Canadian Journal of Public Health

, Volume 100, Issue 5, pp 389–392 | Cite as

Psychometric Properties of a Scale Focusing on Perceived Attributes of a Health Promoting School Approach

  • Marthe DeschesnesEmail author
  • François Trudeau
  • Mababou Kébé
Quantitative Research



The purpose of this paper was to investigate the psychometric properties of a newly-designed scale intended to measure the perceived attributes of a Health Promoting School initiative and its context in terms of factor structure, reliability and predictive validity. The scale was developed to explore possible predictors of the adoption of the Healthy School approach (HS) in Québec.


Data were gathered from a 2007 cross-sectional study of 107 schools and 141 participants (school principals and school health promotion delegates). The scale was based on 7 attributes borrowed from the theories on diffusion of innovation. The factor structure of the scale was tested by exploratory and confirmatory factor analyses.


The final scale included 14 items capturing 4 factors: school contextual barriers, collective efficacy, anticipated benefits and relative advantages. Reliability, in terms of internal consistency of the factors, ranged from a high of 0.85 to a low of 0.60. Three of the 4 factors significantly predicted HS adoption.


Overall, the scale showed good psychometric properties and may be useful to assess the attributes that could influence the adoption of this type of initiative.

Key words

Health promoting school innovation scale development psychometrics 



L’objectif de cet article est de présenter les qualités psychométriques d’un nouvel indice mesurant les attributs perçus d’une approche École en santé (AÉS), en termes de structure factorielle, de fidélité et de validité prédictive.


Les données proviennent d’une enquête postale menée à l’automne 2007 auprès de 107 écoles du Québec et de 141 participants scolaires (directeurs et responsables de la promotion de la santé). La théorie de la diffusion de Rogers ainsi que d’autres écrits sur la diffusion des innovations ont servi à la construction de l’indice. Deux analyses, exploratoire et confirmatoire, ont permis de tester la structure factorielle de l’indice.


L’indice obtenu inclut 14 items répartis en 4 facteurs: contraintes dans l’environnement scolaire, efficacité collective, bénéfices anticipés et avantages relatifs. La consistance interne de ces facteurs varie entre,85 et,60. Les trois premiers facteurs ont permis de prédire l’adoption de l’AÉS.


Globalement, l’indice possède de bonnes qualités psychométriques et peut s’avérer utile pour évaluer l’influence des attributs de ce type d’approche sur son adoption par les écoles.

Mots clés

école en santé innovation indice qualités psychométriques 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    World Health Organization Regional Office for the Western Pacific. Health-Promoting Series 5: Regional Guidelines. Development of Health-Promoting Schools: A Framework for Action. Manila, Philippines: World Health Organization, 1996.Google Scholar
  2. 2.
    Marx E, Wooley SF, Northrop D (Eds.). Health is Academic. A Guide to Coordinated School Health Programs. New York, NY: Teachers College Press, 1998.Google Scholar
  3. 3.
    St Leger L, Nutbeam D. A model for mapping linkages between health and education agencies to improve school health. J Sch Health 2000;70(2):45–50.CrossRefGoogle Scholar
  4. 4.
    Parsons C, Stears D, Thomas C. The health promoting school in Europe: Conceptualising and evaluating the change. Health Educ J 1996;55(3):311–21.CrossRefGoogle Scholar
  5. 5.
    Hoelscher DM, Evans A, Parcel GS, Kelder SH. Designing effective nutrition interventions for adolescents. J Am Diet Assoc 2002;102(3):S52–S63.CrossRefGoogle Scholar
  6. 6.
    James WPT, Rigby NJ, Leach RJ, Kumanyika S, Lobstein T, Swinburn B. Global Strategies to Prevent Childhood Obesity: Forging a Societal Plan That Works. London, UK: International Association for the Study of Obesity/International Obesity Task Force, 2006.Google Scholar
  7. 7.
    Stewart-Brown S. What Is the Evidence on School Health Promotion in Improving Health or Preventing Disease and, Specifically, What Is the Effectiveness of the Health Promoting Schools Approach? Copenhagen, Denmark: World Health Organization, 2006.Google Scholar
  8. 8.
    Warren JM, Henry CJK, Lightowler HJ, Bradshaw SM, Perwaiz S. Evaluation of a pilot school programme aimed at the prevention of obesity in children. Health Promot Int 2003;18(4):287–96.CrossRefGoogle Scholar
  9. 9.
    Ministère de la Santé et des Services sociaux. Rapport annuel de gestion 2006–2007 du ministère de la Santé et des Services sociaux. Québec, QC: Gouvernement du Québec, 2008.Google Scholar
  10. 10.
    Deschesnes M, Martin C, Jomphe Hill A. Comprehensive approaches to school health promotion: How to achieve broader implementation? Health Promot Int 2003;18(4):387–96.CrossRefGoogle Scholar
  11. 11.
    Micucci S. Environmental interventions to improve nutrition and increase physical activity in children and youth. In: Thomas H, Ciliska D, Micucci S, Wilson-Abra J, Dobbins M (Eds.), Effectiveness of Physical Activity Enhancement and Obesity Prevention Programs in Children and Youth. Hamilton, ON: Effective Public Health Practice Project, 2004;223–64.Google Scholar
  12. 12.
    Inchley J, Muldoon J, Currie C. Becoming a health promoting school: Evaluating the process of effective implementation in Scotland. Health Promot Int 2006;22(1):65–71.CrossRefGoogle Scholar
  13. 13.
    Barry MM, Domitrovich C, Lara MA. The implementation of mental health promotion programmes. Promot Educ 2005;12(Suppl 2):30–36.CrossRefGoogle Scholar
  14. 14.
    Kiefer L, Frank J, Di Ruggiero E, Dobbins M, Manuel D, Gully PR, Mowat D. Fostering evidence-based decision-making in Canada: Examining the need for a Canadian population and public health evidence centre and research network. Can J Public Health 2005;96(3):I1–I19.PubMedGoogle Scholar
  15. 15.
    Greenberg MR. The diffusion of public health innovations. Am J Public Health 2006;96(2):209–10.CrossRefGoogle Scholar
  16. 16.
    Greenhalgh T, Robert G, MacFarlane F, Bate P, Kyriakidou O. Diffusion of innovations in service organizations: Systematic review and recommendations. Milbank Q 2004;82(4):581–629.CrossRefGoogle Scholar
  17. 17.
    Rogers EM. Diffusion of Innovations. New York: Free Press, 2003.Google Scholar
  18. 18.
    Oldenburg B, Parcel GS. Diffusion of innovations. In: Glanz K, Rimer BK, Lewis FM (Eds.), Health Behavior and Health Education: Theory, Research, and Practice. San Francisco, CA: Jossey-Bass, 2002;312–34.Google Scholar
  19. 19.
    Sussman S, Valente TW, Rohrbach LA, Skara S, Pentz M-A. Translation in the health professions: Converting science into action. Eval Health Prof 2006;29(1):7–32.CrossRefGoogle Scholar
  20. 20.
    Edwards P, Roberts IG, Clarke MJ, Di Guiseppi C, Wentz R, Kwan I, et al. Methods to increase response rates to postal questionnaires. Cochrane Database Syst Rev 2003;2:1–18.Google Scholar
  21. 21.
    Goldman D. Perceptions of innovations as predictors of implementation levels: The diffusion of a nation-wide health education campaign. Health Educ Q 1992;21(4):429–45.Google Scholar
  22. 22.
    Lafferty CK. Diffusion of an asset building innovation in three Portage County school districts: A model of individual change [dissertation]. Ann Arbor, MI: Kent State University, 2001.Google Scholar
  23. 23.
    Parcel GS, O’Hara-Tompkins NM, Harrist RB, Basen-Engquist KM, McCormick LK, Gottlieb NH, Eriksen MP. Diffusion of an effective tobacco prevention program. Part II: Evaluation of the adoption phase. Health Educ Res 1995;10(3):297–307.CrossRefGoogle Scholar
  24. 24.
    Altman DG. Practical Statistics for Medical Research. Boca Raton, FL: CRC Press, 1991.Google Scholar
  25. 25.
    Nunnally JC, Bernstein IH. Psychometric Theory, 3rd ed. New York: McGraw-Hill, 1994.Google Scholar
  26. 26.
    Loehlin JC. Latent Variable Models: An Introduction to Factor, Path, and Structural Equation Analysis. Mahwah, NJ: Lawrence Erlbaum Associates, 1998.Google Scholar
  27. 27.
    Stevens J. Applied Multivariate Statistics for the Social Sciences. Mahwah, NJ: Lawrence Erlbaum Associates, 2002.Google Scholar
  28. 28.
    Hu LT, Bentler PM. Fit indices in covariance structure modeling: Sensitivity to underparameterized model misspecification. Psychol Methods 1998;3:424–53.CrossRefGoogle Scholar
  29. 29.
    Jöreskog KG, Sörbom D. Lisrel 7: A Guide to the Program and Applications. Chicago, IL: SPSS Inc., 1988.Google Scholar

Copyright information

© The Canadian Public Health Association 2009

Authors and Affiliations

  • Marthe Deschesnes
    • 1
    Email author
  • François Trudeau
    • 2
  • Mababou Kébé
    • 3
  1. 1.Institut national de santé publique du Québec and Université du Québec en OutaouaisQuébecCanada
  2. 2.Université du Québec à Trois-RivièresTrois-RivièresCanada
  3. 3.Institut national de santé publique du QuébecQuébecCanada

Personalised recommendations