Attitudes and Beliefs of Nursing Students Towards the Childhood Overweight Scale

Abstract

The Attitudes and Beliefs of Nursing Students Towards the Childhood Overweight Scale is a 19-item inventory developed by Semerci, Çelik, and Kudubeş in 2023. Its primary function is to quantify the attitudes and beliefs held by Turkish nursing students regarding childhood obesity. This instrument represents a Turkish adaptation of a children’s version originally created by Tsai et al. (2018), which itself stemmed from Allison’s (1995) seminal Attitudes Towards Obese Persons Scale (ATOP) and Beliefs About Obese Persons Scale (BAOP).

The adaptation process included obtaining explicit written permission from Dr. Lauretta Luck and undergoing rigorous psychometric evaluation. This evaluation confirmed the scale’s robustness through expert item analysis for content validity and the use of both exploratory and confirmatory factor analyses (CFA). The results supported a distinct two-factor structure for the ATOP component and a unidimensional, one-factor structure for the BAOP component, demonstrating the scale’s reliability and validity in assessing this critical construct within the target population.

Keywords

Attitudes toward Childhood Obesity, Nursing Students, Self-Concept, Social Relations, Student Beliefs, Scale Adaptation, Psychometric Properties.

Authors

Remziye Semerci, Özge Mengi Çelik, Asli Akdeni̇z Kudubeş.

Purpose

The fundamental goal of the scale is to provide a standardized, quantitative measure of the perceptions and beliefs held by Turkish nursing students concerning childhood obesity. This measurement serves a crucial preparatory function in healthcare education.

By accurately mapping these attitudes and beliefs, the instrument allows educators and researchers to identify potential negative biases, stereotypes, or misconceptions that students may carry. Addressing these biases is essential, as they can significantly impact future clinical practice, patient communication, and the effectiveness of health education programs related to managing childhood overweight and obesity.

Construct

The scale measures two primary, related psychological constructs derived from the original Allison (1995) instruments: Attitudes Towards Obese Persons (ATOP) and Beliefs About Obese Persons (BAOP), specifically tailored to the context of childhood overweight. The entire instrument is composed of 19 items.

The ATOP component focuses on affective responses and underlying feelings towards children who are overweight, further subdivided into dimensions of Self-Concept and Social Relations. The BAOP component assesses cognitive beliefs and knowledge structures held by the students regarding the causes, characteristics, and implications associated with childhood obesity.

Validity

The validity of the Turkish adaptation was established through robust analysis of both content and construct validity.

Regarding Content Validity, the scale underwent expert item analysis, yielding exceptionally high agreement among reviewers. The item–content validity index (I-CVI) ranged impressively from 0.91 to 0.99. Furthermore, the overall scale-level content validity index (S-CVI) was reported as 0.97, confirming that the items comprehensively and relevantly cover the intended domains of attitudes and beliefs toward childhood overweight.

Construct Validity was supported by factor analytic results. For both the ATOP and BAOP children’s versions, the variance explained by the factor models exceeded 40%, which is widely accepted as a strong indicator of successful construct validation. This confirms that the scale items effectively group together to measure the theoretical constructs—attitudes and beliefs—as intended.

Reliability

The internal consistency, a key aspect of psychometric properties, was evaluated using Cronbach’s alpha for the Turkish version of the scale.

For both the ATOP and BAOP subscales, the reported Cronbach’s alpha values were greater than 0.70. This statistical outcome signifies acceptable to good internal consistency, suggesting a high correlation between the items within each subscale, thereby confirming that they reliably measure the same underlying dimension of attitudes or beliefs.

Factor Analysis

To determine the underlying structure of the 19-item scale, both Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) were performed on the data collected from nursing students.

The Exploratory Factor Analysis (EFA) revealed distinct structures for the two main components. The Attitudes Towards Obese Persons (ATOP) subscale demonstrated a two-factorial structure, with both factors exhibiting eigenvalues greater than 1 and collectively accounting for 49.3% of the total variance. Conversely, the Beliefs About Obese Persons (BAOP) subscale was found to be largely unidimensional, supported by a single factor that accounted for 55.92% of the total variance.

The Confirmatory Factor Analysis (CFA) subsequently supported these proposed structures using established goodness-of-fit indices. For the two-factor ATOP model, acceptable indices were reported:

• χ²/df = 2.151

• RMSEA = 0.073

• GFI = 0.932

• CFI = 0.924

The one-factor BAOP model also confirmed its unidimensionality with acceptable fit indices:

• χ²/df = 2.190

• RMSEA = 0.074

• GFI = 0.969

• CFI = 0.976

These consistent results provide strong statistical evidence for the structural validity of the adapted scale within the Turkish context.

Instrument

Test Type: Inventory/Questionnaire (Adaptation)

Format: The scale is a 19-item measure consisting of two primary subscales (ATOP and BAOP). The ATOP component utilizes a five-point Likert type scale with anchors ranging from 1 = Strongly disagree to 5 = Strongly agree. The BAOP component also uses a 5-point Likert-type scale, although specific anchors were not detailed in the source documentation. The specific wording of the test items is proprietary or unavailable in the public domain.

Language Available: Turkish

Population Group: Human (Male and Female)

Age Group: Adulthood (18 years & older)

Population Details: The validation study sample consisted of 3rd and 4th-grade nursing students located in Turkey.

Test Methodology: The rigorous psychometric evaluation involved three core methodologies: 1. Test Validity (specifically assessing Content Validity and Construct Validity); 2. Test Reliability (evaluation of Internal Consistency via Cronbach’s alpha); and 3. Factor Analysis (employing both Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA)).

Keywords

Attitudes towards Obese Persons (ATOP), Beliefs About Obese Persons (BAOP), Turkish Adaptation, Exploratory Factor Analysis (EFA), Internal Consistency, Scale Validation.

Authors

Author ORCID Identifier: No data is Available

Affiliation Email addresses: Remziye Semerci: [email protected]; Özge Mengi Çelik: No data is Available; Asli Akdeni̇z Kudubeş: No data is Available

Correspondence Address: Remziye Semerci: [email protected]

Permissions & Fee and Test Year

Permissions: To obtain permissions for the use of this scale, users are directed to contact the Corresponding Author (Remziye Semerci) directly. The initial Turkish adaptation was conducted with explicit written permission from Dr. Lauretta Luck.

Commercial: No data is Available

Fee: No data is Available

Test Year: 2023

Reference’s

Semerci, R., Çelik, Ö. M., & Kudubeş, A. A. (2023). Investigation of psychometric properties of Turkish version of nursing students’ attitudes and beliefs towards Childhood Obesity Scale. Archives of Psychiatric Nursing, 43, 65–70. doi:10.1016/j.apnu.2022.12.029

Items of the Attitudes and Beliefs of Nursing Students Towards the Childhood Overweight Scale

IMPORTANT: The following scale items must be preserved in their original language and must not be changed in any way.

The Attitudes and Beliefs of Nursing Students Towards the Childhood Overweight Scale is a 19-item measure. This measure is composed of two main scales (subscales):

• Attitudes Towards Obese Persons (ATOP): This subscale is further divided into two components:

  • Self-Concept

  • Social Relations

• Beliefs About Obese Persons (BAOP)

No data is Available regarding the specific wording or content of the individual items within each subscale.