Health vulnerability: evidence of validity of an item bank

Psychometric study with support of Pasquali’s theoretical pole in which 62 specialists with different sociodemographic and academic characteristics were selected and 15 of them responded to the content validity questionnaire. After adjustments, the bank moved to the response process validity phase and was evaluated by 12 health service users. A content validity coefficient was used to evaluate the items and the bank, which had the reliability assessed by the binomial test, considering a percentage of 80% and p-value >0.05.

Results

The bank presented good evidence of content validity by experts. The coefficients were 0.87 for the subject element, 0.86 for the social element and 0.865 for the general element. The target audience made suggestions in the response process validity phase to better understand the items (total coefficient: 0.89), which were considered clear, accurate and understandable.

Conclusion

The final version of the item bank has 535 items, 238 for the subject and 297 for the social element. It presents evidence of validity of content and response process and is suitable for testing the validity of internal structure.

Health vulnerability; Health promotion; Surveys and questionnaires; Validation studies; Psychometrics

Variables	n(%)
Experts
Sex
Female	12(80.0)
Male	3(20.0)
State
Bahia	1(6.7)
Ceará	9(60.0)
Paraíba	1(6.7)
Paraná	2(13.3)
Rio de Janeiro	1(6.7)
Rio Grande do Norte	1(6.7)
Degree area
Nursing	9(60.0)
Speech therapy	1(6.7)
Nutrition	1(6.7)
Physical Education Professional	2(13.3)
Social Service	2(13.3)
Higher degree
Master	10(66.7)
Doctorate	4(26.7)
Post-doctoral	1(6.7)
Clinical practice
Yes	12(80.0)
No	3(20.0)
Management practice
Yes	8(53.3)
No	7(46.7)
Teaching practice
Yes	13(86.7)
No	2(13.3)

Target audience

Sex
Female	7(58.3)
Male	5(41.7)
Color/race
White	6(50.0)
Black	3(25.0)
Brown/mixed race	3(25.0)
Education
Primary school	1(8.3)
Secondary school	5(41.7)
Complete higher education	4(33.3)
Postgraduate studies	2(16.7)
Previous illness
Yes	7(58.3)
No	5(41.7)
Most used service
Clinic	1(8.3)
Hospital	2(16.7)
Primary Care Unit	6(50.0)
Emergency care unit	3(25.0)

Item	Mean CVC^† (clarity, pertinence, relevance) experts	p-value binomial test	Mean CVC^† (clarity, adequacy, understanding) target audience	p-value binomial test
Essential element – subject (238 items)	0.87	-	0.88	-
Functional literacy (38 items)	0.85	0.09	0.85	0.21
Behavior (56 items)	0.86	0.42	0.92	0.46
Interpersonal relationships (19 items)	0.87	0.48	0.90	0.35
Psycho-emotional status (67 items)	0.88	0.67	0.85	0.66
Physical status (58 items)	0.90	0.49	0.87	0.07
Essential element – social (309 items)	0.86	-	0.90	-
Socioeconomic status (59 items)	0.82	0.31	0.90	0.33
Demographic identity (9 items)	0.80	0.30	0.91	0.43
Culture (5 items)	0.80	0.30	0.89	0.31
Family context (24 items)	0.96	0.52	0.91	0.46
Social networks and supports (14 items)	0.83	0.32	0.86	0.48
Gender (12 items)	0.82	0.45	0.91	0.37
Violence (28 items)	0.86	0.53	0.87	0.56
Social control (6 items)	0.88	0.67	0.92	0.68
Ecosystem (16 items)	0.93	0.49	0.85	0.49
Access to fundamental rights (32 items)	0.81	0.47	0.91	0.23
Programmatic status (88 items)	0.91	0.50	0.95	0.56
State (16 items)	0.89	0.48	0.89	0.39

Escola Paulista de Enfermagem, Universidade Federal de São Paulo R. Napoleão de Barros, 754, 04024-002 São Paulo - SP/Brasil, Tel./Fax: (55 11) 5576 4430 - São Paulo - SP - Brazil
E-mail: actapaulista@unifesp.br

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[1] Corresponding author: Raquel Sampaio Florêncio E-mail: raquelsampy@hotmail.com