title: Validation of a questionnaire to measure sexual health knowledge and understanding (Sexual Health Questionnaire) in Nepalese secondary school: A psychometric process.
abstract: BACKGROUND
  School-based sex education has the potential to prevent unwanted pregnancy and to promote positive sexual health at the individual, family and community level.
  
  
  OBJECTIVE
  To develop and validate a sexual health questionnaire to measure young peoples' sexual health knowledge and understanding (SHQ) in Nepalese secondary school.
  
  
  METHODS
  Secondary school students (n = 259, male = 43.63%, female = 56.37%) and local experts (n = 9, male = 90%, female = 10%) were participated in this study. Evaluation processes were; content validity (>0.89), plausibility check (>95), item-total correlation (>0.3), factor loading (>0.4), principal component analysis (4 factors Kaiser's criterion), Chronbach's alpha (>0.65), face validity and internal consistency using test-retest reliability (P > 0.05).
  
  
  RESULTS
  The principal component analysis revealed four factors to be extracted; sexual health norms and beliefs, source of sexual health information, sexual health knowledge and understanding, and level of sexual awareness. Kaiser-Meyer-Olkin (KMO) measure of sampling adequacy demonstrated that the patterns of correlations are relatively compact (>0.80). Chronbach's alpha for each factors were above the cut-off point (0.65). Face validity indicated that the questions were clear to the majority of the respondent. Moreover, there were no significant differences (P > 0.05) in the responses to the items at two time points at seven weeks later.
  
  
  CONCLUSIONS
  The finding suggests that SHQ is a valid and reliable instrument to be used in schools to measure sexual health knowledge and understanding. Further analysis such as structured equation modelling (SEM) and confirmatory factor analysis could make the questionnaire more robust and applicable to the wider school population.
authors: Institute of Education, School of Education and Lifelong Learning, Aberystwyth University, Aberystwyth, Wales, UK.
authors: Dev Raj
authors: DR
authors: Acharya
authors: Institute of Education, School of Education and Lifelong Learning, Aberystwyth University, Aberystwyth, Wales, UK.
authors: Malcolm
authors: M
authors: Thomas
authors: Institute of Education, School of Education and Lifelong Learning, Aberystwyth University, Aberystwyth, Wales, UK.
authors: Rosemary
authors: R
authors: Cann
keywords: Psychometric properties; questionnaires; secondary school; sexual health