Garcia Danilo, Chukwuorji JohnBosco Chika, Kazemitabar Maryam, Iwuagwu Tochi E, Chibuko Chinyere, Sanmartin Ricardo, Chiarolanza Claudia, Seçer İsmail, Cloninger Kevin M
Department of Social Studies, University of Stavanger, Stavanger, Norway.
Department of Behavioral Sciences and Learning, Linköping University, Linköping, Sweden.
BMC Public Health. 2025 Sep 2;25(1):3017. doi: 10.1186/s12889-025-24279-7.
School health programs are critical for promoting the physical, psychological, and social well-being of students and staff, particularly in low- and middle-income countries. Effective evaluation of these programs requires comprehensive and context-sensitive tools. The School Health Assessment Tool for Primary Schools (SHAT-PS), originally developed and validated in Iran, offers a biopsychosocial framework for evaluating key dimensions of school health. Designed for use in low- and middle-resource settings and emphasizing both staff and student well-being, the SHAT-PS provides a promising foundation for addressing gaps in school health assessment. However, although this tool has demonstrated strong psychometric properties in its original context, its applicability in other cultural and educational settings remains underexplored.
This study aimed to validate the SHAT-PS in Nigerian primary schools by examining its factor structure, internal consistency, and contextual relevance.
A total of 706 primary school teachers and school staff from the Nsukka education zone in southeast Nigeria completed the original 76 items of the SHAT-PS. Although the tool was originally developed in Persian, an English version, produced by the original developers through a standard forward and back translation process, was available and used in this study. As English is the official language of instruction in Nigeria, no additional translation was required. Instead, adaptation efforts focused on ensuring contextual and conceptual relevance of the items for the Nigerian educational setting, including expert review and evaluation by Nigerian educational psychologists and school administrators. We employed a cross-sectional design and conducted an Exploratory factor analysis (EFA) on half of the sample and a confirmatory factor analysis (CFA) on the remaining half. Internal consistency was assessed using Cronbach's alpha (α).
EFA and CFA supported a six-factor structure (52 items): (1) School Health Policies, (2) Health Education and Psychological Services, (3) Health Services, Nutrition, and Staff Health, (4) School Hygiene, (5) School Area and Comfort, and (6) Physical Environment. The tool demonstrated good internal consistency (α = 0.66-0.89) and strong construct validity. Variations in responses highlighted its sensitivity to local discrepancies in infrastructure, services, and staff well-being.
The SHAT-PS was successfully validated for use in Nigerian primary schools. Its robust psychometric performance and contextual alignment with national school health priorities make it a valuable tool for monitor school health and inform targeted interventions. Further validation in other regions and among broader stakeholder groups is recommended to enhance its generalizability and support nationwide implementation.
学校健康计划对于促进学生和教职员工的身体、心理和社会福祉至关重要，在低收入和中等收入国家尤其如此。对这些计划进行有效评估需要全面且因地制宜的工具。小学学校健康评估工具（SHAT-PS）最初在伊朗开发并经过验证，它为评估学校健康的关键维度提供了一个生物心理社会框架。SHAT-PS专为资源匮乏地区设计，强调教职员工和学生的福祉，为弥补学校健康评估方面的差距提供了一个有前景的基础。然而，尽管该工具在其原始背景下已显示出强大的心理测量特性，但其在其他文化和教育环境中的适用性仍未得到充分探索。
本研究旨在通过检验其因子结构、内部一致性和情境相关性，在尼日利亚的小学中验证SHAT-PS。
来自尼日利亚东南部Nsukka教育区的706名小学教师和学校工作人员完成了SHAT-PS最初的76个项目。尽管该工具最初是用波斯语开发的，但原始开发者通过标准的正向和反向翻译过程制作了一个英语版本，本研究使用的就是这个版本。由于英语是尼日利亚的官方教学语言，无需额外翻译。相反，调整工作重点是确保这些项目在尼日利亚教育背景下的情境和概念相关性，包括由尼日利亚教育心理学家和学校管理人员进行专家评审和评估。我们采用横断面设计，对一半样本进行探索性因子分析（EFA），对另一半样本进行验证性因子分析（CFA）。使用克朗巴哈系数（α）评估内部一致性。
探索性因子分析和验证性因子分析支持一个六因子结构（52个项目）：（1）学校健康政策，（2）健康教育与心理服务，（3）健康服务、营养与员工健康，（4）学校卫生，（5）学校区域与舒适度，（6）物理环境。该工具显示出良好的内部一致性（α = 0.66 - 0.89）和较强的结构效度。回答的差异突出了其对基础设施、服务和员工福祉方面当地差异的敏感性。
SHAT-PS已成功验证可在尼日利亚小学使用。其强大的心理测量性能以及与国家学校健康优先事项的情境契合度使其成为监测学校健康和为有针对性干预提供信息的宝贵工具。建议在其他地区和更广泛的利益相关者群体中进一步验证，以提高其普遍性并支持在全国范围内实施。
