Development and validation of a pediatric health-promoting behaviors questionnaire based on Persian Medicine (PedHPB-PM)

Persian Medicine (PM) highlights healthy lifestyle practices as fundamental to children’s well-being. However, existing tools for assessing children’s health behaviors do not adequately reflect PM principles. This study aimed to design and validate a PM-based questionnaire to assess health-promoting behaviors in children. This methodological study developed and validated a PM-based instrument in 300 children aged 4–11 years. The initial questionnaire consisted of 74 items across six domains: nutrition, sleep, movement, mental health, excretion, and environmental conditions. Content validity was evaluated by a panel of eleven PM experts. Psychometric assessments included face, content, convergent, and discriminant validity, as well as internal consistency and test–retest reliability using Cronbach’s alpha. Lawshe’s Content Validity Ratio confirmed acceptable content validity for all items (CVR ≥ 0.59). Convergent validity (AVE = 0.535) and discriminant validity were supported. The questionnaire demonstrated excellent reliability (Cronbach’s alpha = 0.91). Based on expert review, 35 items were removed, 4 merged, and 12 modified, resulting in 37 items. Further validation excluded 3 additional items, yielding a final 34-item questionnaire with strong psychometric properties. The PM-based Pediatric Health-Promoting Behaviors Questionnaire is a valid and reliable, culturally tailored tool for assessing children’s lifestyle behaviors in clinical and research settings.