Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
BMC Public Health
Published in: BMC Public Health 1/2016

Open Access 01-12-2015 | Research article

Development and psychometric validation of a scoring questionnaire to assess healthy lifestyles among adolescents in Catalonia

Authors: Lluís Costa-Tutusaus, Myriam Guerra-Balic

Published in: BMC Public Health | Issue 1/2016

Login to get access

Abstract

Background

Lifestyle is intimately related to health. A questionnaire that specifically scores the healthiness of lifestyle of Catalan adolescents is needed. The objective of this study was to develop and validate a scoring questionnaire called VISA-TEEN to assess the healthy lifestyle of young Catalans that can be answered quickly and user-friendly.

Methods

A lifestyle questionnaire was developed based on the analysis of contributions from two focus groups, one with adolescents and the other with people who work with them (teachers and doctors). A panel of experts validated the content of items that were ultimately selected for the VISA-TEEN questionnaire. Three hundred ninety-six adolescents (215 boys and 181 girls, age = 13–19 years) completed the VISA-TEEN. Internal consistency was assessed using Cronbach's alpha (α) reliability coefficient. Test-retest reliability, using an intraclass correlation coefficient (ICC), was calculated based on scores attained two weeks apart. Construct validity was assessed by the extraction of components with an exploratory factor analysis. The relationship between the scores was measured using the health-related quality of life (HRQoL) KIDSCREEN-10 Index (the relationship was assessed by calculating Pearson’s r correlation coefficient). The association of scores in the VISA-TEEN for self-rated health (SRH) was also examined by executing an analysis of variance (ANOVA) between the different categories of this variable. We also calculated the index of fit for factor scales (IFFS) for each component, as well as the discriminatory power of the instrument using Ferguson’s δ (delta) coefficient.

Results

The VISA-TEEN questionnaire showed acceptable reliability (α = 0.66, αest = 0.77) and a very good test-retest agreement (ICC = 0.860). It could be broken down into the following five components, all with an acceptable or very good IFFS (0.7–0.96): diet, substance abuse, physical activity, Rational Use of Technological Leisure (RUTL), and hygiene. Scores on the VISA-TEEN showed significant correlation with the KIDSCREEN index (r = 0.21, p < 0.001) and were associated with SRH (p < 0.001). The discriminatory power was found to be δ = 0.97.

Conclusions

The VISA-TEEN questionnaire developed to study the lifestyle of Catalan adolescents is a valid instrument to apply in this population as it is shown in the present psychometric tests to understand the role of lifestyle in the health of teenagers or to test the efficacy of health campaigns intended to improve teenagers' lifestyle.
Appendix
Available only for authorised users
Literature
1.
WHO. Health Promotion Glossary. Geneva: World Health Organitation; 1997.
2.
Moreno C, Ramos P, Rivera F, Jimenez-Iglesias A, García A. Las conductas relacionadas con la salud y el desarrollo de los adolescentes españoles. Resumen del estudio Health Behaviour in School Aged Clidren (HBSC-2010). Madrid: Ministerio de Sanidad, servicios sociales e igualdad; 2012.
3.
Maynard M, Gunnell D, Emmett P, Frankel S, Davey SG. Fruit, vegetables, and antioxidants in childhood and risk of adult cancer: the Boyd Orr cohort. J Epidemiol Community Health. 2003;57(3):218–25.CrossRefPubMedPubMedCentral
4.
McGartland C, Robson PJ, Murray L, Cran G, Savage MJ, Watkins D, et al. Carbonated soft drink consumption and bone mineral density in adolescence: the Northern Ireland Young Hearts project. J Bone Miner Res Off J Am Soc Bone Miner Res. 2003;18(9):1563–9.CrossRef
5.
Gonzalez-Gross M, Gomez-Lorente JJ, Valtuena J, Ortiz JC, Melendez A. The “healthy lifestyle guide pyramid” for children and adolescents. Nutr Hosp. 2008;23(2):159–68.PubMed
6.
Libuda L, Alexy U, Remer T, Stehle P, Schoenau E, Kersting M. Association between long-term consumption of soft drinks and variables of bone modeling and remodeling in a sample of healthy German children and adolescents. Am J Clin Nutr. 2008;88(6):1670–7.CrossRefPubMed
7.
Verzeletti C, Maes L, Santinello M, Vereecken CA. Soft drink consumption in adolescence: associations with food-related lifestyles and family rules in Belgium Flanders and the Veneto Region of Italy. Eur J Public Health. 2010;20(3):312–7. Available from.CrossRefPubMed
8.
Malik VS, Popkin BM, Bray GA, Despres JP, Willett WC, Hu FB. Sugar-sweetened beverages and risk of metabolic syndrome and type 2 diabetes: a meta-analysis. Diabetes Care. 2010;33(11):2477–83.CrossRefPubMedPubMedCentral
9.
Park S, Sherry B, O’Toole T, Huang Y. Factors associated with low drinking water intake among adolescents: the Florida Youth Physical Activity and Nutrition Survey, 2007. J Am Diet Assoc. 2011;111(8):1211–7.CrossRefPubMed
10.
Rey-Lopez JP, Vicente-Rodriguez G, Repasy J, Mesana MI, Ruiz JR, Ortega FB, et al. Food and drink intake during television viewing in adolescents: the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study. Public Health Nutr. 2011;14(9):1563–9.CrossRefPubMed
11.
Diethelm K, Jankovic N, Moreno LA, Huybrechts I, De Henauw S, De Vriendt T, et al. Food intake of European adolescents in the light of different food-based dietary guidelines: results of the HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence) Study. Public Health Nutr. 2012;15(3):386–98.CrossRefPubMed
12.
Menschik D, Ahmed S, Alexander MH, Blum RW. Adolescent physical activities as predictors of young adult weight. Arch Pediatr Adolesc Med. 2008;162(1):29–33.CrossRefPubMed
13.
US Department of Health and Human Services. 2008 physical activity guidelines for Americans. Washington, DC: Department of Health and Human Services; 2008.
14.
Manonelles P, Alcaraz J, Álvarez J, Jimenez F, Luengo E, Manuz B, et al. La utilidad de la actividad física y de los hábitos adecuados de nutrición como medio de prevención de la obesidad en niños y adolescentes. Documento de consenso de la Federación Española de Medicina del Deporte (FEMEDE). Arch Med del Deport. 2008;XXV(5):333–53.
15.
WHO. Recomendaciones mundiales sobre actividad física para la salud. Geneve: Organización Mundial de la Salud; 2010.
16.
Wen CP, Wai JP, Tsai MK, Yang YC, Cheng TY, Lee MC, et al. Minimum amount of physical activity for reduced mortality and extended life expectancy: a prospective cohort study. Lancet. 2011;378(9798):1244–53.CrossRefPubMed
17.
World Health Organization regional office for Europe. Promoting sport and enhancing health in European Union countries: a policy content analysis to support action. Copenhagen: publications WHO regional office for Europe; 2011.
18.
Moore SC, Patel AV, Matthews CE, Berrington de G, Park Y, Katki HA, et al. Leisure Time Physical Activity of Moderate to Vigorous Intensity and Mortality: A Large Pooled Cohort Analysis. PLoS Med. 2012;9(11):e1001335. Available from: http://​dx.​doi.​org/​10.​1371/​journal.​pmed.​1001335.CrossRefPubMedPubMedCentral
19.
20.
21.
Axelsson J, Sundelin T, Ingre M, Van Someren EJ, Olsson A, Lekander M. Beauty sleep: experimental study on the perceived health and attractiveness of sleep deprived people. BMJ. 2010;341:c6614.CrossRefPubMedPubMedCentral
22.
Chien KL, Chen PC, Hsu HC, Su TC, Sung FC, Chen MF, et al. Habitual sleep duration and insomnia and the risk of cardiovascular events and all-cause death: report from a community-based cohort. Sleep. 2010;33(2):177–84.CrossRefPubMedPubMedCentral
23.
Garaulet M, Ortega FB, Ruiz JR, Rey-Lopez JP, Beghin L, Manios Y, et al. Short sleep duration is associated with increased obesity markers in European adolescents: effect of physical activity and dietary habits. The HELENA study. Int J Obes. 2011;35(10):1308–17.CrossRef
24.
Buxton OM, Cain SW, O’Connor SP, Porter JH, Duffy JF, Wang W, et al. Adverse metabolic consequences in humans of prolonged sleep restriction combined with circadian disruption. Sci Transl Med. 2012;4(129):129ra43.CrossRefPubMedPubMedCentral
25.
26.
27.
Frazier AL, Fisher L, Camargo CA, Tomeo C, Colditz G. Association of adolescent cigar use with other high-risk behaviors. Pediatrics. 2000;106(2):E26.CrossRefPubMed
28.
Salleras L, Taberner JL. Guia per a la prevenció i el control del tabaquisme des de l’àmbit pediàtric. Barcelona: Generalitat de Catalunya. Departament de Sanitat i Seguretat Social. Direcció General de Salut Pública; 2003.
29.
Altarriba FX, Bascones A. Libro blanco sobre la relación entre adolescencia y alcohol en España. Madrid: Fund Alcohol y Sociedad; 2006.
30.
García A. Guia de recomendaciones clínicas: Alcoholismo. Astúrias: Dirección General de Calidad e Innovación en Servicios Sanitarios. Govierno de Asturias; 2008.
31.
Ochoa Mangado E, Madoz-Gúrpide A, Vicente MN. Diagnóstico y tratamiento de la dependencia de alcohol. Med Segur Trab. 2009;55(214):26–40.CrossRef
32.
Klempova D, Sánchez A, Vicente J, Barrio G, Domingo A, Suelves JM, et al. Consumo problemático de cannabis en estudiantes españoles de 14–18 años: validación de escalas. Madrid: Ministerio de Sanidad y Política Social; 2009.
33.
Shapiro GK, Buckley-Hunter L. What every adolescent needs to know: cannabis can cause psychosis. J Psychosom Res. 2010;69(6):533–9.CrossRefPubMed
34.
35.
Casadio P, Fernandes C, Murray RM, Di Forti M. Cannabis use in young people: the risk for schizophrenia. Neurosci Biobehav Rev. 2011;35(8):1779–87.CrossRefPubMed
36.
Degenhardt L, Bucello C, Calabria B, Nelson P, Roberts A, Hall W, et al. What data are available on the extent of illicit drug use and dependence globally? Results of four systematic reviews. Drug Alcohol Depend. 2011;117(2–3):85–101.CrossRefPubMed
37.
Madruga CS, Laranjeira R, Caetano R, Pinsky I, Zaleski M, Ferri CP. Use of licit and illicit substances among adolescents in Brazil: a national survey. Addict Behav. 2012;37(10):1171–5.CrossRefPubMed
38.
Tsiligianni IG, Vardavas CI, Bouloukaki I, Kosmas E, Verigou E, Kiriakaki M, et al. The association between alcohol and tobacco use among elementary and high school students in Crete, Greece. Tob Induc Dis. 2012;10(1):15.CrossRefPubMedPubMedCentral
39.
Puente D, Zabaleta-Del-Olmo E, Pueyo MJ, Salto E, Marsal JR, Bolibar B. Prevalencia y factores asociados al consumo de tabaco en alumnos de enseñanza secundaria de Cataluña. Aten Primaria. 2013;45(6):315–23.CrossRefPubMed
40.
Elena MV. Evaluación del estado de salud bucodental y su relación con estilos de vida saludables en la provincia de Salamanca. Salamanca: Universidad de salamanca, Facultad de Medicina; 2008.
41.
Tagliaferro EP, Ambrosano GM, Meneghim Mde C, Pereira AC. Risk indicators and risk predictors of dental caries in schoolchildren. J Appl Oral Sci. 2008;16(6):408–13.CrossRefPubMedPubMedCentral
42.
Lau CH, Springston EE, Sohn MW, Mason I, Gadola E, Damitz M, et al. Hand hygiene instruction decreases illness-related absenteeism in elementary schools: a prospective cohort study. BMC Pediatr. 2012;12:52.CrossRefPubMedPubMedCentral
43.
Holmberg M, Public health and infections: Health in Sweden. The National Public Health Report 2012. Chapter 15. Scand J Public Health. 2012;40(9 Suppl):275–80.CrossRefPubMed
44.
45.
Lopez-Carmona JM, Rodríguez R, Munguí¬a C, Hernández JL, Casas E. Validez y fiabilidad del instrumento FANTASTIC para medir el estilo de vida en pacientes mexicanos con hipertensión arterial. Atención primaria. 2000;26(8):542–9.CrossRefPubMed
46.
Rodríguez-Moctezuma R, López JM, Munguí¬a C, Hernández JL, Martí¬nez M. Validez y consistencia del instrumento FANTASTIC para medir el estilo de vida en pacientes mexicanos con diabetes mellitus tipo 2. Rev Med. 2003;41(3):215–24.
47.
Walker SN, Kerr MJ, Pender NJ, Sechrist KR. A spanish language version of the Health-Promoting Lifestyles Profile. Nurs Res. 1990;39(5):268–73.CrossRefPubMed
48.
Mahon NE, Yarcheski A, Yarcheski TJ. Psychometric evaluation of the Prsonal Lifestyle Questionnaire for adolescents. Res Nurs Heal. 2002;25(1):68–75.CrossRef
49.
50.
Wärnberg J, Ruiz JR, Ortega FB, Romeo J, Gónzalez-Gross M, Moreno LA, et al. Estudio AVENA (Alimentación y valoración del estado nutricional en adolescentes). Resultados obtenidos 2003–2006. Pediatr Integral. 2006;Supl(1):50–5.
51.
Serra-Majem L, Ribas L, Aranceta J, Pérez L, Saavedra P, Peña L. Obesidad infantil y juvenil en España. Resultados del Estudio enKid (1998–2000). Med Clin. 2003;121(19):725–32.CrossRef
52.
Moukhyer ME, Van Eijk JT, De Vries NK, Bosma H. Health-related behaviors of Sudanese adolescents. Educ Heal. 2008;21(1):1–10.
53.
Sarrafzadegan N, Kelishadi R, Esmailzadeh A, Mohammadifard N, Rabiei K, Roohafza H, et al. Do lifestyle interventions work in developing countries? Finding from the Isfahan Healthy Heart Program in the Islamic Republic of Iran. Bull World Health Organ. 2009;87(1):39–50.CrossRefPubMed
54.
Ruiz-Risueño J. Hábitos deportivos y estilos de vida de los escolares de ESO en los municipios de la provincia de Almería. Retos. 2010;17:49–53.
55.
Russse-Lachance E, Tremblay A, Drapeau V. Lifestyle factors and other health measures in a Canadian university community. Appl Physiol Nutr Metab. 2010;35(4):498–505.CrossRef
56.
Committee SA. Assessing health status and quality-of-life instruments: attributes and review criteria. Qual Life Res. 2002;11:193–205.CrossRef
57.
Valderas JM, Ferrer M, Mendivil J, Garin O, Rajmil L, Herdman M, et al. Development of EMPRO: a tool for the standardized assessment of patient-reported outcome measures. Value Health. 2008;11(4):700–8.CrossRefPubMed
58.
Ravens-Sieberer U, Kidscreen Group Europe. The Kidscreen Questionnaires: Quality of Life Questionnaires for Children and Adolescents; Handbook. Lengerich: Pabst Science Publ; 2006.
59.
60.
Idler EL, Benyamini Y. Self-rated health and mortality: a review of twenty-seven community studies. J Health Soc Behav. 1997;38(1):21–37.CrossRefPubMed
61.
Cronbach LJ, Schönemann P, McKie D. Alpha coefficients for Stratified-Parallel Tests. Educ Psychol Meas. 1965;25(2):291–312.CrossRef
62.
Feldt LS, Brennan RL. Reliability. Washington DC: American Council on Education; 1989. p. 105–146.
63.
Tenenbaum G, Eklund RC, Kamata A. Introduction to measurement in sport and exercise psychology. In: Tenenbaum G, Eklund RC, Kamata A, editors. Introduction to measurement in sport and exercise psychology. Champaign, IL, US: Human Kinetics; 2012. p. 3–7.
64.
Domenech J. Fundamentos de diseño y estadística. UD14. Medida del cambio: Análisi de diseños con medidas intrasujeto. Barcelona: Signo; 2000.
65.
Morales P. La fiabilidad de los tests i las escalas. Madrid: Publicaciones de la Universidad Pontificia Comillas; 2008.
66.
67.
Fleming JS. An index of fit for factor scales. Educ Psychol Meas. 1985;45(4):725–8.CrossRef
68.
Batista-Foguet JM, Coenders G, Alonso J. Análisis factorial confirmatorio. Su utilidad en la validación de cuestionarios relacionados con la salud. Med Clin. 2004;122(Supl 1):21–7.CrossRef
69.
Foster C, Porcari JP, Anderson J, Paulson M, Smaczny D, Webber H, et al. The talk test as a marker of exercise training intensity. J Cardiopulm Rehabil Prev. 2008;28(1):22–4.CrossRef
70.
Quinn TJ, Coons BA. The Talk Test and its relationship with the ventilatory and lactate thresholds. J Sports Sci. 2011;29(11):1175–82.CrossRefPubMed
71.
Loose BD, Christiansen AM, Smolczyk JE, Roberts KL, Budziszewska A, Hollatz CG, et al. Consistency of The Counting Talk Test For Exercise Prescription. J Strength Cond Res. 2012;26(6):1701–7.CrossRefPubMed
72.
Jeanes EM, Foster C, Porcari JP, Gibson M, Doberstein S. Translation of exercise testing to exercise prescription using the talk test. J Strength Cond Res. 2011;25(3):590–6.CrossRefPubMed
73.
74.
Young K. Internet addiction: the emergence of a new clinical disorder. Cyberpsychol Behav. 1998;1(3):237–44.CrossRef
75.
Pérez A, García-Continente X, Grup col·laborador enquesta FRESC-2012. Informe FRESC 2012: 25 anys d'enquestes a adolescents escolaritzats de Barcelona. Barcelona: Agència de Salut Pública de Barcelona; 2013.
76.
77.
Nebot M, Pérez A, Garcia-Continente X, Ariza C, Espelt A, Pasarín M. Informe FRESC 2008. Resultats principals. Barcelona: Agència de Salut Pública de Barcelona; 2010.
78.
Wright ND, Groisman-Perelstein AE, Wylie-Rosett J, Vernon N, Diamantis PM, Isasi CR. A lifestyle assessment and intervention tool for pediatric weight management: the HABITS questionnaire. J Hum Nutr Diet. 2011;24(1):96–100.CrossRefPubMed
79.
Muchotrigo MPG. Estilo de vida saludable en estudiantes de posgrado de Ciencias de la Salud. Psicol y Salud. 2012;22(1):75–87.
80.
Vereecken C, Dupuy M, Rasmussen M, Kelly C, Nansel TR, Al Sabbah H, et al. Breakfast consumption and its socio-demographic and lifestyle correlates in schoolchildren in 41 countries participating in the HBSC study. Int J Public Health. 2009;54 Suppl 2:180–90.CrossRefPubMedPubMedCentral
81.
Nevid J, Rathus S, Rubenstein H. Health in the New Millennium. New York: Worth Pub; 1998.
82.
83.
Morales P. Medición de actitudes en psicología y educación: construcción de escalas y problemas metodológicos. Madrid: Universidad Pontificia Comillas; 2006.
84.
85.
86.
87.
Fismen AS, Samdal O, Torsheim T. Family affluence and cultural capital as indicators of social inequalities in adolescent’s eating behaviours: a population-based survey. BMC Public Health. 2012;12:1036.CrossRefPubMedPubMedCentral
88.
Spies Shapiro LA, Margolin G. Growing Up Wired: Social Networking Sites and Adolescent Psychosocial Development. Clin Child Fam Psychol Rev. 2014;17(1):1–18.CrossRefPubMed
89.
Wolniczak I, Caceres-Delaguila JA, Palma-Ardiles G, Arroyo KJ, Solis-Visscher R, Paredes-Yauri S, et al. Association between Facebook Dependence and Poor Sleep Quality: A Study in a Sample of Undergraduate Students in Peru. PLoS One. 2013;8(3):e59087.CrossRefPubMedPubMedCentral
90.
Do YK, Shin E, Bautista MA, Foo K. The associations between self-reported sleep duration and adolescent health outcomes: what is the role of time spent on Internet use? Sleep Med. 2013;14(2):195–200.CrossRefPubMed
91.
Giron P. Determinants of self-rated health in Spain: differences by age groups for adults. Eur J Public Health. 2012;22(1):36–40.CrossRefPubMed
92.
Darviri C, Artemiadis AK, Tigani X, Alexopoulos EC. Lifestyle and self-rated health: a cross-sectional study of 3,601 citizens of Athens, Greece. BMC Public Health. 2011;11:619.CrossRefPubMedPubMedCentral
93.
De Cocker K, Ottevaere C, Sjostrom M, Moreno LA, Warnberg J, Valtuena J, et al. Self-reported physical activity in European adolescents: results from the HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence) study. Public Health Nutr. 2011;14(2):246–54.CrossRefPubMed
94.
95.
Diaz AA, Trave DD. Quality of dietary habits (adherence to a Mediterranean diet) in pupils of compulsory secondary education. An Sist Navar. 2010;33(1):35–42.
Metadata
Title
Development and psychometric validation of a scoring questionnaire to assess healthy lifestyles among adolescents in Catalonia
Authors
Lluís Costa-Tutusaus
Myriam Guerra-Balic
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2016
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-016-2778-6

Other articles of this Issue 1/2016

BMC Public Health 1/2016 Go to the issue

Research article

Nutritional quality of foods and non-alcoholic beverages advertised on Mexican television according to three nutrient profile models

Research article

The height-, weight- and BMI-for-age of preschool children from Nizhny Novgorod city, Russia, relative to the international growth references

Research article

The effect of war on infant mortality in the Democratic Republic of Congo

Research article

Vitamin D level and its association with adiposity among multi-ethnic adults in Kuala Lumpur, Malaysia: a cross sectional study

Research article

Uptake of HIV testing and counseling, risk perception and linkage to HIV care among Thai university students

Study protocol

The effect of an affordable daycare program on health and economic well-being in Rajasthan, India: protocol for a cluster-randomized impact evaluation study