Psychometric properties of the newly developed Self-Report Environmental Determinants of Health Questionnaire (EDH-Q)

Abstract

Abstract Background The environmental determinants of health (EDH) have a significant impact on people's physical, mental, and social wellbeing. Everyone needs access to environmental resources of all types, including food, materials, and energy, to survive. Currently, no valid and reliable instrument exists for evaluating individuals' perceived levels of EDH. Hence, the purpose of this study was to create the environmental determinants of health questionnaire (EDH-Q) and assess its psychometric properties among undergraduate students in Nigeria. Method A cross-sectional survey was conducted among university undergraduate students in Nigeria. The respondents were selected using a convenience sampling method to evaluate their perceptions regarding EDH. To determine the psychometric properties of the newly created EDH-Q, the Content Validity Index (CVI), Face Validity Index (FVI), Exploratory Factor Analysis (EFA), Confirmatory Factor Analysis (CFA), Composite Reliability (CR), Average Variance Extracted (AVE), Cronbach's alpha, and Intraclass Correlation Coefficient (ICC) were all computed. Results The study involved 300 respondents in the EFA (males 55.7%, females 44.3%) and 430 respondents in the CFA (males 54.0%, females 46.0%). In the EFA, two constructs were identified (the natural environment and the built environment). The EFA model was able to explain 63.57% of the total cumulative variance, and the factor correlation was 0.671. The Cronbach's alpha values of the two constructs were 0.918 (natural environment) and 0.935 (built environment). In the CFA, six pairs of error covariances were included between items within the same construct to improve the fit indices of the initial proposed measurement model. The final re-specified measurement model showed that the EDH-Q, which has two constructs and 18 items, has adequate construct validity (CFI = 0.948, TLI = 0.938, SRMR = 0.046, RMSEA = 0.052, and RMSEA p-value = 0.344). The CRs were 0.845 (natural environment) and 0.854 (built environment). The ICCs were 0.976 (natural environment) and 0.970 (built environment). Conclusion The results show that the newly created EDH-Q has sufficient construct validity and may be utilized to assess participants' perceptions of their level of EDH. Researchers should examine this instrument in populations with different age ranges and other demographic characteristics, as the present study only applied it to undergraduate students who may share similar characteristics.