Validation of the Family Health Behavior Scale for the Brazilian population

Authors: PRETO, LUIZA - Pontifical Catholic University; SCARPATTO, CAMILA - Pontifical Catholic University; GAUDIE LEY, LAURA - Pontifical Catholic University; SILVEIRA, CAROLINA - Pontifical Catholic University; SALERNO, MARGARETH - Pontifical Catholic University; MORENO, JENNETTE - Children'S Nutrition Research Center (CNRC); DE JESUS CASTRO, STELA - Universidade Federal Do Rio Grande Do Norte; BOOIJ, LINDA - University Of Montreal; MATTIELLO, RITA - Pontifical Catholic University

Submitted to: Jornal de Pediatria
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 4/6/2021
Publication Date: 5/6/2021
Citation: Preto, L.T., Scarpatto, C.H., Gaudie Ley, L.L., Silveira, C., Salerno, M.R., Moreno, J.P., de Jesus Castro, S.M., Booij, L., Mattiello, R. 2021. Validation of the Family Health Behavior Scale for the Brazilian population. Jornal de Pediatria. https://doi.org/10.1016/j.jped.2021.04.002.
DOI: https://doi.org/10.1016/j.jped.2021.04.002

Interpretive Summary: Various studies around the world indicate that the percentages of overweight and obesity in childhood and adolescence are high. As a result, it would be useful to have a common, culturally sensitive instrument to assess health behaviors of families allowing comparisons across countries. The Family Health Behavior Scale (FHBS) is one of the very few measurements available and that addresses children's dietary habits, physical activity and parenting practices in a single comprehensive measure. It was originally developed in the United States and has been adapted and validated for the Spanish population. The aim of this study was adapt the Family Health Behavior Scale (FHBS) for Brazilian families and validate this Portuguese version for use in Brazil. Evaluation of the Portuguese version of the Family Health Behavior Scale (FHBS) suggests that it performs well as a measure of family health behaviors related to obesity among Brazilian children.

Technical Abstract: Our objective was to validate the Family Health Behavior Scale (FHBS) for Brazilian families. The sample included 272 children aged 5 to 12 years old. Caregivers and their healthy answered the FHBS and questions about physical activity. In addition, anthropometric measurements of the children's weight and height were performed, as well as the bioimpedance exam. The scale was translated and the following validities were assessed: content (qualitative analysis and content validity index), construct (factor analysis) and concurrent validity (difference between domains and the total score with the categories of BMI, fat percentage and physical activity). Reliability (Cronbach's alpha, ceiling-floor effect, two-half test, intraclass correlation and Bland-Altman) was also assessed. The FHBS instrument performed well with regard to the psychometric properties in the Brazilian population. The content validity index was 0.987. Fit indices of the factor analysis were considered satisfactory, according to Bartlett's sphericity test (chi-square=1927, df=351; p<0.001) and the Kaiser-Meyer-Olkin index (KMO=0.789). Concurrent validity, the differences between the mean of the domains and the total score between the categories of BMI (p=0.011), percentage of fat (0.004) and physical activity (p<0.001) were all significant. The reliability results were Cronbach's alpha internal consistency = 0.83, adequate ceiling-floor effect, 0.8105 (0.09 SD) two-half test, 0.626 intraclass correlation (95% CI: 0.406 to 0.777) and Bland-Altman -0.840 (-22.76 to 21.07). The FHBS adapted for the Brazilian population showed evidence of adequate psychometric performance.