Improving primary school health education through action research : a case study

Limited research has been conducted concerning the actual practice of health education in Victorian schools. This study investigates the health education curriculum at a large primary school in the south-eastern suburbs of Melbourne. The investigation involves a critical analysis of current practices in health education in the upper school through the development of a ‘small’ action research group. Data were gathered through document collection, questionnaires, interviews, discussions, diary and reflective journal entries. The action research group, consisting of the teacher-researcher and upper school teachers, developed, implemented and reflected upon units of work piloted with upper school students. Alternative approaches to health education were explored. The aim was to accommodate critically informed discourse amongst colleagues to promote self-reflective enquiry and facilitate improvements to existing pedagogic practices. During the course of the investigation, factors limiting and facilitating action research and curriculum change in health education, became evident. These included personal, practical, curriculum and organisational constraints operating externally and internally on the school and classroom environments. Despite these constraints, it was demonstrated in this study, that action research can contribute to the improvement of pedagogic practices in health education. Small ‘authentic’ action research projects may provide alternative internal professional development structures for teachers and consequently improve learning opportunities for students.

Adaptation and validation of the Japanese version of the health education impact questionnaire (heiQ-J) for the evaluation of self-management education interventions

Aim:  

Assessment of proximal outcomes of self-management programs : translation and psychometric evaluation of a German version of the Health Education Impact Questionnaire (heiQtm)

Purpose This paper describes the translation, cultural adaption, and psychometric evaluation of a German version of the Health Education Impact Questionnaire (heiQ™), a widely used generic instrument assessing a wide range of proximal outcomes of self-management programs.

Methods The translation was carried out according to international standards and included forward and backward translations. Comprehensibility and content validity were tested using cognitive interviews with 10 rehabilitation inpatients. Psychometric properties were examined in rehabilitation inpatients (n = 1,202) with a range of chronic conditions. Factorial validity was assessed using confirmatory factor analysis; concurrent validity was explored by correlations with comparator scales.

Results The items of the German heiQ™ were well understood by rehabilitation inpatients. The structure of the eight heiQ™ scales was replicated after minor adjustment. heiQ™ scales had higher correlations with comparator scales with similar constructs, particularly mental health concepts than with physical health. Moreover, all heiQ™ scales differentiated between individuals across different levels of depression.

Conclusion The German heiQ™ is comprehensible for German-speaking patients suffering from different types of chronic conditions; it assesses relevant outcomes of self-management programs in a reliable and valid manner. Further studies involving its practical application are warranted.

Measurement of stable changes of self-management skills after rehabilitation: a latent state–trait analysis of the Health Education Impact Questionnaire (heiQ™)

Methods: Subjects were N = 580 patients with rheumatism, asthma, orthopedic conditions or inflammatory bowel disease, who filled out the heiQ™ at the beginning, the end of and 3 months after a disease-specific inpatient rehabilitation program in Germany. Structural equation modeling techniques were used to estimate latent trait-change models and test for measurement invariance in each heiQ™ scale. Coefficients of consistency, occasion specificity and reliability were computed.

Factor structure and measurement invariance of the Health Education Impact Questionnaire: does the subjectivity of the response perspective threaten the contextual validity of inferences?

Objective:
On-going evidence is required to support the validity of inferences about change and group differences in the
evaluation of health programs, particularly when self-report scales requiring substantial subjectivity in response generation are used as outcome measures. Following this reasoning, the aim of this study was to replicate the factor structure and investigate the measurement invariance of the latest version of the Health Education Impact Questionnaire, a widely used health program evaluation measure.
Methods:
An archived dataset of responses to the most recent version of the English-language Health Education Impact
Questionnaire that uses four rather than six response options (N=3221) was analysed using exploratory structural equation
modelling and confirmatory factor analysis appropriate for ordered categorical data. Metric and scalar invariance were
studied following recent recommendations in the literature to apply fully invariant unconditional models with minimum
constraints necessary for model identification.
Results:
The original eight-factor structure was replicated and all but one of the scales (Self Monitoring and Insight) was
found to consist of unifactorial items with reliability of ⩾0.8 and satisfactory discriminant validity. Configural, metric and scalar
invariance were established across pre-test to post-test and population sub-groups (sex, age, education, ethnic background).
Conclusion:
The results support the high level of interest in the Health Education Impact Questionnaire, particularly for use as a pre-test/post-test measure in experimental studies, other pre–post evaluation designs and system-level monitoring and evaluation.

Measurement invariance of English and French Health Education Impact Questionnaire (heiQ) empowerment scales validated for cancer

PURPOSE: If measurement invariance (MI) is demonstrated for a scale completed by respondents from two different language groups, it means that the scale measures the same construct in the same way in both groups. We assessed MI of the French- and English-language versions of the five Health Education Impact Questionnaire (heiQ) empowerment scales validated for the cancer setting. METHODS: Data came from two cross-sectional studies of Canadian cancer survivors (704 English, 520 French). Single-group confirmatory factor analysis (CFA) was used to test whether the hypothesized factor structure of the French-language heiQ empowerment scales fit the data. Multi-group CFAs were conducted to assess different levels of MI conditions (configural, metric, scalar, strict, as well as MI of factor variances, covariances, and latent means) of the French- and English-language heiQ empowerment scales. RESULTS: The correlated five-factor model showed good fit in both language groups (goodness-of-fit indices: CFI ≥ .97; RMSEA ≤ .07). Goodness-of-fit indices and tests of differences in fit between models supported MI of the five-factor model across the two language groups (∆CFI ≤ -.010 combined with ∆RMSEA ≤ .015). CONCLUSIONS: The French- and English-language heiQ empowerment scales measure the same five dimensions of empowerment in the same way across both language groups. Thus, any observed similarities or differences between French- and English-speaking respondents completing these scales are valid and reflect similarities or differences in empowerment across language groups, not measurement artifact. Consequently, heiQ empowerment data from English- and French-speaking respondents can be directly pooled or contrasted in data analyses.