Adaptation and Validation of the Post-Pandemic Health Promotion Behavior of Young Adults in the Digital Age (PS-SGD) Scale in the Turkish Population

Abstract

Background: Young adulthood is a critical developmental period in which individuals establish life-long health behaviors and take responsibility for their own health care. Health promotion strategies tailored to young adults, leveraging digital tools, and addressing challenges exacerbated by events like the COVID-19 pandemic are needed. The aim of this study was to adapt the post-pandemic health promotion behavior of young adults in the digital age (PS-SGD) scale to the Turkish population in order to assess and compare the health behavior of young adults after the pandemic. Methods: A total of 312 participants, aged between 19 and 29 years, were included in the study via non-probabilistic criterion sampling, while the Turkish adaptation process started with translation and back translation methods performed with three language and two health science experts. For statistical analysis, EFA and CFA were conducted to evaluate internal consistency and structural validity. Confirmatory factor analysis was utilized to confirm the structure of the six sub-dimensions. Additionally, measurement invariance was examined regarding participants' gender to determine if the scale accurately captured similar traits across diverse groups. The relationship between the test-retest data was tested by Pearson correlation to measure consistency and its invariance over time. Results: The gender distribution of the sample was found to be 61.3% female and 38.7% male. According to the results of EFA, items 8 and 18 were removed from the Turkish-adapted version. As a result of the reliability analysis conducted with the Turkish version of the scale, the Cronbach alpha coefficient was obtained as 0.851 for the post-pandemic health promotion behavior. Additionally, the scale was rated as reliable with the following Cronbach alpha values: 0.79 for the personal hygiene, 0.78 for dietary habits, 0.72 for using mobile devices, 0.70 for emotional health, 0.68 for health care and physical activity, and 0.51 for social health sub-dimensions. To examine the six sub-dimension factor structures of the scale, fit indices were calculated as chi 2/df (1.722), GFI (0.894), IFI (0.908), TLI (0.892), CFI (0.907), RMSEA (0.048), and SRMR (0.057) and were within acceptable limits. Findings of the multi-group confirmatory factor analysis for measurement invariance were less than or equal to 0.01 for the triangle CFI and triangle RMSEA values across all indices. Consequently, it was observed that the item-factor structure, factor loadings, variances, covariances, and error variances of the scale were equivalent for both male and female young adults, while test-retest results showed a high positive correlation. Conclusions: The Turkish version of the post-pandemic health promotion behavior scale of young adults in the digital age scale, consisting of 25 items and six subscales, was proven to be a valid and reliable tool to measure health promotion behavior in young adults aged 19-29 years.