title: Contextualization and standardization of the supportive leadership behavior questionnaire based on socio- cognitive theory in Iran.
abstract: BACKGROUND
  Effective leadership is of prime importance in any organization and it goes through changes based on accepted health promotion and behavior change theory. Although there are many leadership styles, transformational leadership, which emphasizes supportive leadership behaviors, seems to be an appropriate style in many settings particularly in the health care and educational sectors which are pressured by high turnover and safety demands. Iran has been moving rapidly forward and its authorities have understood and recognized the importance of matching leadership styles with effective and competent care for success in health care organizations. This study aimed to develop the Supportive Leadership Behaviors Scale based on accepted health and educational theories and to psychometrically test it in the Iranian context.
  
  
  METHODS
  The instrument was based on items from established questionnaires. A pilot study validated the instrument which was also cross-validated via re-translation. After validation, 731 participants answered the questionnaire.
  
  
  RESULTS
  The instrument was finalized and resulted in a 20-item questionnaire using the exploratory factor analysis, which yielded four factors of support for development, integrity, sincerity and recognition and explaining the supportive leadership behaviors (all above 0.6). Mapping these four measures of leadership behaviors can be beneficial to determine whether effective leadership could support innovation and improvements in medical education and health care organizations on the national level. The reliability measured as Cronbach's alpha was 0.84.
  
  
  CONCLUSIONS
  This new instrument yielded four factors of support for development, integrity, sincerity and recognition and explaining the supportive leadership behaviors which are applicable in health and educational settings and are helpful in improving self -efficacy among health and academic staff.
authors: 1. Assistant Professor Educational Development Center (EDC), Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran & Affiliated Assistant Professor of LIME and Clinical Education Science Departments, Karolinska Institute, Sweden. Mandana.shirazi@ki.se.
authors: Mandana
authors: M
authors: Shirazi
authors: 2. MD, Oncologist- Associate Professor, Faculty of Medicine, Tehran University of Medical Sciences, Imam Khomeini Hospital, Tehran, Iran. ami6@gmail.com.
authors: Amir Hosein
authors: AH
authors: Emami
authors: 3. MD, Msc Ed Director of Educational Development Center (EDC), Faculty of Medicine, Sabzevar University of Medical Sciences, Sabzevar, Iran. sjmirmoosavi6@gmail.com.
authors: Seyed Jamal
authors: SJ
authors: Mirmoosavi
authors: 4. PhD in Epidemiology, Faculty of Medicine, Bojnord University, Bojnord, Iran. alavinia@health.gov.ir.
authors: Seyed Mohammad
authors: SM
authors: Alavinia
authors: 5. MD, PhD Candidate Deputy of Research at Qom University of Medical Sciences, Iran. zamanian@razi.tums.ac.ir.
authors: Hadi
authors: H
authors: Zamanian
authors: 6. MSc, Nursing in Critical Care Nursing and Midwifery Care Research Center, Tehran University of Medical Sciences, Tehran, Iran. f-fbeigi@razi.tums.ac.ir.
authors: Faezeh
authors: F
authors: Fathollahbeigi
authors: 7. Associate Professor Director Klinicum, Soder Hospital, Karolinska Institute, Sweden. talo.Masiello@ki.se.
authors: Italo
authors: I
authors: Masiello
keywords: Contextualization; Socio- cognitive Theory; Standardization; Supportive Leadership Behavior Questionnaire