Translation, cross-cultural adaptation and validation of the Health Belief Model Questionnaire (HBMQ) for weight management behaviour for use in a Southeast Asian country

In the past 50 years, obesity and being overweight have become significant health concerns that cause a rise in the risk of illness, impairing quality of life and increasing financial burdens worldwide. The purpose of the study is to conduct translation and cross-cultural adaptation of a Health Belief Model Questionnaire (HBMQ) for weight management behaviour into the Malay language and to validate the questionnaire. The HBMQ was adapted and translated into the Malay language based on published international guidelines. The content validity and the face validity were analysed by a panel of 10 experts. A pilot test was conducted with 35 students from Universiti Sains Malaysia to evaluate internal consistency. A cross-sectional study was carried out by distributing the self-administered HBMQ to the general public in Malaysia and 505 subjects were successfully recruited. The construct validity was evaluated by exploratory factor analysis. The first 112 participants completed the survey again one week later for the evaluation of test-retest reliability. In total, 79 questions had an item-level content validity index (I-CVI) score of >0.80 and have been evaluated as excellent inferring acceptable content validity. The remaining seven items in the instrument had an I-CVI score < 0.80 and were removed based on the experts’ consensus. The item-level face validity index value for each item range was between 0.8 and 1.0, indicating a satisfactory level of face validity. For construct validity, eight factors were requested and 74 items had a significant to strong factor loading of >0.4. The rotation of items showed five items had factor loadings <0.4 (item numbers 14, 57, 77, 78 and 79) and have been removed. The findings in this study conclude that the translated Health Belief Model-Malay version has adequate content validity, face validity, construct validity and reliability.