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Peer-reviewedCC BYBMC public health

Cross-cultural adaptation and psychometric validation of the GeKoKIDS scale among Portuguese school-aged children.

  • Maria João Batalha1,2,3
  • Pedro Jesus4
  • Anabela Graça3
  • Ana Rita Pedro2,5
  • Sara Simões Dias6,7
7 affiliations
  1. 1ciTechCare - Center for Innovative Care and Health Technology, Polytechnic of Leiria, Leiria, Portugal.
  2. 2ENSP - Escola Nacional de Saúde Pública - Universidade NOVA de Lisboa, Lisboa, Portugal.
  3. 3Câmara Municipal de Leiria, Leiria, Portugal.
  4. 4School of Health Sciences, Polytechnic of Leiria, Leiria, Portugal.
  5. 5CHRC - Comprehensive Health Research Center - Universidade NOVA de Lisboa, Lisboa, Portugal.
  6. 6ciTechCare - Center for Innovative Care and Health Technology, Polytechnic of Leiria, Leiria, Portugal. [email protected].
  7. 7School of Health Sciences, Polytechnic of Leiria, Leiria, Portugal. [email protected].
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Abstract

Background

Promoting health literacy in childhood is essential, as it lays the foundation for lifelong healthy behaviors and supports informed decision-making. This study aimed to translate, cross-culturally adapt, and psychometrically validate the GeKoKIDS scale for assessing health literacy in portuguese children, addressing the lack of validated instruments for this age group.Methods

The study was conducted at a school in Leiria, Portugal (October-December 2024), with a convenience sample of children aged 10-12 years. The cross-cultural adaptation followed standard procedures including translation-back translation, cognitive debriefing, and content validation by an expert panel. Psychometric evaluation included 83 participants, assessing internal consistency via Cronbach's alpha and corrected item-total correlations. Factorial structure was examined using confirmatory factor analysis (CFA), with χ²/df, CFI, TLI, SRMR and RMSEA as fit indices. Test-retest reliability was assessed using the intraclass correlation coefficient (ICC (3,1)). Convergent validity was evaluated through correlations with perceived parental health guidance and motivation for health learning.Results

The adapted LiSaKIDS retained the original five-domain structure comprising 16 items. Psychometric analyses were conducted on the 14 Likert-type items, resulting in a final 13-item psychometric model after the exclusion of one item. This model demonstrated acceptable-to-good internal consistency (Cronbach's α = 0.807). CFA provided partial support for the proposed four-factor structure (χ²/df = 1.54; CFI = 0.94; TLI = 0.92; SRMR = 0.102; RMSEA = 0.081). Test-retest reliability indicated moderate-to-good temporal stability (ICC (3,1) = 0.724; 95% CI: 0.570-0.829; p < 0.001). Positive correlations were observed with parental health guidance (ρ = 0.417; p < 0.001) and motivation for health learning (ρ = 0.269; p = 0.015).Conclusions

LiSaKIDS is a concise, reliable, and valid instrument for assessing health literacy in portuguese children. The scale demonstrated internal consistency, factorial validity, moderate to good temporal stability, and convergent validity, characteristics that support its use in research and public health initiatives aimed at promoting pediatric health literacy.

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Cite

BibTeXRIS
BibTeX
@article{batalha2026crosscultural,
  title = {{Cross-cultural adaptation and psychometric validation of the GeKoKIDS scale among Portuguese school-aged children.}},
  author = {Maria João Batalha and Pedro Jesus and Anabela Graça and Ana Rita Pedro and Sara Simões Dias},
  journal = {BMC public health},
  year = {2026},
  month = aug,
  doi = {10.1186/s12889-026-28771-6},
  url = {https://europepmc.org/article/MED/42963744},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Cross-cultural adaptation and psychometric validation of the GeKoKIDS scale among Portuguese school-aged children.
AU  - Maria João Batalha
AU  - Pedro Jesus
AU  - Anabela Graça
AU  - Ana Rita Pedro
AU  - Sara Simões Dias
PY  - 2026
DA  - 2026/08/04
JO  - BMC public health
DO  - 10.1186/s12889-026-28771-6
UR  - https://europepmc.org/article/MED/42963744
AB  - Background  Promoting health literacy in childhood is essential, as it lays the foundation for lifelong healthy behaviors and supports informed decision-making. This study aimed to translate, cross-culturally adapt, and psychometrically validate the GeKoKIDS scale for assessing health literacy in portuguese children, addressing the lack of validated instruments for this age group.Methods  The study was conducted at a school in Leiria, Portugal (October-December 2024), with a convenience sample of children aged 10-12 years. The cross-cultural adaptation followed standard procedures including translation-back translation, cognitive debriefing, and content validation by an expert panel. Psychometric evaluation included 83 participants, assessing internal consistency via Cronbach's alpha and corrected item-total correlations. Factorial structure was examined using confirmatory factor analysis (CFA), with χ²/df, CFI, TLI, SRMR and RMSEA as fit indices. Test-retest reliability was assessed using the intraclass correlation coefficient (ICC (3,1)). Convergent validity was evaluated through correlations with perceived parental health guidance and motivation for health learning.Results  The adapted LiSaKIDS retained the original five-domain structure comprising 16 items. Psychometric analyses were conducted on the 14 Likert-type items, resulting in a final 13-item psychometric model after the exclusion of one item. This model demonstrated acceptable-to-good internal consistency (Cronbach's α = 0.807). CFA provided partial support for the proposed four-factor structure (χ²/df = 1.54; CFI = 0.94; TLI = 0.92; SRMR = 0.102; RMSEA = 0.081). Test-retest reliability indicated moderate-to-good temporal stability (ICC (3,1) = 0.724; 95% CI: 0.570-0.829; p < 0.001). Positive correlations were observed with parental health guidance (ρ = 0.417; p < 0.001) and motivation for health learning (ρ = 0.269; p = 0.015).Conclusions  LiSaKIDS is a concise, reliable, and valid instrument for assessing health literacy in portuguese children. The scale demonstrated internal consistency, factorial validity, moderate to good temporal stability, and convergent validity, characteristics that support its use in research and public health initiatives aimed at promoting pediatric health literacy.
SN  - 1471-2458
ER  -