Development and initial validation of a modular life-course health education and science communication needs scale...

This study aimed to develop and preliminarily validate a Modular Life-Course Health Education and Science Communication Needs Scale for Chinese clinical and community service users in Tianjin and their primary caregivers. The scale was intended as a modular needs-assessment instrument to identify perceived health education and science communication needs and communication preferences across life stages and caregiving contexts in local or comparable Chinese service settings, rather than as a tool already validated for national or international use.

An initial item pool was developed through a systematic literature review, thematic analysis of semi-structured interviews (n = 22), two rounds of Delphi expert consultation (n = 15), and a pilot survey, guided by life-course theory and the socio-ecological model of health. Psychometric evaluation was conducted using two independent samples. In Stage 1, item analysis and exploratory factor analysis (EFA) were conducted using data from 487 participants. In Stage 2, confirmatory factor analysis (CFA) was performed using data from 328 participants. Internal consistency was assessed at the module level and, where applicable, at the subdimension level using Cronbach's alpha coefficients with 95% confidence intervals, McDonald's omega coefficients, Spearman-Brown corrected split-half reliabilities, and corrected item-total correlations. Content validity was evaluated using the content validity index (CVI). Convergent and discriminant validity were examined using average variance extracted (AVE) and the Fornell-Larcker criterion.

The final scale comprised 10 modules and 90 items, including six age-specific modules, two context-specific modules, and two preference modules. The age-specific and context-specific modules each encompassed three dimensions: physiological, psychological, and social needs. The response rates for both Delphi rounds were 100%. The expert authority coefficients (Cr) were 0.86 and 0.88, and Kendall's coefficients of concordance (W) were 0.36 and 0.39, respectively (both p < 0.001). The item-level content validity index (I-CVI) ranged from 0.87 to 1.00, and the scale-level content validity index based on the averaging method (S-CVI/Ave) was 0.96. Item analysis showed that item-total correlation coefficients ranged from 0.52 to 0.89 (all p < 0.05), and critical ratio values ranged from 3.12 to 8.45 (all p < 0.01). EFA using principal axis factoring with Promax rotation supported three correlated factors for the age-specific and context-specific modules, corresponding to physiological, psychological, and social needs. Across these modules, the cumulative variance explained ranged from 63.86 to 75.44%, communalities ranged from 0.410 to 0.860, and primary pattern coefficients ranged from 0.601 to 0.900. A single factor was extracted for each preference module, explaining 61.31 and 59.47% of the variance for the format and channel preference modules, respectively; across the two preference modules, factor coefficients ranged from 0.732 to 0.808 and communalities ranged from 0.535 to 0.652. CFA provided preliminary evidence of acceptable model fit across modules, with χ² /df ranging from 1.28 to 2.41, RMSEA from 0.031 to 0.068, CFI from 0.95 to 0.99, TLI from 0.94 to 0.98, and SRMR from 0.028 to 0.055. AVE values for multi-item dimensions ranged from 0.54 to 0.74 across the age-specific and context-specific modules, and from 0.61 to 0.63 across the preference modules, providing preliminary evidence of convergent validity. The single-item social dimension of the hospice and palliative care module was interpreted descriptively rather than through AVE or CR. At the module level, Cronbach's alpha coefficients ranged from 0.80 to 0.87, McDonald's omega coefficients ranged from 0.81 to 0.88, Spearman-Brown corrected split-half reliability coefficients ranged from 0.77 to 0.84, and corrected item-total correlations ranged from 0.52 to 0.82. Subdimension-level reliability estimates were also acceptable.

The Modular Life-Course Health Education and Science Communication Needs Scale showed acceptable preliminary psychometric performance in a Tianjin-based sample of Chinese clinical and community service users and their primary caregivers. The scale may support structured, stage-specific, and context-sensitive assessment of perceived health education and science communication needs and communication preferences in local or comparable Chinese service settings. However, the findings should be interpreted as geographically bounded, and further multicenter, cross-regional, rural-urban, and cross-cultural validation is required before broader national or international application.