The Development of an Instrument to Assess Advocacy Intentions for School Health Education

Abstract

Background: An overlooked group for school health education advocacy training is college students enrolled in personal health courses. They will be investors and stakeholders in the quality of public education, and the health and academic success of students. Purpose: In this article we present the process used to develop a theory-based instrument that can help to assess changes in intentions to advocate for school health education after exposure to an advocacy training intervention conducted with college students enrolled in personal health courses. The instrument constructs were developed based on Theory of Planned Behavior (TPB). Methods: Researchers used a comprehensive instrument design framework, involving the Standards for Educational and Psychological Testing and four stages of pretesting to develop and test the instrument items. A confirmatory factor analysis (CFA) was used to test the relationship among ordinal items in the Likert-type instrument and the constructs in TPB, which the items were developed to measure. Results: Fit indices for the structural model indicated that the proposed model provided a satisfactory fit for the data. Therefore, the final instrument consists of 53 items, measuring intentions of students to engage in school health education advocacy, as a result of implementing an advocacy-training lesson. Discussion: This study resulted in an instrument to measure the effectiveness of an advocacy-training lesson for college students that produces valid and reliable scores. Translation to Health Education Practice: The instrument development processes can be replicated by practitioners when creating surveys to administer in their respective populations.