Development and Psychometric Evaluation of the Lifestyle Medicine Health Behavior Scale

Purpose. The purpose of this study was to develop and validate a scale to measure health behavior across the six pillars of lifestyle medicine: sleep, social connectedness, physical activity, nutrition, substance use, and stress management. A pilot study (n = 94) investigated the construct, convergent, and content validity and reliability of the Lifestyle Medicine Health Behavior (LMHB) scale. Based on the pilot study results and literature, the scale was revised for further psychometric evaluation. Methods. A sample (n = 399) of participants completed the LMHB scale. Confirmatory factor analysis was used to assess construct validity. Face validity was assessed using qualitative feedback. Reliability was assessed using Cronbach's alpha. Results. The final model included five latent dimensions and one observed to represent each of the distinct pillars in lifestyle medicine. The open-ended response item elicited preponderance of positive feedback (∼80%); the scale was perceived as easy to understand and complete. Overall, the scale was reliable (α = 0.84). Conclusion. The LMHB scale assesses health behaviors across all six lifestyle medicine pillars, addressing each one systematically and individually. The scale had sufficient validity and reliability to measure health behaviors in this sample of adults. This is the first lifestyle medicine survey instrument to evaluate content, face, and construct validity and reliability.