Alcohol-impaired Walking in 16 Countries: A Theory-Based Investigation.

Alcohol is a global risk factor for road trauma. Although drink driving has received most of the scholarly attention, there is growing evidence of the risks of alcohol-impaired walking. Alcohol-impaired pedestrians are over-represented in fatal crashes compared to non-impaired pedestrians. Additionally, empirical evidence shows that alcohol intoxication impairs road-crossing judgements. Besides some limited early research, much is unknown about the global prevalence and determinants of alcohol-impaired walking. Understanding alcohol-impaired walking will support health promotion initiatives and injury prevention. The present investigation has three aims: (1) compare the prevalence of alcohol-impaired walking across countries; (2) identify international groups of pedestrians based on psychosocial factors (i.e., Theory of Planned Behaviour (TPB) and perceptions of risk); and (3) investigate how segments of pedestrians form their intention for alcohol-impaired walking using the extended TPB (i.e. subjective norm, attitudes, perceived control, and perceived risk). A cross-sectional design was applied. The target behaviour question was "have you been a pedestrian when your thinking or physical ability (balance/strength) is affected by alcohol?" to ensure comparability across countries. Cluster analysis based on the extended TPB was used to identify groups of countries. Finally, regressions were used to predict pedestrians' intentions per group. A total of 6,166 respondents (Age M(SD) = 29.4 (14.2); Males = 39.2%) completed the questionnaire, ranging from 12.6% from Russia to 2.2% from Finland. The proportion of participants who reported never engaging in alcohol-impaired walking in the last three months ranged from 30.1% (Spain) to 83.1% (Turkey). Four groups of countries were identified: group-1 (Czech Republic, Spain, and Australia), group-2 (Russia and Finland), group-3 (Japan), and group-4 (final ten countries including Colombia, China, and Romania). Pedestrian intentions to engage in alcohol- impaired walking are predicted by perceptions of risk and TPB-psychosocial factors in group-1 and group-4. Favourable TPB-beliefs and low perceived risk increased alcohol-impaired walking intentions. Conversely, subjective norms were not significant in group-2 and only perceived risk predicted intention in group-3. The willingness of pedestrians to walk when alcohol-impaired differs significantly across the countries in this study. Perceived risk was the only common predictor among the 16 countries.

Assessing Knowledge-Based and Perceived Health Literacy Among Japanese Adolescents: A Cross-Sectional Study.

Health literacy assessment is a major aspect of planning health education for adolescents. We evaluated the health literacy of Japanese adolescents using both perceived and knowledge-based health literacy scales. Study questionnaires were administered to 773 junior and senior high school students aged 12 to 18 years. We tested a model describing the hierarchical relations between functional, communicative, critical, and knowledge-based health literacy using path analysis. Critical health literacy was found to be influenced by functional, communicative, and knowledge-based health literacy, while functional and knowledge-based health literacy were correlated. The model, with slight modification, was supported. The result indicates that perceived functional health literacy scores did not directly correlate with higher perceived critical health literacy; rather, they only informed critical health literacy when participants had high knowledge-based health literacy.

Item response theory analysis of the Utrecht Work Engagement Scale for Students (UWES-S) using a sample of Japanese university and college students majoring medical science, nursing, and natural science.

OBJECTIVES: The Utrecht Work Engagement Scale for Students has been used internationally to assess students' academic engagement, but it has not been analyzed via item response theory. The purpose of this study was to conduct an item response theory analysis of the Japanese version of the Utrecht Work Engagement Scale for Students translated by authors. Using a two-parameter model and Samejima's graded response model, difficulty and discrimination parameters were estimated after confirming the factor structure of the scale. RESULTS: The 14 items on the scale were analyzed with a sample of 3214 university and college students majoring medical science, nursing, or natural science in Japan. The preliminary parameter estimation was conducted with the two parameter model, and indicated that three items should be removed because there were outlier parameters. Final parameter estimation was conducted using the survived 11 items, and indicated that all difficulty and discrimination parameters were acceptable. The test information curve suggested that the scale better assesses higher engagement than average engagement. The estimated parameters provide a basis for future comparative studies. The results also suggested that a 7-point Likert scale is too broad; thus, the scaling should be modified to fewer graded scaling structure.

A New Functional Health Literacy Scale for Japanese Young Adults Based on Item Response Theory.

Health literacy predicts health outcomes. Despite concerns surrounding the health of Japanese young adults, to date there has been no objective assessment of health literacy in this population. This study aimed to develop a Functional Health Literacy Scale for Young Adults (funHLS-YA) based on item response theory. Each item in the scale requires participants to choose the most relevant term from 3 choices in relation to a target item, thus assessing objective rather than perceived health literacy. The 20-item scale was administered to 1816 university students and 1751 responded. Cronbach's α coefficient was .73. Difficulty and discrimination parameters of each item were estimated, resulting in the exclusion of 1 item. Some items showed different difficulty parameters for male and female participants, reflecting that some aspects of health literacy may differ by gender. The current 19-item version of funHLS-YA can reliably assess the objective health literacy of Japanese young adults.

Constructing the Japanese version of the Maslach Burnout Inventory-Student Survey: Confirmatory factor analysis.

AIM: To examine the factorial validity of the Maslach Burnout Inventory-Student Survey, using a sample of 2061 Japanese university students majoring in the medical and natural sciences (67.9% male, 31.8% female; Mage = 19.6 years, standard deviation = 1.5). The back-translated scale used unreversed items to assess inefficacy. METHODS: The inventory's descriptive properties and Cronbach's alphas were calculated using SPSS software. The present authors compared fit indices of the null, one factor, and default three factor models via confirmatory factor analysis with maximum-likelihood estimation using AMOS software, version 21.0. RESULTS: Intercorrelations between exhaustion, cynicism, and inefficacy were relatively higher than in prior studies. Cronbach's alphas were 0.76, 0.85, and 0.78, respectively. Although fit indices of the hypothesized three factor model did not meet the respective criteria, the model demonstrated better fit than did the null and one factor models. The present authors added four paths between error variables within items, but the modified model did not show satisfactory fit. Subsequent analysis revealed that a bi-factor model fit the data better than did the hypothesized or modified three factor models. CONCLUSION: The Japanese version of the Maslach Burnout Inventory-Student Survey needs minor changes to improve the fit of its three factor model, but the scale as a whole can be used to adequately assess overall academic burnout in Japanese university students. Although the scale was back-translated, two items measuring exhaustion whose expressions overlapped should be modified, and all items measuring inefficacy should be reversed in order to statistically clarify the factorial difference between the scale's three factors.