Cross-cultural adaptation and psychometric evaluation of the Chinese adapted and revised Food Allergy Self-Efficacy Scale for Parents

Qi Li¹Zhigang Liu²Jiao Li¹Min Pan³Yuli Li¹Xinxia Chen¹Jiao Liu¹Hongyue Dai¹Yuxin Tang¹Lanting Zhao¹Ju Wang^1*

• ¹School of Nursing and Rehabilitation, Shandong University, Jinan, China
• ²Jinan Maternity and Child Care Hospital Affiliated to Shandong First Medical University, Jinan, China
• ³Shandong Provincial Hospital, Jinan, China

Background: Food allergy (FA) in Chinese children is a growing public health concern. Parental FA self-efficacy, characterized by parents’ confidence in managing children’s FA, correlates with parental and children’s well-being. However, there is currently no Chinese valid scale for measuring the parental FA self-efficacy. This study culturally adapted and revised the Food Allergy Self-Efficacy Scale for Parents (FASE-P) into Chinese, and examined the psychometric properties of the Chinese adapted and revised FASE-P (CAR-FASE-P). Methods: Cross-cultural adaptation of the FASE-P was firstly conducted through forward translation, back translation, expert consultation and cognitive interview with parents of FA children. To assess the psychometric properties, a total of 372 parents of FA children were recruited in the outpatient clinic of hospitals in Jinan, Shandong, China, and 30 parents participated in the retest. Item analysis, validity (including content validity, structural validity and criterion-related validity) and reliability (including internal consistency reliability, split-half reliability, test-retest reliability) of the CAR-FASE-P were examined. Results: After two rounds of expert panel reviews, adequate content validity of the preliminary CAR-FASE-P was confirmed, with the item-level content validity index ranging from 0.800 to 1.000 and the scale-level content validity index of 0.944. Exploratory factor analysis identified 4 factors accounting for 66.074% of the total variance. The modified confirmatory factor analysis model demonstrated that the 5-factor model fitted the data well (χ²/df = 1.556, root mean square error of approximation = 0.049, comparative fit index = 0.983, Tucker-Lewis index = 0.981, weighted root mean square residual = 0.911). The total Cronbach's α was 0.912, and the split-half and the test-retest reliability coefficients were 0.815 and 0.798, respectively. The scores of CAR-FASE-P were significantly correlated with General Self-Efficacy Scale scores (r=0.226, P < 0.001). The final version of CAR-FASE-P was a five-factor structure composed of 23 items. Conclusion: Evaluated in a Chinese sample, the CAR-FASE-P demonstrated preliminary evidence for validity and reliability, suggesting its potential utility for assessing parental self-efficacy in food allergy management.