Scale development: Factors affecting diet, exercise, and stress management (FADESM)

Background: The objective of this study was to develop scales measuring personal and environmental factors that affect dietary fat intake behavior, physical activity, and stress management in low-income mothers. Methods: FADESM (factors affecting diet, exercise, and stress management) scales were developed using the Social Cognitive Theory to measure personal (outcome expectancies, self-efficacy, emotional coping response) and environmental (physical environment, social environment, situation) factors affecting dietary fat intake behavior, physical activity, and stress management. Low-income African American and white mothers were recruited from the Special Supplemental Nutrition Program for Women, Infants, and Children in three counties in Michigan. In Phase one, 45 mothers completed individual cognitive interviews. Content analyses were performed. In Phase two, items modified from the cognitive interviews were administered to 216 mothers. Factor analysis and multiple indicators/multiple causes were performed. Results: Results of cognitive interviews were used to revise items for the instrument that was tested in Phase two. The factor solution revealed 19 dimensions to measure personal and environmental factors affecting dietary fat intake behavior (three dimensions), physical activity (eight dimensions), and stress management (eight dimensions). Results of multiple indicators/multiple causes model showed scale invariance. Of 19 dimensions, 15 had Cronbach alpha between 0.76 and 0.94 and four were between 0.66 and 0.69. All dimensions had composite construct reliability scores between 0.74 to 0.97 and satisfactory construct and discriminant validities. Conclusion: The theory-based FADESM scales have documented good validity and reliability for measuring factors affecting dietary fat intake behavior, physical activity, and stress management in low-income women. Results of this study support the use of these scales with low-income African American and white mothers in community settings.