyzed using explanatory factor analysis, t‑test, and correlations
in SPSS 16. Results: The findings of content and face validity showed almost perfect results for
both content validity ratio = 1 and content validity index = 1. The explanatory factor analysis
indicated a 7‑subscale measure (Eigenvalue >1, factor loading >0.4), and discriminate validity
revealed satisfying results P < 0.05 for 6 out of 7 subscales. Internal consistency as measured
by the Cronbach’s alpha coefficient was acceptable for subscales. Conclusions: In general,
the findings suggest that this newly generated scale is a reliable and valid specific questionnaire
for assessing pregnant women’s preferences for mode of delivery. However, further studies are
needed to establish stronger psychometric properties for the questionnaire.

Abstract Background: Today, the dental practitioners are finding many more medically compromised
patients in their practice. Aims: The aim of this study was standardization of the European
Medical Risk Related History (EMRRH) questionnaire for use among Persian population.
Materials and Methods: The English original version of the EMRRH questionnaire was translated
into Persian language by a forward–backward translation method. Then reliability was tested
on 50 subjects. Also, the sensitivity, specificity, and validity of the questionnaire were assessed.
Statistical Analysis Used: Cohen’s kappa, a measure of agreement between observers that
includes an adjustment for chance agreement, was likewise calculated. Results: The reliability
coefficient (Cronbach’s alpha) of the EMRRH was above the recommended 0.7 threshold
and considered excellent (alpha 0.87). Specificity of the questions was 94% and of per
EMRRH item was 93%. Sensitivity per question was 86.1% and of per EMRRH item was
94%. Cohen’s kappa for the questionnaire was 0.89 and for subsequent questions was 0.82.
Conclusions: The EMRRH (Persian version) has been shown to be valid in comparison with
the gold standard (a medical history taken by a physician experienced) and this instrument
would be an effectual method of history taking for the dentist.

Abstract Introduction: Measurement tools designed to ensure the achievements of studies’ objectives
must be evaluated. Based on the health promotion model (HPM), the present study was
conducted to assess the validity and reliability of the designed questionnaire of hypertensive
patients’ nutritional perceptions. Methodology: In a cross‑sectional study, the mentioned
questionnaire was assessed based on opinions of 11 experienced faculty members and
671 hypertensive patients in rural areas in the year 2013. To evaluate the reliability, internal
consistency (Cronbach’s alpha) was calculated. Concerning the validity of the questionnaire,
its content and construct validity were examined. Data analysis was performed using
Statistical Package for the Social Sciences version 18 (SPSS Inc., Chicago, IL, USA).
Results: Spearman‑Brown and Cronbach’s alpha coefficients results were acceptable in all
constructs indicating a satisfactory reliability of the questionnaire. Questionnaire’s questions
were highly correlated with the total score signifying the internal consistency of the questions;
therefore, all questions had a similar effect on the total score and the removal of each did no
increase the alpha significantly (all questions had acceptable reliability). Factor analyses showed
that all questions had acceptable factor loading and suitable validity. Moreover, the entire
constructs of the questionnaire were approved by experts with high validity coefficient of 0.9.
Conclusion: The designed questionnaire for assessment of the HPM constructs regarding
hypertensive patients’ nutritional issues had appropriate psychometric characteristics. Reliability
and validity of the questionnaire were also satisfactory and its overall structure was approved.

Abstract Background: Effective safety education can prevent many occupational accidents. To educate
the public about safety effectively, determinants of safe behavior must be addressed. Personality
constructs are among the most important determinants of safe behavior. One of the personality
constructs that has been studied recently in relation to accidents is locus of control. The main
aim of this study was designing, validating, and determining the reliability of safety locus of
control scale. Materials and Methods: This study was a descriptive, cross‑sectional study. The
“forward–backward” procedure was applied to translate safety locus of control scale (Jones
and Becker 1985) from English to Persian. To determine the scientific validity of the scale , face
validity and content validity by expert judgments were used. Internal consistency was determined
using Cronbach’s α‑coefficient. Questionnaires were distributed to a group of 400 workers from
different parts of Isfahan Steel Company. Finally, 317 workers completed the questionnaires.
Exploratory factor analysis was performed with software SPSS13, and confirmatory factor
analysis was performed with software LISREL8.8. Results: The exploratory factor analysis
results revealed that the three components of the items can be extracted from the scale including
internal control (4 questions), environmental and equipment control (4 questions), and chance
and fate (4 questions). Confirmatory factor analysis using maximum likelihood estimation results
indicated that the data had good fit with three‑component scale and fit indices were acceptable:
c2
∕df=3.96, df=41, c2
=120.59, RMSIA=0.080, 95% Confidence Interval=0.64–0.097, CFI=0.96,
GFI=0.94, AGFI=0.89. The internal control components and equipment and environmental
control were negatively correlated with each other (P≤0.05, r=−0.41). Also, a weak correlation
between chance and fate and environmental and equipment control was seen (P≤0.05, r=0.31).
Conclusion: In most studies, designing a scale and determining its validity and reliability is
costly and time consuming. The available reliable and valid scale leads to reduced costs and
accelerated research. In other words, duplication will be avoided. The scale obtained in this study
can be used in safety and industrial psychology research.

Abstract Background: Lifestyle choices and individuals’ behaviors have the potential to influence
health and improve the quality of life. Objectives: The purpose of this study was to develop
and psychometrically test an instrument for measuring healthy lifestyle in Iranian adolescents.
Materials and Methods: A comprehensive literature review related to health‑promoting lifestyles
was used to identify potential scale items. Data were collected from 797 school students. Construct
validity was analyzed using exploratory factor analysis. Confirmatory factor analysis (CFA) was
used to cross‑validate. Results: Nine factors emerged that explained 59.8% of the variance in
the 43 items. Cronbach’s a coefficient Healthy Lifestyle Questionnaire was r=0.82. After the
model was modified, the fit indices indicated that the data were an adequate‑to‑good fit to the
proposed models. Conclusions: The current study provides some support to the internal and
external validity of the healthy lifestyles questionnaire for Iranian adolescents.