DOI: 10.5061/dryad.v15dv41wd
title: A cross sectional study on adaptation and initial validation of a test to evaluate health claims among high school students – Croatian version

description: Objectives: We validated the Croatian version of the test using
 multiple-choice questions (MCQs) from the Claim Evaluation Tools item bank
 of the Informed Health Choices project, and measured the ability of high
 school students to appraise health claims. Setting: 16 high schools from
 the urban agglomeration of the city of Split, Croatia. Participants: Final
 year high school students of at least 18 years of age. Interventions: 18
 MCQs from the item bank considered relevant for high school students were
 translated. After face-validity testing, the questionnaire was piloted and
 sent to a convenient sample of 302 high school students. Primary and
 secondary outcome measures: Difficulty and discrimination indices were
 calculated for each MCQ to determine the validity of translation and the
 weight of MCQs. We assessed basic metric characteristics and performed
 initial validation of the test. Two tests were created, the full (18 MCQs)
 and the short version (12 MCQs). We analysed differences in test score
 according to gender and school. Results: The response rate was 96% (75%
 female respondents). Metric characteristics of both tests were
 satisfactory (Cronbach α=0.71 for the full and α=0.73 for the short
 version). The mean score (± standard deviation) for the full version was
 11.15±3.43 and 8.13±2.76 for the short version. There were 6 easy and 12
 moderately difficult questions. Questions concerning effectiveness and
 dissimilar comparison groups were answered correctly by fewer than 40% of
 students. Female students and those from grammar and health schools scored
 higher on both tests. Conclusions: Both tests showed good metric
 characteristics and may be used for quick and reliable assessments of
 adolescents’ ability to appraise health claims. They may be used to
 identify needs and inform development of educational activities to foster
 critical thinking about health among adolescents
description: From the full set of questions available in the Claim Evaluation
 Tools item bank, we selected items referring to the Key Concepts that
 were considered eligible for high school students in the current health
 education model. Finally, a set of 18 items was included in the
 questionnaire. Each of the 18 MCQs consisted of a scenario leading to a
 treatment claim and a question with 3 or 4 possible answers. 
 W created an online questionnaire using a Google Docs form. The
 form contained information about the scope of the study that students had
 to go through before answering questions. Completing the questionnaire was
 considered as consent for participation. The first part of the
 questionnaire included demographic data, like age, gender and the type of
 school participants attended. All answers from the test were automatically
 imported in an Excel file (Ver. Office 2007, Microsoft Corporation,
 Redmond, WA, USA). We coded the answers and analysed
 the data using the SPSS v.24 (IBM Corp., Armonk, New York). 
 We used descriptive statistics to present data from the test
 regarding the demographics, as well as frequencies of correct answers, and
 have presented those as absolute numbers and percentages for each test
 question. The overall test scores were presented using means (M) and
 standard deviations (SD). For each question, we
 assessed gender differences using the MannWhitney test. Gender differences
 in the overall test results were analysed using the t-test for independent
 samples. The variance of the overall test results
 regarding the type of school was assessed using the One-way ANOVA test.
 p&lt;0.05 was considered statistically significant.
 Least Significant Test (LSD) Fisher test was used for post-hoc
 analyses of the differences in the overall test scores between groups of
 female and male students in relation to the type of school.
 Multiple regression analyses were performed to investigate the
 overall multivariate effect of the two variables, gender and the type of
 school, as well as to determine the level of individual contribution of
 each of these variables on the overall test results. 
description: The items from the Claim Evaluation Tools item bank are not
 publicly available, but access can be obtained from the IHC Project
 leaders upon request. The Supplementary file contains the list of Key
 Concepts of the questions selected for the Croatian test.