Cross-Cultural Validation and Psychometric Properties Test of the Healthy
Lifestyle Intention Scale for University Students
#MMPMID41341737
Kähkönen O
; Engblom J
; Lau Y
; Wong EL
; Tian CY
; Cheung AW
; Chan HHH
; Oikarinen A
Chronic Dis Transl Med
2025[Dec]; 11
(4
): 293-305
PMID41341737
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BACKGROUND: University students are internationally recognized as a population at
risk due to unhealthy lifestyle behaviors and elevated health risks. Supporting
positive behavioral change requires understanding their intentions to adopt
healthier habits. This study aimed to psychometrically evaluate and culturally
validate the healthy lifestyle intention scale (HLIS) in three countries and
regions. METHODS: A cross-sectional methodological study was conducted in 2023
among university students in Finland (n?=?753), Singapore (n?=?750), and Hong
Kong, China (n?=?767). The HLIS was developed based on the Adherence to Treatment
of Patients with Chronic Disease Instrument. Psychometric evaluation included
Spearman's ?, Cronbach's ?, and both exploratory and confirmatory factor
analyses. RESULTS: Findings from all three countries and regions indicated that
Spearman's ? values ranged from weak to high across the dimensions of
self-readiness (0.23-0.69), family support (0.42-0.78), peer support (0.48-0.80),
and social media influence (0.48-0.80). Cronbach's ? values demonstrated
acceptable internal consistency (0.41-0.92). Structural validity was supported by
confirmatory factor analysis. While the Finnish model suggested a need for
further refinement (comparative fit index [CFI]?=?0.81, root mean square error of
approximation [RMSEA]?=?0.11), the models for Singapore (CFI?=?0.92,
RMSEA?=?0.07) and Hong Kong, China (CFI?=?0.92, RMSEA?=?0.07) showed strong fit
indices. CONCLUSION: The current version of the HLIS demonstrates promising
psychometric properties for assessing health-related behavioral intentions among
university students in a cross-cultural context. Further validation with more
diverse international samples is recommended.