Design and Validation of a Knowledge Questionnaire on Healthy Eating, Personal Hygiene, And Physical Activity (Hephpa) For 8–12-Year-Old School Children

Introduction: Childhood obesity is a complex global challenge linked to genetic, environmental and lifestyle factors, the prevention of which requires changing habits through health promotion and education; however, there is a lack of instruments to study this reality in a comprehensive and articulated manner. Objective: Design and evaluate the reliability and validity of a questionnaire to assess the dimensions of healthy eating, personal hygiene and physical activity in children between 8 and 12 years of age. Method: For this purpose, a study with a non-experimental design was proposed, developed in 5 stages: 1) item construction, 2) content validation by experts, 3) cognitive piloting, 4) analysis of item responses, and 5) reliability assessment. The first version of the self-administered questionnaire with a preliminary battery of 67 items gave way to an initial version of the instrument with 40 questions related to the three main dimensions of the questionnaire. Content validation techniques such as the Content Validity Ratio (CVR) and the Content Validity Index (CVI) were used during the instrument validation process. The 40 items designed were rated by 3 experts. A pilot test was conducted with 221 elementary school students. Results: all items had a CVR greater than 0.5823, indicating that the instrument can be used in its current state. In addition, the CVI value obtained was 0.9650, demonstrating a high content validity of the instrument. This result is revalidated by the high number of agreements among the experts in the “Indispensable” and “Useful but not indispensable” categories (118 out of 120 possible agreements). The internal consistency of the instrument was evaluated by calculating Cronbach's alpha coefficient for the 40 items that make up the three dimensions. The alpha coefficient obtained was 0.960, indicating high reliability of the instrument. In addition, the items of each dimension were analyzed and none of them presented a Cronbach's alpha coefficient lower than 0.85. Conclusions: Content validity yielded an overall CVI of 0.9650 and Cronbach's alpha coefficient for each dimension was 0.964, 0.957 and 0.964 for food, personal hygiene and physical activity, respectively. This indicates that the instrument is internally consistent and therefore reliable. Furthermore, it can measure one, two or all three dimensions, and can be used to measure the impact of educational interventions in these areas in the school population aged 8 to