Related Experiment Video
Updated: Feb 8, 2026

Qualitative and Quantitative Validation of Tools with Rating Scales Aimed at Assessing the Quality of University Service-Learning
Published on: August 29, 2025
Item Generation and Content Validity of the Child-Adolescent Bullying Scale
Rachel L Difazio1, Tania D Strout, Judith A Vessey
1Rachel L. Difazio, PhD, RN, PPCNP-BC, FAAN, is Nurse Scientist, Orthopedic Center, Boston Children's Hospital, and Instructor, Harvard Medical School, Boston, Massachusetts. Tania D. Strout, PhD, RN, MS, is Director of Research and Associate Professor, Department of Emergency Medicine, Maine Medical Center, Tufts University School of Medicine, Portland. Judith A. Vessey, PhD, MBA, RN, FAAN, is Lelia Holden Carroll Professor in Nursing, William F. Connell School of Nursing, Boston College, Chestnut Hill, Massachusetts, and Nurse Scientist, Medicine Patient Services, Boston Children's Hospital, Massachusetts. Amanda Lulloff, MSN, RN, PCNS, CPHON, is Nurse Educator, Dana-Farber Jimmy Fund Clinic, Boston, Massachusetts.
Background:
Healthcare providers do not uniformly screen young patients for exposure to bullying, and no screening instruments have been developed for widespread use in clinical settings.
Objectives:
The objectives of this study were to (a) generate scale items by identifying and eliciting concepts relevant to youths with potential exposure to bullying as well as to professionals who work with bullied youths and (b) assess the content validity of the new Child-Adolescent Bullying Scale (CABS) instrument.
Methods:
A mixed-methods design was used to develop an initial pool of 52 items. The study was conducted in four phases: (I) comprehensive review of the existing literature; (II) concept elicitation through the conduct of focus groups with school-age youths and professionals who work with bullied youths; (III) concept selection and item construction; and (IV) content validation assessment of relevance, clarity, and dimension of each item by a panel of 30 international bullying and measurement experts through completion of an online survey.
Results:
An initial pool of 52 potential items was developed during Phases I-III of the study. During Phase IV, item- and scale-level content validity indices were calculated and were used to refine the item pool. These strategies resulted in a new, 22-item tool, with scale-level content validity indices of .954 for clarity and .920 for representativeness.
Discussion:
Evaluation of the CABS tool with a sample of youths drawn from healthcare settings will be necessary to assess the performance of the CABS items, further evaluate its psychometric properties, and further refine the tool.
More Related Videos
Related Concept Videos
Bullying
Reliability and Validity
Cognitive Development During Adolescence
pH Scale
Stereotype Content Model
Data Validation
Key parameters for method validation include:

