# A scale for assessing the health of children aged 3–6 years in China: development and validation of the TCM constitution scale (3–6 years)

## TL;DR

This study created and tested a 47-item health assessment tool for 3–6-year-old children based on Traditional Chinese Medicine.

## Contribution

A new TCM-based health scale for preschool children was developed and validated with strong psychometric properties.

## Key findings

- The scale showed high internal consistency (Cronbach’s α of 0.924) and good test–retest reliability (ICC of 0.86).
- Exploratory factor analysis identified nine factors explaining 52.853% of the variance.
- The tool demonstrated promising reliability and validity for assessing preschool children's health.

## Abstract

Based on the Chinese Medicine constitution, this study developed a questionnaire specifically tailored for preschool children.

First, a TCM constitution scale for children aged 3–6 years was developed using face-to-face interviews, Delphi expert consultation, and Classical Test Theory (CTT). The Delphi method was conducted via email, and five CTT indicators were selected: decision value–critical ratio, dispersion trend, item–total correlation, internal consistency, and factor loading. Second, the psychometric properties of the scale were assessed, including reliability (internal consistency, test–retest reliability, and split-half reliability) and content validity. Exploratory factor analysis (EFA) was used to evaluate the structural validity of the items.

The CCMQ 2.0 consisted of 47 items selected from the original 49 items of version 1.0. Exploratory factor analysis yielded a Kaiser–Meyer–Olkin (KMO) value of 0.886, and Bartlett’s test of sphericity was significant (χ2 = 5308.679, p < 0.001), indicating that the data were suitable for factor analysis. Nine common factors were extracted, accounting for a cumulative variance contribution of 52.853%. The internal consistency of the CCMQ 2.0 was high, with a Cronbach’s α of 0.924, and the test–retest reliability was satisfactory, with an intraclass correlation coefficient (ICC) of 0.86. Overall, the scale showed promising preliminary psychometric properties, although further validation is needed.

This study developed and preliminarily evaluated a 47-item Traditional Chinese Medicine (TCM) constitution scale for assessing the physical and mental health of children aged 3 to 6 years. The scale demonstrated good reliability and validity, providing a promising alternative tool for large-scale pediatric health assessments.