This  is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.A Multicultural Lifestyle Change Questionnaire that included English, French and Chinese versions which was developed by Ning Tang was pilot-tested in 98 English, French and Chinese speaking immigrants in two adjacent cities (Ottawa and Gatineau) of Canada. The participants were recruited by a purposive sampling and answered the questions in the questionnaire with self-reporting. The pilot-testing results exhibited that the questionnaire had higher validity (face validity, content validity, criterion-related validity and construct validity) and reliability (test-retest reliability). After being revised appropriately, the questionnaire could be used in multicultural lifestyle changes surveys in full population and more wide use

MacDougall, Colin James

Tang, Ning

International Journal of Current Research

Flinders Academic Commons

                                                               A PILOT-TESTING STUDY OF MULTICULTURAL LIFESTYLE CHANGE QUESTIONNAIREIN OTTAWA AND GATINEAU, CANADA*Dr.  Ning TangDiscipline of Public Health, School of Health Sciences, Faculty of Medicine, Nursing andARTICLE INFO                                          ABSTRACT  A Multicultural Lifestyle Change Questionnaire that included English, French and Chinese versions which was developed by Ning Tang was pilotimmigrants in two adjacent cities (Ottawa and Gatineau) of Caby a purposive sampling pilot-testing results exhibited that the qcriterionrevised appropriately, the qpopulation and       Copyright © 2015 Ning Tang and Colin MacDougall. This unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.      INTRODUCTION  As immigrant population grew and influence of immigrant lifestyle change enlarged on health status in the immigrant countries (i.e. Canada), it is necessary to do mand larger-scale research concerning health and lifestyles associating with immigrants (Méjean 2007). the most effective ways to identify the immigrant lifestyle and health status changes was through the use of lifestyle questionnaire survey (Charnley 2008), which needed a valid and reliable multicultural lifestyle change questionnaire.present, though some of health survey researchers have constructed some questionnaires for different cultures and used them in some of multicultural health surveys, public health surveys still lack valid and reliable multicultural measurement instruments to assess lifestyle and health status changes in diverse cultural immigrant sub-groups (Vereecken 2010Therefore, a trilingual multicultural lifestyle questionnaire was developed by Ning Tang for the multicultural lifestylesurvey. However, validity and reliability of theinstrument had to be evaluated before it was used in the survey.A pilot study is usually conducted in order to evaluate validity,  *Corresponding author: Dr.  Ning Tang, P.H.  Discipline of Public Health, School of Health Sciences, Faculty of Medicine, Nursing and Health Sciences, Flinders University, Australia.  ISSN: 0975-833X  Vol. Article History: Received 20th August, 2015 Received in revised form  19th September, 2015 Accepted 13th October, 2015 Published online 30th November, 2015  Key words:   Immigration, Multicultural Questionnaire, Pilot-Testing, Evaluation, Validity, Reliability. Citation: Ning Tang and Colin MacDougall, Gatineau, Canada”, International Journal of Current Research    RESEARCH ARTICLE    , P.H. and Colin MacDougall  Flinders University, Australia        -tested in 98 English, French and Chinese speaking nada. The participants were recruited and answered the questions in the questionnaire with selfuestionnaire had higher validity (face validity,-related validity and construct validity) and reliability (tuestionnaire could be used in multicultural lifestyle changes surveys in full more wide use. is an open access article distributed under the Creative Commons Att  ore integrated Obviously, one of At ).  change  multicultural    reliability and other characteristics of the designed questionnaire (Luepker 2004, Dillman 2007, SC 2010pilot-testing study of the Multicultural Lifestyle Change Questionnaire was performed in the target population (English, French and Chinese speaking immvalidity and reliability of the questionnaire.  MATERIALS AND METHODS    Pilot-Testing Method  English, French and Chinese speaking immigrants generation at Adult Educational Centres/Schools, Community Churches and Residential Communities in Gatineau and Ottawa were identified as the pilotThe immigrant participants must have been 18have resided in Ottawa or Gatineaubeen 16 years or older when they arrived in Canada. At least 90 immigrants (not less than 20 subjects for each subEnglish, French and Chinese immigrants) in the two cities were recruited as the pilot-testing particlifestyle change questionnaire. The sample size was based on the sampling recommendation of Dillman for a pilot study (Dillman 2007recommendation of Altman - testing (Altman 1999, Ekeberg 2008Available online at http://www.journalcra.com International Journal of Current Research 7, Issue, 11, pp.22717-22720, November, 2015   INTERNATIONAL     2015. “A pilot-testing study of multicultural lifestyle change questionnaire in Ottawa and , 7, (11), 22717-22720.  z   Health Sciences,    -reporting. The  content validity, est-retest reliability). After being ribution License, which permits  ). Thus, a igrants) in order to evaluate   of the first -testing sampling population.  years or older,  one year or more, and had -group of ipants of the multicultural – about 100 subjects ), and the general at least 50 subjects for a pilot-). Random sampling was  JOURNAL  OF CURRENT RESEARCH  deemed impracticable for the study and could be biased because immigrant status of three language sub-groups could not be identified effectively according to the sampling criteria. Purposive-sampling methods were applied in the study to recruit qualified immigrant participants. The paper-and-pencil mode of self-administered questionnaire completed in the presence of research staff was employed to administration of the pilot-testing data collection of the multicultural questionnaire (Tang 2008).   Analysis Method of Validity and Reliability  Face validity and content validity of the multicultural questionnaire were assessed respectively by inspection of pilot-testing subjects and review of experts (Wikipedia 2010); criterion-related validity was assessed statistically by Pearson correlation coefficient value (0.4 or higher Pearson correlation coefficient for satisfactory validity) (Eshaghi 2006, Ekeberg 2008). Construct validity was evaluated statistically by alpha coefficient value (0.7 or higher Cronbach's alpha coefficient for satisfactory construct validity) (Garson 2010, Eshaghi 2006). Test-retest reliability of the multicultural questionnaire was assessed statistically by alpha coefficient value (0.7 or higher Cronbach's alpha coefficient was regarded as acceptable test-retest reliability) (Grau 2007, Hopkins 2010, Garson 2010, Luban 2010).   Ethical Approval   The pilot-testing study of the Multicultural Lifestyle Change Questionnaire was part of a multicultural lifestyle change research project that was approved by Social and Behavioural Research Ethics Committee, Flinders University in Australia in 2010.                                                            RESULTS AND DISCUSSION  In total, 98 qualified immigrant participants (respectively 24, 40 and 34 subjects for English, French and Chinese speaking immigrants) in Ottawa and Gatineau, Canada were recruited by a purposive sampling to the pilot-testing study. Using self-reporting, they answered questions of Smoking Change, Alcohol Consumption Change, MoodChange, SleepChange, Physical ActivityChange, Dietary Change, Health Status Change and Demographyin the multicultural lifestyle change questionnaire (pilot-testing) of English, French or Chinese versions, twice, 2 weeks apart. The survey data showed that all of questions in three versions of the Multicultural Lifestyle Change Questionnaire for the pilot-testing could be understood equally and completed easily by English, French and Chinses speaking immigrants. Three versions of the Multicultural Lifestyle Change Questionnaire for the pilot-testing were affirmed by multicultural research experts, questionnaire design specialists, and bilingual teachers or specialists. The results of Pearson coefficient calculation for criterion-related validity analysis and alpha coefficient calculation for test-retest reliability analysis were presented in the Analysis Result Table of Validity and Reliability.   According to inspection of the pilot-testing immigrants of the three language sub-groups, and assessment of the research experts and specialists, the pilot-testing questionnaire had higher face validity and content validity.   Criterion-related validity of a questionnaire may be assessed by Pearson correlation coefficient (Eshaghi 2006, Ekeberg 2008). General criterion-related validity of the multicultural lifestyle change questionnaire should be assessed by most of the Pearson correlation coefficients and the average Pearson                            Analysis Result Table of Validity and Reliability  Criterion-related validity   Test-retest reliability Item *Pearson correlation coefficient (r) Item **Cronbach's alpha coefficients (α) Independent variable Dependent variable Smoking change Smoking behavior change 0.842 Gender Smoking change -0.473 Alcohol consumption change -0.427 Smoking belief change 0.892 Mood change -0.393 Alcohol consumption change Alcohol consumption behavior change 0.883 Sleep change -0.387 Physical activity change 0.462 Alcohol consumption belief change 0.919 Dietary change 0.362 Mood change Mood status change 0.711 Health status change 0.369 Mother tongue  Smoking change 0.373 Mood belief change 0.724 Alcohol consumption change 0.358 Sleep change Sleep behavior change 0.759 Mood change 0.456 Sleep belief change 0.685 Sleep change 0.463 Physical activity change 0.483 Physical activity change Physical activity behavior change 0.680 Dietary change 0.464 Health status change 0.482 Physical exercise belief change 0.675 Category of immigration Smoking change 0.545 Alcohol consumption change 0.457 Dietary change Dietary behavior change 0.642 Mood change 0.418 Sleep change 0.378 Dietary belief change 0.708 Physical activity change 0.468 Dietary change 0.525 Health status change 0.683 Health status change 0.388 Average ( ṝ ) 0.435 Average (ᾱ) 0.754 Notes:*Pearson correlation coefficient  r ˃ 0.40; **Cronbach's Alpha coefficients α ˃ 0.70.   22718               Ning Tang and Colin MacDougall, A pilot-testing study of multicultural lifestyle change questionnaire in Ottawa and Gatineau, Canada correlation coefficients instead of the single Pearson correlation coefficient, because the questionnaire was an integrated questionnaire which included many independent and dependent variables. It was unreasonable that the single Pearson coefficient was applied in assessing criterion-related validity of the integrated questionnaire. Most of the Pearson coefficients and the average Pearson coefficient were over 0.40, which showed that the multicultural questionnaire had higher criterion-related validity (Eshaghi 2006, Ekeberg 2008).   Construct validity might be also expressed as reliability (correlation) (Westen2003, Smith 2005). Cronbach's alpha coefficient to evaluate reliability may be used to assess construct validity. Most of the alpha coefficients and averagealpha coefficient were over 0.70, which showed that the multicultural questionnaire had higher construct validity (Hopkins 2010).   Test–retest reliability of a questionnaire can be assessed by Cronbach's alpha coefficient (Eshaghi 2006, Ekeberg 2008). General test–retest reliability of the multicultural questionnaire should be assessed by most of the alpha coefficients and the average Cronbach's alpha coefficient instead of the single alpha coefficient, as it was also unreasonable that the single alpha coefficient was used in assessing test–retest reliability of the integrated questionnaire. Most of the alpha coefficients and the averagealpha coefficient were over 0.70, which exhibited that the multicultural questionnaire had higher test–retest reliability (Grau 2007, Hopkins 2010).   Conclusion  Consequently, integrated analysis results disclosed that the unique multicultural lifestyle change questionnaire had higher validity (face validity, content validity, criterion-related validity and construct validity) andreliability (test–retest reliability), and could be applied to the related multicultural lifestyle change surveysin full immigrant population and more wide use after being revised appropriately.   Competing Interests  The authors declare that they have no conflict of interests.   Acknowledgements   The authors appreciate lingual support of the bilingual teachers, Claude Couture and Denis Mascotto in Centre de formation professionnelle Vision-Avenir, Commission scolaire des Portages-de-l’Outaouais, Gatineau, Québec, Canada. Particularly, the authors are very grateful to assistance of immigrant health expert, Dr. Brian Gushulak in Immigration Health Consultants in Canada.   Funding Statement  The pilot-testing study of the multicultural lifestyle change questionnaire was part of the principal researcher (correspondent author)’s DrPH (Doctor of Public Health) project (multicultural lifestyle change research project in Canada). The research project was funded by the correspondent author.   REFERENCES  Altman, D.G. 1999. Practical statistics for medical research. Chapman & Hall. http://www.alibris.com/booksearch? qwork=5282646 .  Charnley, G. 2008. 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