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alipoor F, rafiee H, baloochi M, eslami F, afsharpooya H. (2024). Construction and validation of the short form of social health questionnaire in Iran (SHQ16). refahj. 24(94), : 8 doi:10.32598/refahj.24.94.4475.1
URL: http://refahj.uswr.ac.ir/article-1-4293-en.html
URL: http://refahj.uswr.ac.ir/article-1-4293-en.html
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Introduction
Social health is one of the key dimensions of health that influences the well-being of individuals and society. Different perspectives on the concept of social health exist in global studies. One perspective defines social health as an attribute and characteristic of an individual’s social life and considers the individual as the unit of analysis. This is the perspective adopted by the World Health Organization. Another perspective views social health as an attribute of a society and focuses on the health of the society as a whole. According to this perspective, social health means a society with favorable conditions for health. Given the importance of social health for the overall health of individuals, this study adopts the individual approach to social health. Various tools are available for measuring social health from an individual approach, but some of them are specific to certain populations or contexts. Therefore, when using tools and questionnaires, the culture and social environment of a society should be taken into account, as they may affect the way people interpret and respond to the questions. Hence, it is essential to select a tool and a questionnaire that are culturally relevant and context-sensitive for creating a social health questionnaire for the social context of a country. Consequently, it appears that research in the field of social health requires tools that are suitable for Iranian society and have adequate validity and reliability. This research was conducted to develop and validate a social health questionnaire for the culture of Iranian society.
Method
This study employed a correlational design. Exploratory factor analysis was used to assess the validity of the instrument and Cronbach’s alpha test was used to evaluate its reliability. The study was conducted in 31 provinces of the country, and from each province, three cities were randomly selected: the capital city, one city with low social damage, and one city with high social damage (based on the available provincial statistics and the opinions of experts in the field of social damage). Thus, the total number of cities was 93. The study’s sample size was 60,853 people, which was determined according to the prevalence of the lowest percentage of social harm and the aim of describing the prevalence of the types of harm measured in the study at the provincial level with a 95% confidence interval. The sampling method in each city was multi-stage cluster sampling. The required sample size was randomly selected based on the sex and age ratio of each city and the research questionnaires were completed by the participants. Initially, based on the review of sources and the available instruments, including the social health questionnaire of Rafiei et al. and the social health questionnaire with the social capital approach of Mousavi et al., 40 items for the “social health questionnaire” were developed. This pool was given to ten experts related to the topic of social health to express their opinion about the content validity of each item on a scale from 0 (completely inappropriate) to 10 (completely appropriate). The items that received an average positive evaluation from the experts were selected. Then, these items were administered along with the checklist of demographic variables. Based on the remaining items in the factor analysis, Cronbach’s alpha was also computed and the final form of the questionnaire, which consisted of 16 main items, was obtained. In this study, exploratory factor analysis was used to develop the instrument. Data analysis was performed with SPSS software and principal component analysis with Varimax orthogonal rotation.
Findings
Exploratory factor analysis was used to investigate and identify the number of factors based on the questions in the researcher’s social health questionnaire. Bartlett’s test of sphericity and Kaiser-Meir-Olkin (KMO) scale were used to check the data fit for factor analysis. The result of Bartlett’s test of sphericity and the value of the KMO scale (KMO=0.876) indicated the suitability of the data for factor analysis. Based on this criterion, four factors were extracted, which explained about 70% of the data variance (Chart 1). Table 2 shows the cumulative percentage of explained variance for each factor and how much each factor accounts for the variance of the entire questionnaire. Ultimately, four factors were able to explain about 69.38% of the total variance. These four factors are social responsibility, social trust, political participation, and organizational support. Table 3 displays the correlation between items and factors, and the rotated component matrix of the items. It can be determined which factor each question is loaded on after rotation, and the position of each question in the corresponding factor by referring to the factor loadings. Cronbach’s alpha coefficient was used to check the internal consistency of the researcher’s social health questionnaire. The value of Cronbach’s alpha coefficient for each factor and the entire social health questionnaire are presented in Table 4. According to the obtained coefficients, it was found that the questionnaire has high internal consistency in terms of components and the whole questionnaire.
Discussion
The questionnaire has acceptable internal consistency and validity regarding components and the whole questionnaire. Also, according to the results, it was found that the researcher’s social health questionnaire has acceptable validity. The optimal size of a questionnaire depends on the context and purpose of the study, but some studies suggest that shorter questionnaires yield better results. In this research, an attempt was made to create a questionnaire that is fully compatible with the native culture of the country and based on its social and cultural characteristics. Designing a questionnaire specifically for a country’s culture is beneficial in this way: it ensures that the questions are relevant and meaningful for the target population. This can improve the quality of the data collected and increase the validity of the study results. In general, the size and diversity of the participants, national implementation, favorable validity and reliability results, suitability to Iranian culture, and the appropriate number of questions in the questionnaire compared to previous questionnaires, have made it a suitable tool for measuring social health at the individual level.
Ethical considerations
Authors’ contributions:All authors contributed in designing, running, and writing all parts of the research.
Funding: No direct financial support was received from any institution or organization for the preparation of this article.
Conflicts of interest: This article does not overlap with other published works of the authors.
Following the ethics of research: In this article, all rights related to research ethics have been respected.
Social health is one of the key dimensions of health that influences the well-being of individuals and society. Different perspectives on the concept of social health exist in global studies. One perspective defines social health as an attribute and characteristic of an individual’s social life and considers the individual as the unit of analysis. This is the perspective adopted by the World Health Organization. Another perspective views social health as an attribute of a society and focuses on the health of the society as a whole. According to this perspective, social health means a society with favorable conditions for health. Given the importance of social health for the overall health of individuals, this study adopts the individual approach to social health. Various tools are available for measuring social health from an individual approach, but some of them are specific to certain populations or contexts. Therefore, when using tools and questionnaires, the culture and social environment of a society should be taken into account, as they may affect the way people interpret and respond to the questions. Hence, it is essential to select a tool and a questionnaire that are culturally relevant and context-sensitive for creating a social health questionnaire for the social context of a country. Consequently, it appears that research in the field of social health requires tools that are suitable for Iranian society and have adequate validity and reliability. This research was conducted to develop and validate a social health questionnaire for the culture of Iranian society.
Method
This study employed a correlational design. Exploratory factor analysis was used to assess the validity of the instrument and Cronbach’s alpha test was used to evaluate its reliability. The study was conducted in 31 provinces of the country, and from each province, three cities were randomly selected: the capital city, one city with low social damage, and one city with high social damage (based on the available provincial statistics and the opinions of experts in the field of social damage). Thus, the total number of cities was 93. The study’s sample size was 60,853 people, which was determined according to the prevalence of the lowest percentage of social harm and the aim of describing the prevalence of the types of harm measured in the study at the provincial level with a 95% confidence interval. The sampling method in each city was multi-stage cluster sampling. The required sample size was randomly selected based on the sex and age ratio of each city and the research questionnaires were completed by the participants. Initially, based on the review of sources and the available instruments, including the social health questionnaire of Rafiei et al. and the social health questionnaire with the social capital approach of Mousavi et al., 40 items for the “social health questionnaire” were developed. This pool was given to ten experts related to the topic of social health to express their opinion about the content validity of each item on a scale from 0 (completely inappropriate) to 10 (completely appropriate). The items that received an average positive evaluation from the experts were selected. Then, these items were administered along with the checklist of demographic variables. Based on the remaining items in the factor analysis, Cronbach’s alpha was also computed and the final form of the questionnaire, which consisted of 16 main items, was obtained. In this study, exploratory factor analysis was used to develop the instrument. Data analysis was performed with SPSS software and principal component analysis with Varimax orthogonal rotation.
Findings
Exploratory factor analysis was used to investigate and identify the number of factors based on the questions in the researcher’s social health questionnaire. Bartlett’s test of sphericity and Kaiser-Meir-Olkin (KMO) scale were used to check the data fit for factor analysis. The result of Bartlett’s test of sphericity and the value of the KMO scale (KMO=0.876) indicated the suitability of the data for factor analysis. Based on this criterion, four factors were extracted, which explained about 70% of the data variance (Chart 1). Table 2 shows the cumulative percentage of explained variance for each factor and how much each factor accounts for the variance of the entire questionnaire. Ultimately, four factors were able to explain about 69.38% of the total variance. These four factors are social responsibility, social trust, political participation, and organizational support. Table 3 displays the correlation between items and factors, and the rotated component matrix of the items. It can be determined which factor each question is loaded on after rotation, and the position of each question in the corresponding factor by referring to the factor loadings. Cronbach’s alpha coefficient was used to check the internal consistency of the researcher’s social health questionnaire. The value of Cronbach’s alpha coefficient for each factor and the entire social health questionnaire are presented in Table 4. According to the obtained coefficients, it was found that the questionnaire has high internal consistency in terms of components and the whole questionnaire.
Discussion
The questionnaire has acceptable internal consistency and validity regarding components and the whole questionnaire. Also, according to the results, it was found that the researcher’s social health questionnaire has acceptable validity. The optimal size of a questionnaire depends on the context and purpose of the study, but some studies suggest that shorter questionnaires yield better results. In this research, an attempt was made to create a questionnaire that is fully compatible with the native culture of the country and based on its social and cultural characteristics. Designing a questionnaire specifically for a country’s culture is beneficial in this way: it ensures that the questions are relevant and meaningful for the target population. This can improve the quality of the data collected and increase the validity of the study results. In general, the size and diversity of the participants, national implementation, favorable validity and reliability results, suitability to Iranian culture, and the appropriate number of questions in the questionnaire compared to previous questionnaires, have made it a suitable tool for measuring social health at the individual level.
Ethical considerations
Authors’ contributions:All authors contributed in designing, running, and writing all parts of the research.
Funding: No direct financial support was received from any institution or organization for the preparation of this article.
Conflicts of interest: This article does not overlap with other published works of the authors.
Following the ethics of research: In this article, all rights related to research ethics have been respected.
Type of Study: orginal |
Received: 2023/12/30 | Accepted: 2024/07/22 | Published: 2024/10/5
Received: 2023/12/30 | Accepted: 2024/07/22 | Published: 2024/10/5
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Social Welfare Quarterly
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