Psychometric Properties of the Persian Version of Sexual and Reproductive Health Illustrative Questionnaire
Authors: Merghati-Khoei Effat , Motamedi Mahnaz , Shahbazi Mohammad , Rahimi-Naghani Shahrzad , Salehi Mehrdad , Hajebi Ahmad , Shah Safieh 
Published: May 2020

Abstract
Background: Sexual health is a human right, yet there is a lack of comprehensive, standardized and culturally appropriate instruments to assess sexual health in Iran.Objectives: This study aimed to assess the psychometric properties of the Persian version of the Sexual and Reproductive Health Illustrative Questionnaire (SRH-IQ).Material and methods: This was a methodological psychometric study conducted in Tehran, Iran, during 2014–2015, with a sample of 755 men and women aged 15–49 years. The SRH-IQ was translated and adapted via the method recommended by the world health organization.. Qualitative and quantitative face and content validity were evaluated and the construct validity assessed using exploratory and confirmatory factor analysis. The internal consistency and the stability of the tool were assessed using Cronbach’s alpha, Intraclass Correlations Coefficient (ICC) and test–retest method.Results: Several items were changed in accordance with the cultural and religious beliefs of Iranians. The mean item-level content validity index (I-CVI) was 0.98; the content validity ratio (CVR) was high at 0.976; and scale-level content validity average (S-CVI/Ave) and scale level content validity universal agreement (S-CVI/UA) were found to be 0.97 and 0.94, respectively. Exploratory and Confirmatory factor analysis confirmed that all items in domains were significant, and the results supported goodness of fit indices, too. The final Cronbach’s alpha coefficients of all sub-scales were > 0.60 indicating acceptable internal consistency. Test-Retest data analysis showed that the ICC was higher than 0.88 for most items (0.75–0.99). Kappa coefficients were above 0.8 in most instances (0.65–0.99).Conclusion: Given the appropriate validity and reliability of the Persian version of the SRH Questionnaire, it can be used to assess sexual health knowledge, attitudes, behaviour and outcomes of Iranian adults.Plain English Summary Sexual health is an integral component of human right, and it is an important basis for an individual’s physical and psychological well-being, as well as the social and economic development of communities. Evaluating the sexual health needs of people is necessary to address sexual health goals. Several studies have been conducted within the field of sexual health in Iran, however, no Persian instrument is available to assess the sexual health needs of adults within the reproductive ages. In order to make it applicable within the context of Iranian culture, we have investigated the psychometric properties of the Persian version of the Sexual and Reproductive Health Illustrative Questionnaire (SRH-IQ) among Iranian men and women in reproductive age. With this aim, we have recruited 755 men and women aged between 15-49 years in urban Tehran, Iran. Several items of the questionnaire were changed in accordance with the cultural and religious beliefs of Iranians. Exploratory and Confirmatory factor analysis confirmed that all items in domains were significant, and the results supported goodness of fit indices, too. All in all, this study has given the appropriate validity and reliability of the Persian version of the SRH Questionnaire, and it can be used to assess sexual health knowledge, attitudes, behaviour and outcomes of Iranian adults.