Design, Psychometric and Application of the Healthy City Indicators Questionnaire

Abstract

Background and Objectives: Today's problems of cities make it necessary to pay attention to the idea of healthy cities more than in the past. A requirement to have a healthy city is to identify health indicators in different dimensions. The study of these indicators requires accurate and reliable measurement tools. In this regard, the study was conducted with the aim of designing and psychometrically and using the questionnaire of the indicators of Healthy city. Materials and Methods: A descriptive study was conducted in the first stage on 300 adults aged 20 and over in Isfahan city and in the second stage on 150 people in 1402. The initial questionnaire of healthy city indicators was designed with 107 items based on the opinions of professors and experts in the fields of urban planning, urban engineering, environmental health, psychology, health and social welfare, health policy, health in disasters. In different stages of psychometrics, face validity, content validity (CVR, CVI), criteria (divergent and convergent), exploratory factor analysis and reliability were measured using Cronbach's alpha method. Descriptive statistics, Pearson's correlation coefficient, Student's t-test and analysis of variance were used to report the data in the software (version 26, SPSS Inc., Chicago, IL). Results: In the phase of determining quantitative face and content validity (CVR greater than 0.51 and CVI greater than 0.79 was acceptable), 52 items out of 107 items of the questionnaire were removed. All the remaining 55 items had a significant correlation with the total score of the questionnaire in the internal consistency measurement stage. In the Varimax exploratory factor analysis stage, 5 factors had an eigenvalue greater than one and were named as follows: "welfare, support and social participation" by explaining 53.99 of the variance; "Public, health and sanitary services"; "Cultural, educational and residential accesses"; "Emergency, health and social management"; and "fitness and urban beauty". Convergent and divergent validity was confirmed due to the stronger correlation between each item's score with its respective dimension score (P<0.0001), and lower correlation with other dimensions. Reliability was calculated using Cronbach's alpha coefficient for the entire questionnaire at 0.959 and for the questionnaire scales in the range of 0.934 to 0.784. According to the findings of the application stage, no statistically significant difference was observed between the average score of the indicators of Healthy city by sex, education level, and employment status of the citizens. Conclusion: The psychometrics of the questionnaire of the indicators of Healthy city indicated that the evaluations carried out in different stages were approved, as a result, the questionnaire has sufficient validity and reliability and usability. The results of this study can be used by policy makers and agents of the urban area and benefit from the benefits of planning related to measuring and using the tools of all citizens. © 2024 Iranian Association of Health Education and Health Promotion. All rights reserved.