# Development and Psychometric Validation of an App-Integrated Questionnaire to Assess Healthy Habits in Children (Ages 8–11): Implications for Pediatric Nursing Practice

## TL;DR

A new questionnaire was developed and validated to assess healthy habits in children aged 8–11, offering a useful tool for pediatric nurses and educators.

## Contribution

A validated four-factor questionnaire integrated into an mHealth app for assessing children's healthy habits.

## Key findings

- The questionnaire covers four domains: technology use, diet and growth, psychological well-being, and physical activity.
- The instrument showed good model fit and reliability for assessing children's health habits.
- It supports school-based health promotion through structured monitoring and feedback.

## Abstract

What are the main findings?
•A brief, four-factor questionnaire (21 items) was psychometrically validated to assess healthy habits in children aged 8–11, covering technology use, diet and growth, psychological well-being, and physical activity.•The instrument demonstrated good model fit and reliability, supporting its use as a multidimensional assessment tool in school-aged children.

A brief, four-factor questionnaire (21 items) was psychometrically validated to assess healthy habits in children aged 8–11, covering technology use, diet and growth, psychological well-being, and physical activity.

The instrument demonstrated good model fit and reliability, supporting its use as a multidimensional assessment tool in school-aged children.

What are the implications of the main findings?
•The questionnaire provides pediatric nurses and educators with a practical, developmentally appropriate tool to monitor children’s lifestyle habits and identify targets for early preventive intervention. When integrated into the Healthy Jeart mHealth app, it supports feasible school-based health promotion through structured monitoring, feedback, and reinforcement of healthy behaviors.

The questionnaire provides pediatric nurses and educators with a practical, developmentally appropriate tool to monitor children’s lifestyle habits and identify targets for early preventive intervention. When integrated into the Healthy Jeart mHealth app, it supports feasible school-based health promotion through structured monitoring, feedback, and reinforcement of healthy behaviors.

Introduction: Promoting healthy habits in childhood is fundamental for fostering long-term well-being. This study aimed to develop and psychometrically validate an app-integrated instrument to assess knowledge, habits, and attitudes related to health in children aged 8–11, within the context of the MHealth intervention Healthy Jeart. Methods: A quantitative, cross-sectional design was used. An initial item pool underwent expert content validation before being administered to a sample of 623 children from primary education centers in Andalusia, Spain. Construct validity was examined through exploratory and confirmatory factor analyses. Results: The analyses supported a coherent four-factor structure comprising 21 items: (1) Use of technologies, (2) diet and growth, (3) psychological well-being, and (4) physical activity and well-being. The instrument demonstrated satisfactory model fit and internal consistency, providing a multidimensional assessment of children’s health-related behaviors. The sample was recruited from primary schools in Andalusia (Spain), which may limit the generalizability of the findings to other regions and cultural contexts. Conclusions: The validated instrument offers a reliable and efficient means of evaluating healthy habits in children aged 8–11, particularly when embedded within digital interventions such as Healthy Jeart. It represents a valuable tool for educators and pediatric nursing professionals working in school settings, enabling early identification of gaps in health literacy and supporting targeted interventions that promote holistic child well-being.