Perceived social support and self-efficacy beliefs for healthy eating and physical activity among Arabic-speaking university students: adaptation and implementation of health beliefs survey questionnaire.

BACKGROUND Few assessment tools exist for investigating perceived social support and self-efficacy behaviors in Arabic-speaking populations. Moreover, literature on the levels of social support and self-efficacy for adopting healthy eating and engaging in regular physical activity among Arabic-speaking young adults is currently lacking. This study aimed to adapt the Health Beliefs Survey Questionnaire (HBSQ) for Arabic-speaking populations and assess perceived social support and self-efficacy for adopting healthy eating and increased physical activity among university students. METHODS In the first stage of the study, forward and backward translation and pretesting of the social support and self-efficacy scales of the HBSQ were conducted. The adapted questionnaire was administered to female university students (n = 258), and a subsample of 195 participants retook the questionnaire after 1 month. Construct validity was assessed with confirmatory factor analysis. The internal consistency of each subscale item was assessed by Cronbach's alpha coefficient, and reproducibility was tested with intraclass correlation coefficients (ICCs) and Bland-Altman plots. In the second stage, the adapted questionnaire was used to assess the perceived social support and self-efficacy levels in a different sample of Arabic-speaking female university students (n = 283). RESULTS Based on the results from confirmatory factor analysis, 6 items were selected for the social support scale and 19 items for the self-efficacy scale. The adapted questionnaire showed moderate to high internal reliability (Cronbach alpha coefficient = 0.681 to 0.900). The ICCs of the various subscales ranged from 0.666 to 0.997, indicating moderate to excellent reproducibility of the culturally adapted questionnaire. This was confirmed by Bland-Altman analysis. Participants in the second stage of the study reported significantly higher (P < 0.001) perceived support from family compared to friends in reducing sugar intake and increasing fiber consumption. CONCLUSIONS The results of the psychometric testing indicate the shortened Arabic HBSQ is a reliable tool for assessing perceived social support from family and close friends as well as for evaluating self-efficacy for choosing healthy foods and increasing physical activity among female university students.