The recovery rate of initial participants in the study was 100%, and the effective rate was 97%. The recovery rate of retest participants in the study was 99.1%, and the effective rate was 96%. There were no missing data in either sample. No violations of normality in total score distributions were evident. The skewness and kurtosis values for items were within acceptable limits across samples.
With the preliminary 54 items, we conducted item analysis; the critical ratio (< 3), item-total correlation (< 0.4), and factor loading (< 0.45) indicators were below the standard. According to the results of the item analysis, the indices of Q8 (“I eat fast.”) were less than the statistical standards; thus, we removed Q8, (Table 1).
Validity was tested by KMO and Bartlett’s test of sphericity. The KMO value was 0.97, greater than 0.60, and Bartlett’s test of sphericity showed high significance (χ2 = 230, 05786.12, df = 1378, and P < 0.01), indicating the existence of common factors among variables, which are very suitable for factor analysis.
In exploratory factor analysis, we removed the items with factor load below 0.5 for the next rotation. From the results of the principal component analysis using varimax rotation, four common factors with 23 items were extracted (Table 2). The first factor contained ten items and accounted for 26.6% of the variance; it was labeled “mastering and applying healthy behavior knowledge”. This domain includes disease prevention and control, safety consciousness, basic health knowledge, rational nutrition, and a healthy lifestyle. The second factor contained five items and accounted for 17.8% of the variance, it was labeled “exercise awareness and habits”. This domain includes exercise habits, exercise persistence, and exercise emotions of senior high school students. The third factor contained four items and accounted for 14.0% of the variance; it was labeled “environment adaptation”. This domain includes social community ability, adaptability, and the ability to deal with the relationship between cooperation and competition. The fourth component contained four items and accounted for 12.2% of the variance; it was labeled “emotional regulation”. This domain includes the understanding of emotions and the identification of different emotions. The details for each factor with the 23 items are shown in Table 3. The explanation rate of the cumulative variance after rotation was 70.7%, which was greater than 50%, indicating that the amount of information of the item can be effectively extracted. The Cronbach’s alpha values for each factor, as well as for the overall scale, were high, namely, 0.937 for Factor 1, 0.907 for Factor 2, 0.863 for Factor 3, 0.874 for Factor 4, and 0.958 for the overall scale, suggesting good reliability and high internal consistency for each factor and the scale as a whole.
In confirmatory factor analysis, the four-factor health behavior structure model was found to have an acceptable fit to the data (Fig. 1), since the RMSEA value (= 0.06), was below 0.08, CMIN/DF (3.18) was below 5, RMR (0.04) was below 0.05, and each of CFI (0.92), GFI (0.90), and TLI (0.91) were at least 0.90 based on the criteria recommended by Dullie [36]. Besides this, the factor loadings ranged between 0.53 and 0.88 and were significant, indicating a good relationship between the observed variable and latent variable [37].
Table 1
Item analysis summary table.
Items
|
Critical ratio
|
Item-Total Correlation
|
Communality
|
Factor loading
|
Substandard index Note
|
Q1
|
14.471
|
0.675**
|
0.462
|
0.680
|
0
|
retain
|
Q2
|
15.197
|
0.647**
|
0.397
|
0.630
|
0
|
retain
|
Q3
|
14.611
|
0.667**
|
0.440
|
0.663
|
0
|
retain
|
Q4
|
18.284
|
0.674**
|
0.431
|
0.657
|
0
|
retain
|
Q5
|
16.484
|
0.677**
|
0.449
|
0.670
|
0
|
retain
|
Q6
|
20.324
|
0.719**
|
0.485
|
0.696
|
0
|
retain
|
Q7
|
16.588
|
0.634**
|
0.369
|
0.607
|
0
|
retain
|
Q8
|
2.372
|
0.028
|
0.000
|
-0.020
|
4
|
delete
|
Q9
|
19.498
|
0.694**
|
0.469
|
0.685
|
0
|
retain
|
Q10
|
14.354
|
0.678**
|
0.483
|
0.695
|
0
|
retain
|
Q11
|
13.769
|
0.673**
|
0.485
|
0.696
|
0
|
retain
|
Q12
|
17.451
|
0.642**
|
0.391
|
0.625
|
0
|
retain
|
Q13
|
17.382
|
0.622**
|
0.364
|
0.603
|
0
|
retain
|
Q14
|
15.877
|
0.703**
|
0.499
|
0.706
|
0
|
retain
|
Q15
|
20.901
|
0.780**
|
0.606
|
0.779
|
0
|
retain
|
Q16
|
15.048
|
0.645**
|
0.417
|
0.646
|
0
|
retain
|
Q17
|
13.71
|
0.636**
|
0.414
|
0.644
|
0
|
retain
|
Q18
|
18.059
|
0.647**
|
0.403
|
0.635
|
0
|
retain
|
Q19
|
19.124
|
0.747**
|
0.566
|
0.752
|
0
|
retain
|
Q20
|
18.998
|
0.723**
|
0.538
|
0.733
|
0
|
retain
|
Q21
|
15.765
|
0.704**
|
0.523
|
0.723
|
0
|
retain
|
Q22
|
13.434
|
0.678**
|
0.493
|
0.702
|
0
|
retain
|
Q23
|
17.915
|
0.729**
|
0.548
|
0.740
|
0
|
retain
|
Q24
|
16.836
|
0.695**
|
0.482
|
0.694
|
0
|
retain
|
Q25
|
16.053
|
0.705**
|
0.522
|
0.723
|
0
|
retain
|
Q26
|
14.57
|
0.708**
|
0.534
|
0.731
|
0
|
retain
|
Q27
|
15.845
|
0.718**
|
0.551
|
0.742
|
0
|
retain
|
Q28
|
19.844
|
0.767**
|
0.601
|
0.775
|
0
|
retain
|
Q29
|
19.354
|
0.732**
|
0.554
|
0.744
|
0
|
retain
|
Q30
|
18.972
|
0.692**
|
0.470
|
0.686
|
0
|
retain
|
Q31
|
21.143
|
0.739**
|
0.538
|
0.734
|
0
|
retain
|
Q32
|
19.58
|
0.698**
|
0.477
|
0.691
|
0
|
retain
|
Q33
|
20.848
|
0.722**
|
0.504
|
0.710
|
0
|
retain
|
Q34
|
22.557
|
0.730**
|
0.515
|
0.718
|
0
|
retain
|
Q35
|
21.568
|
0.751**
|
0.570
|
0.755
|
0
|
retain
|
Q36
|
24.894
|
0.800**
|
0.623
|
0.790
|
0
|
retain
|
Q37
|
20.409
|
0.761**
|
0.596
|
0.772
|
0
|
retain
|
Q38
|
16.939
|
0.699**
|
0.508
|
0.712
|
0
|
retain
|
Q39
|
18.083
|
0.733**
|
0.556
|
0.745
|
0
|
retain
|
Q40
|
19.92
|
0.780**
|
0.616
|
0.785
|
0
|
retain
|
Q41
|
16.93
|
0.739**
|
0.573
|
0.757
|
0
|
retain
|
Q42
|
19.087
|
0.731**
|
0.541
|
0.735
|
0
|
retain
|
Q43
|
18.462
|
0.725**
|
0.548
|
0.740
|
0
|
retain
|
Q44
|
14.275
|
0.650**
|
0.437
|
0.661
|
0
|
retain
|
Q45
|
21.102
|
0.758**
|
0.583
|
0.763
|
0
|
retain
|
Q46
|
23.211
|
0.713**
|
0.480
|
0.693
|
0
|
retain
|
Q47
|
21.854
|
0.735**
|
0.531
|
0.729
|
0
|
retain
|
Q48
|
16.096
|
0.646**
|
0.434
|
0.659
|
0
|
retain
|
Q49
|
19.611
|
0.664**
|
0.422
|
0.649
|
0
|
retain
|
Q50
|
16.354
|
0.673**
|
0.474
|
0.689
|
0
|
retain
|
Q51
|
17.8
|
0.691**
|
0.477
|
0.690
|
0
|
retain
|
Q52
|
18.835
|
0.673**
|
0.452
|
0.673
|
0
|
retain
|
Q53
|
20.228
|
0.656**
|
0.400
|
0.632
|
0
|
retain
|
Q54
|
18.6
|
0.704**
|
0.502
|
0.709
|
0
|
retain
|
Judgement
criterion
|
≥ 3.00
|
≥ 0.400
|
≥ 0.200
|
≥ 0.450
|
|
|
Table 2. Exploratory factor analysis result.
Item
|
Component
|
Communality
|
Factor1
|
Factor2
|
Factor 3
|
Factor 4
|
I will actively try my best to prevent all kinds of diseases.
|
0.796
|
|
|
|
0.743
|
I have the awareness and ability regarding security precautions.
|
0.789
|
|
|
|
0.749
|
I understand the harm, routes of transmission, and preventive measures of infectious disease.
|
0.784
|
|
|
|
0.723
|
I have a comprehensive grasp of methods of self-protection and mutual protection in exercise.
|
0.716
|
|
|
|
0.717
|
I never litter and I can garbage sort.
|
0.708
|
|
|
|
0.644
|
I understand the harm of malnutrition to health.
|
0.680
|
|
|
|
0.632
|
I know the characteristics and changing rules of psychological development during puberty.
|
0.656
|
|
|
|
0.623
|
I have good personal and public health habits.
|
0.626
|
|
|
|
0.580
|
I understand that different intensities of exercise have different nutritional needs.
|
0.611
|
|
|
|
0.606
|
I have a good sense of health and pay attention to developing a healthy and civilized lifestyle.
|
0.524
|
|
|
|
0.639
|
Even if there is no physical examination, I will still stick to physical exercise.
|
|
0.840
|
|
|
0.794
|
I have good physical exercise habits.
|
|
0.784
|
|
|
0.773
|
I can actively participate in or organize sports competitions in my class.
|
|
0.777
|
|
|
0.716
|
I know that physical exercise produces more positive emotions than negative emotions.
|
|
0.746
|
|
|
0.720
|
I can keep exercising for my favorite sports.
|
|
0.743
|
|
|
0.701
|
I can quickly adapt to a new learning and living environment.
|
|
|
0.805
|
|
0.796
|
I have good social communication abilities.
|
|
|
0.778
|
|
0.774
|
I will take the initiative to ask my classmates to do physical exercise together in a new class.
|
|
|
0.712
|
|
0.720
|
I know that a harmonious combination of competition and cooperation will make me progress faster.
|
|
|
0.564
|
|
0.620
|
I can distinguish between positive and negative emotions.
|
|
|
|
0.761
|
0.844
|
I know depression is a negative emotion.
|
|
|
|
0.707
|
0.703
|
I have a positive, optimistic, and cheerful attitude towards life.
|
|
|
|
0.598
|
0.723
|
I understand the harm of unhealthy emotions to health.
|
|
|
|
0.518
|
0.695
|
Eigenvalue
|
6.115
|
4.105
|
3.223
|
2.811
|
—
|
Explanatory Variance
|
26. 6%
|
17.8%
|
14.0%
|
12.2%
|
—
|
Cumulative % of explanatory variance
|
26. 6%
|
44.4%
|
58.4%
|
70.7%
|
—
|
Note: Factor 1: mastering and applying healthy behavior knowledge; Factor 2: exercise awareness and habits; Factor 3: environment adaptation; Factor 4: emotional regulation. |