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 Table of Contents  
REVIEW ARTICLE
Year : 2015  |  Volume : 22  |  Issue : 4  |  Page : 195-201

Principles and methods of validity and reliability testing of questionnaires used in social and health science researches

Oladimeji Akeem Bolarinwa
From the Department of Epidemiology and Community Health, University of Ilorin and University of Ilorin Teaching Hospital, Ilorin, Nigeria

Date of Web Publication14-Jan-2016

Correspondence Address:
Oladimeji Akeem Bolarinwa
From the Department of Epidemiology and Community Health, University of Ilorin and University of Ilorin Teaching Hospital, Ilorin
Nigeria
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1117-1936.173959

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  Abstract 

The importance of measuring the accuracy and consistency of research instruments (especially questionnaires) known as validity and reliability, respectively, have been documented in several studies, but their measure is not commonly carried out among health and social science researchers in developing countries. This has been linked to the dearth of knowledge of these tests. This is a review article which comprehensively explores and describes the validity and reliability of a research instrument (with special reference to questionnaire). It further discusses various forms of validity and reliability tests with concise examples and finally explains various methods of analysing these tests with scientific principles guiding such analysis.

Keywords: Questionnaire, reliability, social and health, validity


How to cite this article:
Bolarinwa OA. Principles and methods of validity and reliability testing of questionnaires used in social and health science researches. Niger Postgrad Med J 2015;22:195-201

How to cite this URL:
Bolarinwa OA. Principles and methods of validity and reliability testing of questionnaires used in social and health science researches. Niger Postgrad Med J [serial online] 2015 [cited 2021 Jun 14];22:195-201. Available from: https://www.npmj.org/text.asp?2015/22/4/195/173959


  Introduction Top


The different measurements in social science research require quantification of abstracts, intangible and construct that may not be observable. [1] However, these quantification will come in the different forms of inference. In addition, the inferences made will depend on the type of measurement. [1] These can be observational, self-report, interview and record review. The various measurements will ultimately require measurement tools through which the values will be captured. One of the most common tasks often encountered in social science research is ascertaining the validity and reliability of a measurement tool. [2] The researchers always wish to know if the measurement tool employed actually measures the intended research concept or construct (is it valid? or true measures?) or if the measurement tools used to quantify the variables provide stable or consistent responses (is it reliable? or repeatable?). As simple as this may seems, it is often omitted or just mentioned passively in the research proposal or report. [2] This has been adduced to the dearth of skills and knowledge of validity and reliability test analysis among social and health science researchers. From the author's personal observation among researchers in developing countries, most students and young researchers are not able to distinguish validity from reliability. Likewise, they do not have the prerequisite to understand the principles that underline validity and reliability testing of a research measurement tool.

This article therefore sets out to review the principles and methods of validity and reliability measurement tools used in social and health science researches. To achieve the stated goal, the author reviewed currents articles (both print and online), scientific textbooks, lecture notes/presentations and health programme papers. This is with a view to critically review current principles and methods of reliability and validity tests as they are applicable to questionnaire use in social and health researches.

Validity expresses the degree to which a measurement measures what it purports to measure. Several varieties have been described, including face validity, construct validity, content validity and criterion validity (which could be concurrent and predictive validity). These validity tests are categorised into two broad components namely; internal and external validities. [3],[4],[5] Internal validity refers to how accurately the measures obtained from the research was actually quantifying what it was designed to measure whereas external validity refers to how accurately the measures obtained from the study sample described the reference population from which the study sample was drawn. [5]

Reliability refers to the degree to which the results obtained by a measurement and procedure can be replicated. [3],[4],[5] Though reliability importantly contributes to the validity of a questionnaire, it is however not a sufficient condition for the validity of a questionnaire. [6] Lack of reliability may arise from divergence between observers or instruments of measurement such as a questionnaire or instability of the attribute being measured [3],[4] which will invariably affect the validity of such questionnaire. There are three aspects of reliability, namely: Equivalence, stability and internal consistency (homogeneity). [5] It is important to understand the distinction between these three aspects as it will guide the researcher on the proper assessment of reliability of a research tool such as questionnaire. [7] [Figure 1] shows graphical presentation of possible combinations of validity and reliability. [8]
Figure 1: Graphical presentation of possible combinations of validity and reliability

Click here to view


Questionnaire is a predetermined set of questions used to collect data. [2] There are different formats of questionnaire such as clinical data, social status and occupational group.[3] It is a data collection 'tool' for collecting and recording information about a particular issue of interest. [2],[5] It should always have a definite purpose that is related to the objectives of the research, and it needs to be clear from the outset on how the findings will be used. [2],[5] Structured questionnaires are usually associated with quantitative research, which means research that is concerned with numbers (how many? how often? how satisfied?). It is the mostly used data collection instrument in health and social science research. [9]

In the context of health and social science research, questionnaires can be used in a variety of survey situations such as postal, electronic, face-to-face (F2F) and telephone. [9] Postal and electronic questionnaires are known as self-completion questionnaires, i.e., respondents complete them by themselves in their own time. F2F and telephone questionnaires are used by interviewers to ask a standard set of questions and record the responses that people give to them. [9] Questionnaires that are used by interviewers in this way are sometimes known as interview schedules. [9] It could be adapted from an already tested one or could be developed as a new data tool specific to measure or quantify a particular attribute. These conditions therefore warrant the need to test validity and reliability of questionnaire. [2],[5],[9]


  Methods Used for Validity Test of a Questionnaire Top


A drafted questionnaire should always be ready for establishing validity. Validity is the amount of systematic or built-in error in questionnaire. [5],[9] Validity of a questionnaire can be established using a panel of experts which explore theoretical construct as shown in [Figure 2]. This form of validity exploits how well the idea of a theoretical construct is represented in an operational measure (questionnaire). This is called a translational or representational validity. Two subtypes of validity belongs to this form namely; face validity and content validity. [10] On the other hand, questionnaire validity can be established with the use of another survey in the form of a field test and this examines how well a given measure relates to one or more external criterion, based on empirical constructs as shown in [Figure 2]. These forms could be criterion-related validity [10],[11] and construct validity. [11] While some authors believe that criterion-related validity encompasses construct validity, [10] others believe both are separate entities. [11] According to the authors who put the 2 as separate entities, predictive validity and concurrence validity are subtypes of criterion-related validity while convergence validity, discriminant validity, known-group validity and factorial validity are sub-types of construct validity [Figure 2]. [10] In addition, some authors included hypothesis-testing validity as a form of construct validity. [12] The detailed description of the subtypes are described in the next paragraphs.
Figure 2: Graphical representation of the subtypes of various forms of validity tests

Click here to view



  Face Validity Top


Some authors [7],[13] are of the opinion that face validity is a component of content validity while others believe it is not. [2],[14],[15] Face validity is established when an individual (and or researcher) who is an expert on the research subject reviewing the questionnaire (instrument) concludes that it measures the characteristic or trait of interest. [7],[13] Face validity involves the expert looking at the items in the questionnaire and agreeing that the test is a valid measure of the concept which is being measured just on the face of it. [15] This means that they are evaluating whether each of the measuring items matches any given conceptual domain of the concept. Face validity is often said to be very casual, soft and many researchers do not consider this as an active measure of validity. [11] However, it is the most widely used form of validity in developing countries. [15]


  Content Validity Top


Content validity pertains to the degree to which the instrument fully assesses or measures the construct of interest. [7],[15],[16],[17] For example, a researcher is interested in evaluating employees' attitudes towards a training program on hazard prevention within an organisation. He wants to ensure that the questions (in the questionnaire) fully represent the domain of attitudes towards the occupational hazard prevention. The development of a content valid instrument is typically achieved by a rational analysis of the instrument by raters (experts) familiar with the construct of interest or experts on the research subject. [15],[16],[17] Specifically, raters will review all of the questionnaire items for readability, clarity and comprehensiveness and come to some level of agreement as to which items should be included in the final questionnaire. [15] The rating could be a dichotomous where the rater indicates whether an item is 'favourable' (which is assign a score of +1) or 'unfavourable' (which is assign score of +0). [15] Over the years however, different ratings have been proposed and developed. These could be in Likert scaling or absolute number ratings. [18],[19],[20],[21] Item rating and scale level rating have been proposed for content validity. The item-rated content validity indices (CVI) are usually denoted as I-CVI. [15] While the scale-level CVI termed S-CVI will be calculated from I-CVI. [15] S-CVI means the level of agreement between raters. Sangoseni et al.[15] proposed a S-CVI of ≥0.78 as significant level for inclusion of an item into the study. The Fog Index, Flesch Reading Ease, Flesch-Kincaid readability formula and Gunning-Fog Index are formulas that have also been used to determine readability in validity. [7],[12] Major drawback of content validity is that it is also adjudged to be highly subjective like face validity. However, in some cases, researchers could combine more than one form of validity to increase validity strength of the questionnaire. For instance, face validity has been combined with content validity [15],[22],[23] criterion validity. [13]


  Criterion-related Validity Top


Criterion-related validity is assessed when one is interested in determining the relationship of scores on a test to a specific criterion. [24],[25] It is a measure of how well questionnaire findings stack up against another instrument or predictor. [5],[25] Its major disadvantage is that such predictor may not be available or easy to establish. There are 2 variants of this validity type as follows:

Concurrence

This assesses the newly developed questionnaire against a highly rated existing standard (gold standard). When the criterion exists at the same time as the measure, we talk about concurrent validity. [24],[25],[26],[27] Concurrent validity refers to the ability of a test to predict an event in the present form. For instance, in a simplest form, a researcher may use questionnaire to elucidate diabetic patients' blood sugar level reading in the last hospital follow-up visits and compare this response to laboratory reading of blood glucose for such patient.

Predictive

It assesses the ability of the questionnaire (instrument) to forecast future events, behaviour, attitudes or outcomes. This is assessed using correlation coefficient. Predictive validity is the ability of a test to measure some event or outcome in the future. [24],[28] A good example of predictive validity is the use of hypertensive patients' questionnaire on medication adherence to medication to predict their future medical outcome such as systolic blood pressure control. [28],[29]


  Construct Validity Top


Construct validity is the degree to which an instrument measures the trait or theoretical construct that it is intended to measure. [5],[16],[30],[31],[32],[33],[34] It does not have a criterion for comparison rather it utilizes a hypothetical construct for comparison. [5],[11],[30],[31],[32],[33],[34] It is the most valuable and most difficult measure of validity. Basically, it is a measure of how meaningful the scale or instrument is when it is in practical use. [5],[24] There are four types of evidence that can be obtained for the purpose of construct validity depending on the research problem, as discussed below:

Convergent validity

There is evidence that the same concept measured in different ways yields similar results. In this case, one could include two different tests. In convergent validity where different measures of the same concept yield similar results, a researcher uses self-report versus observation (different measures). [12],[33],[34],[35],[36] The 2 scenarios given below illustrate this concept.

Scenario one

A researcher could place meters on respondent's television (TV) sets to record the time that people spend with certain health programmes on TV. Then, this record can be compared with survey results on 'exposure to health program on televised' using questionnaire.

Scenario two

The researcher could send someone to observe respondent's TV use at their home and compare the observation results with the survey results using questionnaire.

Discriminant validity

There is evidence that one concept is different from other closely related concepts. [12],[34],[36] Using the scenarios of TV health programme exposure above, the researcher can decide to measure the exposure to TV entertainment programmes and determine if they differ from TV health programme exposure measures. In this case, the measures of exposure to TV health programme should not be highly related to the measures of exposure to TV entertainment programmes.

Known-group validity

In known-group validity, a group with already established attribute of the outcome of construct is compared with a group in whom the attribute is not yet established. [11],[37] Since the attribute of the two groups of respondents is known, it is expected that the measured construct will be higher in the group with related attribute but lower in the group with unrelated attribute. [11],[36],[37],[38] For example, in a survey that used questionnaire to explore depression among two groups of patients with clinical diagnosis of depression and those without. It is expected (in known-group validity) that the construct of depression in the questionnaire will be scored higher among the patients with clinically diagnosed depression than those without the diagnosis. Another example was shown in a study by Singh et al.[38] where cognitive interview study was conducted among school pupils in 6 European countries.

Factorial validity

This is an empirical extension of content validity. This is because it validates the contents of the construct employing the statistical model called factor analysis. [11],[39],[40],[41],[42] It is usually employed when the construct of interest is in many dimensions which form different domains of a general attribute. In the analysis of factorial validity, the several items put up to measure a particular dimension within a construct of interest is supposed to be highly related to one another than those measuring other dimensions. [11],[39],[40],[41],[42] For instance, using health-related quality of life questionnaire using short form - 36 version 2 (SF-36v2). This tool has 8 dimensions and it is therefore expected that all the items of SF-36v2 questionnaire measuring social function (SF), which is one of the 8 dimension, should be highly related than those items measuring mental health domain which measure another dimension. [43]

Hypothesis-testing validity

Evidence that a research hypothesis about the relationship between the measured concept (variable) or other concepts (variables), derived from a theory, is supported. [12],[44] In the case of TV viewing, for example, there is a social learning theory stating how violent behaviour can be learned from observing and modelling televised physical violence. From this theory, we could derive a hypothesis stating a positive correlation between physical aggression and the amount of televised physical violence viewing. If the evidence collected supports the hypothesis, we can conclude that there is a high degree of construct validity in the measurements of physical aggression and viewing of televised physical violence since the two theoretical concepts are measured and examined in the hypothesis-testing process.


  Methods Used for Reliability Test of a Questionnaire Top


Reliability is an extent to which a questionnaire, test, observation or any measurement procedure produces the same results on repeated trials. In short, it is the stability or consistency of scores over time or across raters. [7] Keep in mind that reliability pertains to scores not people. Thus, in research, one would never say that someone was reliable. As an example, consider judges in a platform diving competition. The extent to which they agree on the scores for each contestant is an indication of reliability. Similarly, the degree to which an individual's responses (i.e., their scores) on a survey would stay the same over time is also a sign of reliability. [7] It is worthy to note that lack of reliability may arise from divergences between observers or instruments of measurement or instability of the attribute being measured. [3] Reliability of the questionnaire is usually carried out using a pilot test. Reliability could be assessed in three major forms; test-retest reliability, alternate-form reliability and internal consistency reliability. These are discussed below.


  Test-retest Reliability (or Stability) Top


Test-retest correlation provides an indication of stability over time. [5],[12],[27],[37] This aspect of reliability or stability is said to occur when the same or similar scores are obtained with repeated testing with the same group of respondents. [5],[25],[35],[37] In other words, the scores are consistent from 1 time to the next. Stability is assessed through a test-retest procedure that involves administering the same measurement instrument such as questionnaire to the same individuals under the same conditions after some period of time. It is the most common form in surveys for reliability test of questionnaire.

Test-rest reliability is estimated with correlations between the scores at time 1 and those at time 2 (to time x). Two assumptions underlie the use of the test-retest procedure; [12]

  • The first required assumption is that the characteristic that is measured does not change over the time period called 'testing effect' [11]
  • The second assumption is that the time period is long enough yet short in time that the respondents' memories of taking the test at time 1 do not influence their scores at time 2 and subsequent test administrations called 'memory effect'.


It is measured by having the same respondents complete a survey at two different points in time to see how stable the responses are. In general, correlation coefficient (r) values are considered good if r ≥ 0.70. [38],[45]

If data are recorded by an observer, one can have the same observer make two separate measurements. The comparison between the two measurements is intra-observer reliability. In using this form of reliability, one needs to be careful with questionnaire or scales that measure variables which are likely to change over a short period of time, such as energy, happiness and anxiety because of maturation effect. [24] If the researcher has to use such variables, then he has to make sure that test-retest is done over very short periods of time. Potential problem with test-retest in practice effect is that the individuals become familiar with the items and simply answer based on their memory of the last answer. [45]


  Alternate-form Reliability (or Equivalence) Top


Alternate form refers to the amount of agreement between two or more research instruments such as two different questionnaires on a research construct that are administered at nearly the same point in time. [7] It is measured through a parallel form procedure in which one administers alternative forms of the same measure to either the same group or different group of respondents. It uses differently worded questionnaire to measure the same attribute or construct. [45] Questions or responses are reworded or their order is changed to produce two items that are similar but not identical. This administration of the various forms occurs at the same time or following some time delay. The higher the degree of correlation between the two forms, the more equivalent they are. In practice, the parallel forms procedure is seldom implemented, as it is difficult, if not impossible, to verify that two tests are indeed parallel (i.e., have equal means, variances and correlations with other measures). Indeed, it is difficult enough to have one well-developed instrument or questionnaire to measure the construct of interest let alone two. [7]

Another situation in which equivalence will be important is when the measurement process entails subjective judgements or ratings being made by more than one person. [5],[7] Say, for example, that we are a part of a research team whose purpose is to interview people concerning their attitudes towards health educational curriculum for children. It should be self-evident to the researcher that each rater should apply the same standards towards the assessment of the responses. The same can be said for a situation in which multiple individuals are observing health behaviour. The observers should agree as to what constitutes the presence or absence of a particular health behaviour as well as the level to which the behaviour is exhibited. In these scenarios, equivalence is demonstrated by assessing inter-observer reliability which refers to the consistency with which observers or raters make judgements. [7]

The procedure for determining inter-observer reliability is:

No of agreements/no of opportunities for agreement ×100.

Thus, in a situation in which raters agree in a total of 75 times out of 90 opportunities (i.e. unique observations or ratings) produces 83% agreement that is 75/90 = 0.83 × 100 = 83%.


  Internal Consistency Reliability (or Homogeneity) Top


Internal consistency concerns the extent to which items on the test or instrument are measuring the same thing. The appeal of an internal consistency index of reliability is that it is estimated after only one test administration and therefore avoids the problems associated with testing over multiple time periods. [5] Internal consistency is estimated via the split-half reliability index [5] and coefficient alpha index [22],[23],[25],[37],[42],[46],[47],[48],[49] which is the most common used form of internal consistency reliability. Sometimes, Kuder-Richardson formula 20 (KR-20) index was used. [7],[50]

The split-half estimate entails dividing up the test into two parts (e.g. odd/even items or first half of the items/second half of the items), administering the two forms to the same group of individuals and correlating the responses. [7],[10] Coefficient alpha and KR-20 both represent the average of all possible split-half estimates. The difference between the two is when they would be used to assess reliability. Specifically, coefficient alpha is typically used during scale development with items that have several response options (i.e., 1 = strongly disagree to 5 = strongly agree) whereas KR-20 is used to estimate reliability for dichotomous (i.e., yes/no; true/false) response scales. [7]

The formula to compute KR-20 is:

KR-20 = n/(n − 1)[1 − Sum(piqi)/Var(X)].

Where;

n = Total number of items

Sum(piqi) = Sum of the product of the probability of alternative responses

Var(X) = Composite variance.

And to calculate coefficient alpha (a) by Allen and Yen, 1979: [51]

a = n/(n − 1)[1 − Sum Var (Yi)/Var (X)].

Where n = Number of items

Sum Var(Yi) = Sum of item variances

Var(X) = Composite variance.

It should be noted that KR-20 and Cronbach alpha can easily be estimated using several statistical analysis software these days. Therefore, researchers do not have to go through the laborious exercise of memorising the mathematical formula given above. As a rule of thumb, the higher the reliability value, the more reliable the measure. The general convention in research has been prescribed by Nunnally and Bernstein, [52] which states that one should strive for reliability values of 0.70 or higher. It is worthy of note that reliability values increase as test length increases. [53] That is, the more items we have in our scale to measure the construct of interest, the more reliable our scale will become. However, the problem with simply increasing the number of scale items when performing applied research is that respondents are less likely to participate and answer completely when confronted with the prospect of replying to a lengthy questionnaire. [7] Therefore, the best approach is to develop a scale that completely measures the construct of interest and yet does so in as parsimonious or economical manner as is possible. A well-developed yet brief scale may lead to higher levels of respondent participation and comprehensiveness of responses so that one acquires a rich pool of data with which to answer the research question.


  Short Note on SPSS and Reliability Test Top


Reliability can be established using a pilot test by collecting data from 20 to 30 subjects not included in the sample. Data collected from pilot test can be analysed using SPSS (Statistical Package for Social Sciences, by IBM incorporated) or any other related software. SPSS provides two key pieces of information in the output viewer. These are 'correlation matrix' and 'view alpha if item deleted' columns. [54],[55] Cronbach alpha (a) is the most commonly used measure of internal consistency reliability [45] and so it will be discussed here. Conditions that could affect Cronbach values are [54],[55]

  1. Numbers of items; scale of <10 variables could cause Cronbach alpha to be low
  2. Distribution of score; normality increases Cronbach alpha value while skewed data reduces it
  3. Timing; Cronbach alpha does not indicate the stability or consistency of the test over time
  4. Wording of the items; negative-worded questionnaire should be reversed before scoring
  5. Items with 0, 1 and negative scores: Ensure that items/statements that have 0 s, 1 s and negatives are eliminated.


The detailed step by step procedure for the reliability analysis using SPSS can be found on internet and standard tests. [54],[55] But, note that the reliability coefficient (alpha) can range from 0 to 1, with 0 representing a questionnaire that is not reliable and 1 representing absolutely reliable questionnaire. A reliability coefficient (alpha) of 0.70 or higher is considered acceptable reliability in SPSS.


  Conclusion Top


This article reviewed validity and reliability of questionnaire as an important research tool in social and health science research. The article observed the importance of validity and reliability tests in research and gave both literary and technical meanings of these tests. Various forms and methods of analysing validity and reliability of questionnaire were discussed with the main aim of improving the skills and knowledge of these tests among researchers in developing countries.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
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82 Improving the validity, relevance and feasibility of the continuum of care framework for maternal health in South Africa: a thematic analysis of experts’ perspectives
Mamothena Carol Mothupi,Lucia Knight,Hanani Tabana
Health Research Policy and Systems. 2020; 18(1)
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83 Developing a readiness self-assessment tool for low- and middle-income countries establishing new radiotherapy services: A participant validation study
Andrew Donkor,Tim Luckett,Sanchia Aranda,Verna Vanderpuye,Jane Phillips
Physica Medica. 2020; 71: 88
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84 Comments on "Reliability and Validity of an Adapted Questionnaire Assessing Occupational Exposures to Hazardous Chemicals among Health Care Workers in Bhutan"
Priya Dutta,Varsha Chorsiya
The International Journal of Occupational and Environmental Medicine. 2020; 11(4): 215
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85 Towards a Unified Criteria Model for Usability Evaluation in the Context of Open Source Software Based on a Fuzzy Delphi Method
Kareem A. Dawood,Khaironi Y. Sharif,ABDUL A. GHANI,H. Zulzalil,A.A. Zaidan,B.B. Zaidan
Information and Software Technology. 2020; : 106453
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86 Examination of marketing mix performance in relation to sustainable development of the Poland’s confectionery industry
Pawel Tadeusz Kazibudzki,Tomasz Witold Trojanowski,Isabel Novo-Cortí
PLOS ONE. 2020; 15(10): e0240893
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87

Medication Non-Adherence and Associated Factors Among Diabetic Patients Visiting General Hospitals in the Eastern Zone of Tigrai, Northern Ethiopia
Ephrem Mebrahtu Araya,Haylay Araya Gebrezgabiher,Gebretsadkan Hintsa Tekulu,Niguse Meles Alema,Desalegn Getnet,Hirut Teame Gebru,Betelhem Anteneh Adamu
Patient Preference and Adherence. 2020; Volume 14: 2071
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88 Establishing basic requirements for textile and garment mass production units in the Tanzanian context
Ismail W.R. Taifa,Gervaz G. Lushaju
Research Journal of Textile and Apparel. 2020; 24(4): 321
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89 An evaluation of online students’ persistence intentions
Asifa Ilyas,Muhammad Kashif Zaman
Asian Association of Open Universities Journal. 2020; 15(2): 207
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90 The McGill Quality of Life Questionnaire-Revised (MQOL-R). Psychometric properties and validation of a Brazilian version on palliative care patients: a cross-sectional study
Paul Vicuña Serrano,Gerardo Beltran Serrano,Iraci L. S. Torres,Roberta Rossi Graudner,Wolnei Caumo
Health and Quality of Life Outcomes. 2020; 18(1)
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91 Providing Sustainable Knowledge for the Young Graduates of Economic and Social Sciences. Case Study: Comparative Analysis of Required Global Competences in Two Romanian Universities
Lavinia Cornelia Butum,Lumini?a Nicolescu,Sergiu Octavian Stan,Andrei Gaitanaru
Sustainability. 2020; 12(13): 5364
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92 Measurement properties of preference-based measures for economic evaluation in COPD: a systematic review
Ava Mehdipour,Marla K. Beauchamp,Joshua Wald,Nicole Peters,Ayse Kuspinar
Quality of Life Research. 2020;
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93 The anti-clot treatment scale (ACTS): validation of the translated Arabic version among patients undergoing warfarin therapy in Saudi Arabia
Sireen Abdul Rahim Shilbayeh,Alnada Abdalla Ibrahim
Health and Quality of Life Outcomes. 2020; 18(1)
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94 Guiding towards register awareness in an undergraduate EFL curriculum in Italy
Register Studies. 2020;
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95 The physical impact of long bone fractures on adults in KwaZulu-Natal
Sevani Singaram,Mergan Naidoo
South African Journal of Physiotherapy. 2020; 76(1)
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96 A qualitative exploration of teachers’ perspective on smartphones usage in higher education in developing countries
Shakeel Iqbal,Zeeshan Ahmed Bhatti
International Journal of Educational Technology in Higher Education. 2020; 17(1)
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97 Development of assesment instruments to measure quality of MOOC-Platform in engineering mathematics 1 course
I Yuniwati,A D Yustita,S A Hardiyanti,I W Suardinata
Journal of Physics: Conference Series. 2020; 1567: 022102
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98 Community pharmacists’ knowledge of and attitudes toward antibiotic use, resistance, and self-medication in Jordan
Derar H. Abdel-Qader,Abdullah Albassam,Najlaa Saadi Ismael,Asma’ A. El-Shara’,Ahmad Z. Al Meslamani,Penny J. Lewis,Salim Hamadi,Osama Mohamed Ibrahim,Nadia Al Mazrouei
Drugs & Therapy Perspectives. 2020;
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99 Physical Preparation in Female Rugby Codes: An Investigation of Current Practices
Omar Heyward,Ben Nicholson,Stacey Emmonds,Gregory Roe,Ben Jones
Frontiers in Sports and Active Living. 2020; 2
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100 Challenges and enablers of the embedded researcher model
Dominiek Coates,Sharon Mickan
Journal of Health Organization and Management. 2020; 34(7): 743
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101 Évaluation dæun dispositif de continuité pédagogique à distance mis en place auprès d’étudiants MERM pendant le confinement sanitaire lié au COVID-19
Claudine Zorn,Marie-Laurence Feffer,Éric Bauer,Jean-Philippe Dillenseger
Journal of Medical Imaging and Radiation Sciences. 2020;
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102 Development of the Childhood Nonverbal Communication Scale
Mohammad Majid Oryadi-Zanjani
Journal of Autism and Developmental Disorders. 2020;
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103 Enhancing community pharmacists’ provision of medication adherence support to older adults: A mixed methods study using the Theoretical Domains Framework
Deborah E. Patton,Cristín Ryan,Carmel M. Hughes
Research in Social and Administrative Pharmacy. 2020;
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104 Protocol of a multicentric prospective cohort study for the VALIDation of the IBD-disk instrument for assessing disability in inflammatory bowel diseases: the VALIDate study
C. Le Berre,A. Bourreille,M. Flamant,G. Bouguen,L. Siproudhis,M. Dewitte,N. Dib,E. Cesbron-Metivier,T. Goronflot,M. Hanf,P.-A. Gourraud,E. Kerdreux,A. Poinas,C. Trang-Poisson
BMC Gastroenterology. 2020; 20(1)
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105 Opioid prescription practice behavior among medical and surgical specialty physicians
Uzung Yoon,Tho Nguyen,Marc C. Torjman,Daniella Miele,Ellen Hauck,Michael Williams
Journal of Substance Use. 2020; : 1
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106 Developing Verb Picture Naming Test for Persian adults and determining its psychometric properties
Maryam Namdar Khatibani,Azar Mehri,Shohreh Jalaie,Mahdi Dastjerdi Kazemi
Applied Neuropsychology: Adult. 2020; : 1
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107

Development and Psychometric Validation of a Questionnaire to Evaluate Knowledge and Attitude Towards Medication Error Reporting Among Pharmacists
Ruzmayuddin Mamat,Siti Asarida Awang,Ab Fatah Ab Rahman
Drug, Healthcare and Patient Safety. 2020; Volume 12: 95
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108 Validação de conteúdo de Instrumento de Avaliação da Atenção Nutricional na Atenção Primária à Saúde
Ana Beatriz PACITO-ALMEIDA,Angélica Barbosa Neres SANTANA,Lia Thieme Oikawa ZANGIROLANI,Maria Angélica Tavares de MEDEIROS
Revista de Nutrição. 2020; 33
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109 The psychological impact of the COVID-19 pandemic on dental healthcare professionals
Aditya Shetty,Raksha Bhat,Preethesh Shetty,MithraN Hegde,U SKrishna Nayak,Neevan D’souza
Journal of International Oral Health. 2020; 12(8): 98
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110 Content validation of the Nutritional Attention Assessment Instrument in Primary Health Care
Ana Beatriz PACITO-ALMEIDA,Angélica Barbosa Neres SANTANA,Lia Thieme Oikawa ZANGIROLANI,Maria Angélica Tavares de MEDEIROS
Revista de Nutrição. 2020; 33
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111 Development and Validation of a Short Version Sport Orientation Questionnaire for Chinese Adolescents (SOQ-CA)
Jindong Chang,Yali Yi,Naiqing Song
Frontiers in Psychology. 2020; 11
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112 Examining human attitudes toward shared mobility options and autonomous vehicles
Alireza Rahimi,Ghazaleh Azimi,Xia Jin
Transportation Research Part F: Traffic Psychology and Behaviour. 2020; 72: 133
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113 Development and Validation of Scale using Rasch Analysis to Measure Students’ Entrepreneurship Readiness to Learn Embedded System Design Course
Intisar Ibrahim Ridwan,Kamilah Radin Salim,Zulkifli Adam,Izzeldin I. Mohd,Nazar El Fadil
Procedia Computer Science. 2020; 172: 545
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114

Measuring the Patient Experience of Mental Health Care: A Systematic and Critical Review of Patient-Reported Experience Measures
Sara Fernandes,Guillaume Fond,Xavier Y Zendjidjian,Karine Baumstarck,Christophe Lançon,Fabrice Berna,Franck Schurhoff,Bruno Aouizerate,Chantal Henry,Bruno Etain,Ludovic Samalin,Marion Leboyer,Pierre-Michel Llorca,Magali Coldefy,Pascal Auquier,Laurent Boyer
Patient Preference and Adherence. 2020; Volume 14: 2147
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115 Developing a questionnaire to measure psychological disturbance associated with tooth loss
Zaki Kudsi,Michael R Fenlon,Kirsty Hill,Aylin Baysan
Journal of Dentistry. 2020; : 103353
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116 Validity and Reliability Study of the Turkish Version of Multiple Sclerosis Self-Management Scale
Öznur Erbay,Öznur Usta Yesilbalkan,Nur Yüceyar,Meltem Baklan,Ayfer Karadakovan,Mustafa Agah Tekindal
Journal of Neuroscience Nursing. 2020; 52(3): 122
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117 The Adoption of Online Product Information: Cognitive and Affective Evaluations
Tsan-Ching Kang,Shin-Yuan Hung,Albert H. Huang
Journal of Internet Commerce. 2020; : 1
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118 Psychometric Properties of Persian Version of Structured Clinical Interview for DSM-5-Research Version (SCID5-RV): A Diagnostic Accuracy Study
Parvaneh Mohammadkhani,Ameneh Setareh Forouzan,Zahra Hooshyari,Imaneh Abasi
Iranian Journal of Psychiatry and Behavioral Sciences. 2020; In Press(In Press)
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119 Parents’ attitude towards their children and adolescents affected by leprosy in an endemic district in West Bengal, India
Joydeepa Darlong,Pitchaimani Govindharaj
Leprosy Review. 2020; 91(3): 282
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120 Asynchronously Embedding Psychological Test Questions into Human–Robot Conversations for User Profiling
Tsung-Ren Huang,Yu-Wei Liu,Shin-Min Hsu,Joshua O. S. Goh,Yu-Ling Chang,Su-Ling Yeh,Li-Chen Fu
International Journal of Social Robotics. 2020;
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121 Assessment instruments for lower urinary tract dysfunction in children: Symptoms, characteristics and psychometric properties
Jabiael Carneiro da Silva Filho,Isabel Cristina Ramos Vieira Santos,Marília Perrelli Valença,Jéssica Emanuela Mendes Morato,Sérgio Ricardo Ferreira dos Santos Filho,Angela Lessa de Andrade
Journal of Pediatric Urology. 2020;
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122 Cross-cultural Adaptation and Validation of the Hong Kong-Chinese version of Childrenæs Voice Handicap Index-10 for Parents (CVHI-10-P(HK))
Elaine Kwong
Journal of Voice. 2020;
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123 Impact of Rectus Diastasis Repair on Abdominal Strength and Function: A Systematic Review
Jessica Gormley,Andrea Copeland,Haley Augustine,Charlotte Axelrod,Mark McRae
Cureus. 2020;
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124 Evaluation of Service Quality of Public Transportation (Study Case of Trans Padang)
Carmel M. Henmaidi,Carmel M. Jonrinaldi,Hilmi Yenny
IOP Conference Series: Materials Science and Engineering. 2020; 1003: 012030
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125 A two models modification for determining cloud computing adoption for web-based services in academic libraries in Nigeria
Adeyinka Tella,Scholastica Chizoma Ukwoma,Isaiah Kayode Adeniyi
The Journal of Academic Librarianship. 2020; 46(6): 102255
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126 Flipped jigsaw activity as a small group peer-assisted teaching learning tool in Biochemistry Department among Indian Medical Graduate: An experimental study
Vibha Uppal,Neha Uppal
Biochemistry and Molecular Biology Education. 2020;
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127 A Hybrid Method for the Cross-Cultural Adaptation of Self-Report Measures
Atul Kumar Goyal,Jaimanti Bakshi,Naresh K Panda,Rakesh Kapoor,Dharam Vir,Krishan Kumar,Pankaj Aneja,Balwinder Singh,Meenu Gupta,Sumittar Singh Walia
International Journal of Applied Positive Psychology. 2020;
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128 Sustainability Indicators in Restaurants: The Development of a Checklist
Dayanne da Costa Maynard,Renata Puppin Zandonadi,Eduardo Yoshio Nakano,Raquel Braz Assunção Botelho
Sustainability. 2020; 12(10): 4076
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129 Healthy eating in pregnancy, education for midwives: A pre-post intervention study
Shwikar Othman,Mary Steen,Julie-Anne Fleet,Rasika Jayasekara
European Journal of Midwifery. 2020; 4(May)
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130 An investigation of dental students’ perceptions about the characteristics of effective instructors and their related factors
Muhammad Ashraf Nazir,Asim Al-Ansari,Faraz Ahmed Farooqi
European Journal of Dental Education. 2019;
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131 Social Determinants of Health Assessment Tool: Implications for Healthcare Practice
Suzy Barcelos Winchester
Social Work in Public Health. 2019; : 1
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132 An assessment of the replicability of a standard and modified sanitary risk protocol for groundwater sources in Greater Accra
W. Yentumi,M. Dzodzomenyo,K. Sashie-Doe,J. Wright
Environmental Monitoring and Assessment. 2019; 191(2)
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133 Construct validity of six sentiment analysis methods in the text of encounter notes of patients with critical illness
Gary E. Weissman,Lyle H. Ungar,Michael O. Harhay,Katherine R. Courtright,Scott D. Halpern
Journal of Biomedical Informatics. 2019; 89: 114
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134 Risk factors influencing the building projects in Pakistan: from perspective of contractors, clients and consultants
Asad Kamal,Muhammad Abas,Dildar Khan,Rai Waqas Azfar
International Journal of Construction Management. 2019; : 1
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135 Validation of Modified Dental Anxiety Scale for Dental Extraction Procedure (MDAS-DEP)
Tantry Maulina,Salma Nadiyah Ridho,Farah Asnely Putri
The Open Dentistry Journal. 2019; 13(1): 358
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136 Social determinants of health in mental health care and research: a case for greater inclusion
Joseph J Deferio,Scott Breitinger,Dhruv Khullar,Amit Sheth,Jyotishman Pathak
Journal of the American Medical Informatics Association. 2019;
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137 Nutritional Screening Tools Used and Validated for Cancer Patients: A Systematic Review
Nélia Pinheiro Mendes,Thalita Alves de Barros,Carla de Oliveira Barbosa Rosa,Sylvia do Carmo Castro Franceschini
Nutrition and Cancer. 2019; : 1
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138 Superior long term functional and scar outcome of Meek micrografting compared to conventional split thickness skin grafting in the management of burns
Shi Zhen Lee,Ahmad Sukari Halim
Burns. 2019;
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139 An investigation into the construction industry’s view on fire prevention in high-rise buildings post Grenfell
Iman Farah Mohamed,David John Edwards,Monica Mateo-Garcia,Glenn Costin,Wellington Didibhuku Didibhuku Thwala
International Journal of Building Pathology and Adaptation. 2019; 38(3): 451
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140 Associating of mother’s health literacy with sunlight protective behaviors of teenage children: application of social cognitive theory
Nooshin Peyman,Seyedeh Belin Tavakoly Sany,Mahnaz Nasehnezhad,Hassan Doosti,Christophe Chesneau,Gordon Ferns
International Journal of Health Promotion and Education. 2019; : 1
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141 Exploring Engineering Undergraduate Students’ Attitudes toward Mathematical Problem Posing
Mahboubeh Nedaei,Farzad Radmehr,Michael Drake
Journal of Professional Issues in Engineering Education and Practice. 2019; 145(4): 04019009
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142 Development and psychometric evaluation of the Perceived Social Stigma Questionnaire (PSSQ-for adults with epilepsy): A mixed method study
Abbas Shamsalinia,Reza Masoudi,Reza Ebrahimi Rad,Fatemeh Ghaffari
Epilepsy & Behavior. 2019; 96: 141
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143 Midwifery Student Evaluation of Practice: The MidSTEP tool — Perceptions of clinical learning experiences
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Women and Birth. 2019;
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144 Development and clinimetric properties of the Dutch Breast Edema Questionnaire (BrEQ-Dutch version) to diagnose the presence of breast edema in breast cancer patients
Hanne Verbelen,Tessa De Vrieze,Timia Van Soom,Jill Meirte,Mireille Van Goethem,Godelieve Hufkens,Wiebren Tjalma,Nick Gebruers
Quality of Life Research. 2019;
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145 Development and Validation of a 49-Item Sports Nutrition Knowledge Instrument (49-SNKI) for Adult Athletes
Christine A. Karpinski,Karen Reznik Dolins,Jessica Bachman
Topics in Clinical Nutrition. 2019; 34(3): 174
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146 Symptom awareness measures for breast and cervical cancer in sub-Saharan Africa: A scoping review
Jennifer N. Githaiga,Fiona M. Walter,Suzanne E. Scott,Amos D. Mwaka,Jennifer Moodley
South African Journal of Oncology. 2019; 3
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147 Cross-Cultural Adaptation and Validation of the 10-Item Conjoint Community Resiliency Assessment Measurement in a Community-Based Sample in Southwest China
Ke Cui,Ziqiang Han
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148 Blending QR code with video learning in the pedagogical process for the college foundation level
Waleed Ahmed,Essam Zaneldin
Interactive Technology and Smart Education. 2019; 17(1): 67
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149 Development and Validation of the Immune Status Questionnaire (ISQ)
Livia J. F. Wilod Versprille,Aurora J. A. E. van de Loo,Marlou Mackus,Lizanne Arnoldy,Titia A. L. Sulzer,Sterre A. Vermeulen,Smedra Abdulahad,Hendrikje Huls,Ton Baars,Andrew Scholey,Aletta D. Kraneveld,Johan Garssen,Joris C. Verster
International Journal of Environmental Research and Public Health. 2019; 16(23): 4743
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150 Behavioural threshold analysis: methodological and practical considerations for applications in information security
Dirk Snyman,Hennie Kruger
Behaviour & Information Technology. 2019; : 1
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151 A cross-cultural clustering study of similarities and dissimilarities based on concept words cheap, reliable, and high quality and their corresponding color associations
Ahsan Abdullah
Color Research & Application. 2019;
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152 Predictors of self-perceived cultural responsiveness in entry-level physiotherapy students in Australia and Aotearoa New Zealand
Maxine Te,Felicity Blackstock,Caroline Fryer,Peter Gardner,Louise Geary,Suzanne Kuys,Kerstin McPherson,Irmina Nahon,Clarice Tang,Lynne Taylor,Gisela Van Kessel,Kelly van der Zwan,Lucy Chipchase
BMC Medical Education. 2019; 19(1)
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153 Development and validation of a questionnaire to assess the doctors and nurses knowledge of acute oxygen therapy
Olufemi O. Desalu,Adeniyi O. Aladesanmi,Olutobi B. Ojuawo,Christopher M. Opeyemi,Rasheedah M. Ibraheem,Zakari A. Suleiman,Olanrewaju O. Oyedepo,Kikelomo T. Adesina,Taofeek Oloyede,Emmanuel O. Sanya,Vineet Gupta
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154 An Assessment of Inter-Observer Agreement in Water Source Classification and Sanitary Risk Observations
Joseph Okotto-Okotto,Peggy Wanza,Emmah Kwoba,Weiyu Yu,Mawuli Dzodzomenyo,S. M. Thumbi,Diogo Gomes da Silva,Jim A. Wright
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155 Assessment of long-term sickness absence: content and face validity of a new questionnaire based on qualitative data from nominal groups
Kaat Goorts,Charlotte Vanovenberghe,Charlotte Lambreghts,Eline Bruneel,Dorina Rusu,Sofie Vandenbroeck,Lode Godderis
BMC Medical Research Methodology. 2019; 19(1)
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156 Measuring coastal citiesæ resilience toward coastal hazards: Instrument development and validation
Rina Suryani Oktari,Louise K. Comfort,Louise K. Syamsidik,Putra Dwitama
Progress in Disaster Science. 2019; : 100057
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157 Screening tools for HIV-associated neurocognitive disorders among adults living with HIV in sub-Saharan Africa: A scoping review
Patrick N. Mwangala,Charles R. Newton,Melanie Abas,Amina Abubakar
AAS Open Research. 2019; 1: 28
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158 Validity and reliability of the Heart Disease Fact Questionnaire (HDFQ): a Rasch measurement model approach
Lemye Zehirlioglu,Hatice Mert
Primary Care Diabetes. 2019;
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159 Gastrointestinal Dysfunction in Critical Illness: A Review of Scoring Tools
Varsha M. Asrani,Annabelle Brown,Wei Huang,Ian Bissett,John A. Windsor
Journal of Parenteral and Enteral Nutrition. 2019;
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160 Psychometrics of the students´ attitudes towards addressing sexual health scale for students in social work
Kristina Areskoug-Josefsson,Michael Sjökvist,Pia H. Bülow,Bo Rolander
Social Work Education. 2019; : 1
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161 Marine litter and public involvement in beach cleaning: Disentangling perception and awareness among adults and children, Bay of Biscay, Spain
Fernando Rayon-Viña,Laura Miralles,Sara Fernandez-Rodríguez,Eduardo Dopico,Eva Garcia-Vazquez
Marine Pollution Bulletin. 2019; 141: 112
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162 Hearing in Real-Life Environments (HERE)
Antje Heinrich,Tuija M. Mikkola,Hannele Polku,Timo Törmäkangas,Anne Viljanen
Ear and Hearing. 2019; 40(2): 368
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163 Food Trucks: Assessment of an Evaluation Instrument Designed for the Prevention of Foodborne Diseases
Lígia Isoni Auad,Verônica Cortez Ginani,Eliana dos Santos Leandro,Elke Stedefeldt,Sascha Habu,Eduardo Yoshio Nakano,Aline Costa Santos Nunes,Renata Puppin Zandonadi
Nutrients. 2019; 11(2): 430
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164 Video-based e-learning for an undergraduate engineering course
Essam Zaneldin,Waleed Ahmed,Bilal El-Ariss
E-Learning and Digital Media. 2019; 16(6): 475
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165 Animal- and human-derived products in otolaryngology, counselling and consent: A survey study
Hassan Mohammed,Kate Blackmore
Clinical Ethics. 2019; 14(3): 132
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166 Translation, Cross-Cultural Adaptation, and Validation of the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) into the Malay Language
Ahmad Badruridzwanullah Zun,Mohd Ismail Ibrahim,Ariffin Marzuki Mokhtar,Ahmad Sukari Halim,Wan Nor Arifin Wan Mansor
International Journal of Environmental Research and Public Health. 2019; 16(11): 2054
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167 Demand side management opportunities, framework, and implications for sustainable development in resource-rich countries: Case study Qatar
Ebubekir S. Sahin,I. Safak Bayram,Muammer Koc
Journal of Cleaner Production. 2019; : 118332
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168 Development and validation of the QUECOMIICAT questionnaire: a tool to assess disease-related knowledge in patients with inflammatory bowel disease
Francesc Casellas,Ester Navarro,Paloma Amil,Claudia Barber,Laura Marín,Jordi Guardiola,Eloy Espín,Empar Sainz,Xavier Aldeguer,Marta Gallego,Francsica Murciano,Esther García-Planella,Javier Martín-de-Carpi,Juan Manuel Mendive,Assumpció González-Mestre
Revista Española de Enfermedades Digestivas. 2019; 111
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169 Multiple sclerosis national registry system in Iran: Validity and reliability of a minimum data set
Sarvenaz Shahin,Sharareh Eskandarieh,Abdorreza Naser Moghadasi,Nazanin Razazian,Seyed Mohammad Baghbanian,Fereshteh Ashtari,Asghar bayati,Ali Manouchehrinia,Omid Beiki,Farnam Mohebi,Mahdieh Mokhber Dezfuli,Mohammad Ali Sahraian
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170 Knowledge, skills and functionalities requirements for quantity surveyors in building information modelling (BIM) work environment: an international Delphi study
Abdullahi Babatunde Saka,Daniel W.M. Chan
Architectural Engineering and Design Management. 2019; : 1
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171 An Empirical Study to Investigate the Impact of Communication Issues in GSD in Pakistan’s IT Industry
Ghana Ammad,Uzair Iqbal Janjua,Tahir Mustafa Madni,Muhammad Faisal Cheema,Ahmed R. Shahid
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172 PSYCHOMETRIC PROPERTIES OF MEASUREMENT INSTRUMENTS: CONCEPTUAL BASIS AND EVALUATION METHODS - PART II
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173 Psychometric properties of the scale for non-adherence to antiretroviral medication (NAME) among HIV-infected patients
Zahra Hosseini,Hassan Eftkhar,Teamur Aghamolaei,Abbas Ebadi,Saharnaz Nedjat,Ladan Abbasian,Minasadat hashemi parast
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174 Validation of Knowledge Questionnaire for Patients With Liver Cirrhosis
Jeyamani Ramachandran,Richard Woodman,Kate Muller,Rachel Wundke,Rosemary McCormick,Billingsley Kaambwa,Alan Wigg
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175 The embedded researcher model in Australian healthcare settings: Comparison by degree of ‘embeddedness’
Dominiek Coates,Sharon Mickan
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176 The measurement scale of resilience among family caregivers of children with cancer: a psychometric evaluation
Filiberto Toledano-Toledano,José Moral de la Rubia,Yunier Broche-Pérez,Miriam Teresa Domínguez-Guedea,Víctor Granados-García
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177 Validity and reproducibility testing of the Molar Incisor Hypomineralisation (MIH) Index
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178 Development of a web-based user experience evaluation system for home appliances
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179 PROPRIEDADES PSICOMÉTRICAS DE INSTRUMENTOS DE MEDIDAS: BASES CONCEITUAIS E MÉTODOS DE AVALIAÇÃO - PARTE I
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180 Logical validation and evaluation of practical feasibility for the SCRuM (School Clinical Rugby Measure) test battery developed for young adolescent rugby players in a resource-constrained environment
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181 Screening tools for HIV-associated neurocognitive disorders among adults living with HIV in sub-Saharan Africa: A scoping review
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185 Association of health literacy with type 2 diabetes mellitus self-management and clinical outcomes within the primary care setting of Iran
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189 Development and initial validation of a cutaneous leishmaniasis impact questionnaire
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190 Translation, cross-cultural adaptation, and reliability of the Understanding COPD questionnaire for use in Brazil
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192 Investigating the types, causes and severity of claims in construction projects in the UAE
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193 The Role of European Patient Organizations in Pharmacovigilance
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194 Validity and reliability of an adapted arabic version of the long international physical activity questionnaire
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195 SOSYAL MEDYADAKI GELISMELERI KAÇIRMA KORKUSUNUN (FOMO) IÇGÜDÜSEL ALIMLARA ETKISININ ÖZ BELIRLEME KURAMI ILE AÇIKLANMASI
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196 Post stem cell transplantation revaccination: A survey of the current practices in India
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197 TEST-RETEST RELIABILITY OF UKRAINIAN VERSION OF THE HAEMO-QOL QUESTIONNAIRE
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198 Psychometric assessment of the cultural capacity scale Spanish version in Chilean nursing students
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199 Controlling You Watching Me: Measuring Perception Control on Social Media
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200 The association of health literacy with illness perceptions, medication beliefs, and medication adherence among individuals with type 2 diabetes
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