A scale for assessing the healthy of children aged 3-6 years in China —— Development and verification of the TCM constitution scale (3-6 years)

Wenle LI¹Siying Dong²Zhuqing Li³Shunqi CHEN⁴Yuyang Cai¹Minghua BAI^1*Jia-Xu Chen^1*Ji Wang^1*

• ¹Bejing University of Chinese Medicine, Beijing, China
• ²Anhui University of Chinese Medicine, Hefei, China
• ³Nanjing University of Chinese Medicine, Nanjing, China
• ⁴China Academy of Chinese Medical Sciences Institute of Basic Theory of Traditional Chinese Medicine, Beijing, China

Background Based on the Constitution in Chinese Medicine, this study developed a constitution questionnaire specifically adapted for preschool children. Methods First, a TCM constitution scale for children aged 3–6 years was developed using face-to-face interviews, Delphi expert consultation, Classical Test Theory (CTT). The Delphi method was conducted via email, and five CTT indicators were selected: decision value–critical ratio, dispersion trend, item–total correlation, internal consistency, and factor loading. Second, the psychometric properties of the scale were assessed, including reliability ( internal consistency,test–retest reliability and split-half reliability), and content validity. Exploratory factor analysis (EFA) was used to evaluate the structural validity of the items. Results The CCMQ 2.0 consisted of 47 items selected from the original 49 items of version 1.0. Exploratory factor analysis yielded a Kaiser–Meyer–Olkin (KMO) value of 0.886, and Bartlett's test of sphericity was significant (χ² = 5308.679, p < 0.001), indicating the data were suitable for factor analysis. Nine common factors were extracted, accounting for a cumulative variance contribution of 52.853%. The internal consistency of the CCMQ 2.0 was high, with a Cronbach's α of 0.924, and the test–retest reliability was satisfactory, with an intraclass correlation coefficient (ICC) of 0.86. Overall, the scale showed promising preliminary psychometric properties, though further validation is needed. Conclusion This study developed and preliminarily evaluated a 47-item Traditional Chinese Medicine (TCM) constitution scale for assessing the physical and mental health of children aged 3 to 6 years. The scale demonstrated good reliability and validity, offering a promising alternative tool for large-scale pediatric health assessments.