{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T06:49:38Z","timestamp":1791355778094,"version":"4.3.1"},"reference-count":60,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Effective community health promotion requires information about residents\u2019 health-related characteristics and the interpersonal, environmental, organizational, and policy supports they perceive. The Multidimensional Assessment Scale for Social-Ecological Healthy Communities MASE-HC was designed as a multidimensional resident-reported instrument, not as a unidimensional measure or an objective community-level rating. We report its development and initial psychometric evaluation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Items were generated through literature review, a two-round Delphi survey, content-validity assessment, and cognitive interviews. A purposive sample of 412 adult community residents was recruited from one community health service center in Anhui Province, China. Subsample 1 (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f206) was used for item analysis and exploratory factor analysis, and Subsample 2 (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f206) was used for confirmatory factor analysis, convergent and discriminant validity assessment, and hypothesis-based associations with self-rated health. Internal consistency was evaluated in the total sample (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f412).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Data from 412 participants were analyzed. EFA identified a six-factor solution for the final 39-item MASE-HC, accounting for 61.411% of the variance. The final CFA specified six correlated first-order factors and did not evaluate a higher-order general factor. After four post-hoc within-factor residual covariances were added, the refined model showed generally acceptable fit (\u03c7\n                      <jats:sup>2<\/jats:sup>\n                      \/df\u202f=\u202f1.741, RMSEA\u202f=\u202f0.060, SRMR\u202f=\u202f0.0649, CFI\u202f=\u202f0.906, TLI\u202f=\u202f0.898, and IFI\u202f=\u202f0.907); TLI was marginally below 0.90. The Fornell\u2013Larcker criterion was satisfied for all six factors, whereas convergent validity and internal consistency were comparatively weaker for Diet and Nutrition. Self-rated health was positively associated with five of the six subscales.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The MASE-HC showed preliminary support for a six-factor multidimensional structure in the present sample. The Diet and Nutrition subscale requires further refinement, and independent psychometric evaluation and replication in larger, more representative samples are needed before routine use or any community-level comparison.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1957359","type":"journal-article","created":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T05:50:52Z","timestamp":1791352252000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Measuring residents\u2019 perceptions of social-ecological healthy communities: development and initial psychometric evaluation of a multidimensional scale"],"prefix":"10.3389","volume":"14","author":[{"given":"Xinyu","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Health Promotion and Behavioral Sciences, School of Public Health, Anhui Medical University","place":["Hefei, Anhui, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhengmei","family":"Liao","sequence":"additional","affiliation":[{"name":"Department of Health Promotion and Behavioral Sciences, School of Public Health, Anhui Medical University","place":["Hefei, Anhui, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tianqi","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Health Promotion and Behavioral Sciences, School of Public Health, Anhui Medical University","place":["Hefei, Anhui, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Health Promotion and Behavioral Sciences, School of Public Health, Anhui Medical University","place":["Hefei, Anhui, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiufeng","family":"Gu","sequence":"additional","affiliation":[{"name":"Department of Health Promotion and Behavioral Sciences, School of Public Health, Anhui Medical University","place":["Hefei, Anhui, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiajun","family":"Feng","sequence":"additional","affiliation":[{"name":"Department of General Medicine, Daoxiangcun Street Community Health Service Center","place":["Hefei, Anhui, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Xu","sequence":"additional","affiliation":[{"name":"Anhui Cancer Institute","place":["Hefei, Anhui, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danni","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Health Promotion and Behavioral Sciences, School of Public Health, Anhui Medical University","place":["Hefei, Anhui, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,10,7]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"282","DOI":"10.4278\/0890-1171-10.4.282","article-title":"Translating social ecological theory into guidelines for community health promotion","volume":"10","author":"Stokols","year":"1996","journal-title":"Am J HEALTH Promot"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1037\/\/0003-066x.47.1.6","article-title":"Establishing and maintaining healthy environments. Toward a social ecology of health promotion","volume":"47","author":"Stokols","year":"1992","journal-title":"Am Psychol"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"364","DOI":"10.1177\/1090198111418634","article-title":"Social ecological approaches to individuals and their contexts: twenty years of health education & behavior health promotion interventions","volume":"39","author":"Golden","year":"2012","journal-title":"Health Educ Behav"},{"key":"ref4","first-page":"43","article-title":"Ecological models of health behavior","author":"Sallis","year":"2015","journal-title":"Health Behavior: Theory, Research, and Practice"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"341","DOI":"10.1037\/\/0003-066x.50.5.341","article-title":"A framework for health promotion and disease prevention programs","volume":"50","author":"Winett","year":"1995","journal-title":"Am Psychol"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"351","DOI":"10.1177\/109019818801500401","article-title":"An ecological perspective on health promotion programs","volume":"15","author":"McLeroy","year":"1988","journal-title":"Health Educ Q"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"113","DOI":"10.1097\/00124784-200603000-00002","article-title":"Community health assessment: driving the need for current, easily accessible population health data","volume":"12","author":"Irani","year":"2006","journal-title":"J Public Health Manag Pract"},{"key":"ref8","year":"2026"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"1667","DOI":"10.3390\/ijerph20031667","article-title":"Community health assessment tools adoptable in nursing practice: a scoping review","volume":"20","author":"Pazzaglia","year":"2023","journal-title":"Int J Environ Res Public Health"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1186\/s12913-022-08983-3","article-title":"A scoping review of community health needs and assets assessment: concepts, rationale, tools and uses","volume":"23","author":"Ravaghi","year":"2023","journal-title":"BMC Health Serv Res"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"2634","DOI":"10.3390\/buildings14092634","article-title":"Socio-ecological factors in building a healthy community: a comparative study of healthy community assessment standards","volume":"14","author":"Zhao","year":"2024","journal-title":"Buildings"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1111\/0081-1750.00059","article-title":"Ecometrics: toward a science of assessing ecological settings, with application to the systematic social observation of neighborhoods","volume":"29","author":"Raudenbush","year":"1999","journal-title":"Sociol Methodol"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"858","DOI":"10.1093\/aje\/kwm040","article-title":"Assessing the measurement properties of neighborhood scales: from psychometrics to ecometrics","volume":"165","author":"Mujahid","year":"2007","journal-title":"Am J Epidemiol"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"e0003549","DOI":"10.1371\/journal.pgph.0003549","article-title":"Community efficacy for non-communicable disease management (COEN): conceptualization and measurement","volume":"4","author":"Xiong","year":"2024","journal-title":"PLOS Global Public Health"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"1452738","DOI":"10.3389\/fpubh.2025.1452738","article-title":"Development and validation of the multi-dimensional health resilience scale for community-dwelling adults","volume":"13","author":"Ge","year":"2025","journal-title":"Front Public Health"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"880","DOI":"10.1186\/s12913-025-13069-x","article-title":"Healthy lives 5 axis scale for individuals with complex health and social needs: assessment of validity and reliability","volume":"25","author":"White","year":"2025","journal-title":"BMC Health Serv Res"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"1302","DOI":"10.3390\/healthcare14101302","article-title":"Development and validation of the primary care needs assessment (PCNA) questionnaire: a participatory multidimensional approach to identifying health needs","volume":"14","author":"Papakosta-Gaki","year":"2026","journal-title":"HealthCare"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"e104","DOI":"10.1002\/lim2.104","article-title":"Healthy lifestyle scales to assess general and clinical population: a systematic review with narrative synthesis","volume":"5","author":"Dehghani","year":"2024","journal-title":"Lifestyle Med"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"108976","DOI":"10.1016\/j.maturitas.2026.108976","article-title":"Healthy living concepts and definitions: a systematic review with concept analysis proposing a four-dimensional model","volume":"210","author":"Trujillo-C\u00e1ceres","year":"2026","journal-title":"Maturitas"},{"key":"ref20","volume-title":"Scale Development: Theory and Applications","author":"DeVellis","year":"2012"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"149","DOI":"10.3389\/fpubh.2018.00149","article-title":"Best practices for developing and validating scales for health, social, and behavioral research: a primer","volume":"6","author":"Boateng","year":"2018","journal-title":"Front Public Health"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"1494261","DOI":"10.3389\/fpsyg.2024.1494261","article-title":"Psychological, psychiatric, and behavioral sciences measurement scales: best practice guidelines for their development and validation","volume":"15","author":"Stefana","year":"2024","journal-title":"Front Psychol"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"104","DOI":"10.1177\/109442819800100106","article-title":"A brief tutorial on the development of measures for use in survey questionnaires","volume":"1","author":"Hinkin","year":"1998","journal-title":"Organ Res Methods"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"684","DOI":"10.1177\/0269216317690685","article-title":"Guidance on conducting and REporting DElphi studies (CREDES) in palliative care: recommendations based on a methodological systematic review","volume":"31","author":"J\u00fcnger","year":"2017","journal-title":"Palliat Med"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"489","DOI":"10.1002\/nur.20147","article-title":"The content validity index: are you sure you know what\u2019s being reported? Critique and recommendations","volume":"29","author":"Polit","year":"2006","journal-title":"Res Nurs Health"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"1159","DOI":"10.1007\/s11136-018-1829-0","article-title":"COSMIN methodology for evaluating the content validity of patient-reported outcome measures: a delphi study","volume":"27","author":"Terwee","year":"2018","journal-title":"Qual Life Res"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"287","DOI":"10.1093\/poq\/nfm006","article-title":"Research synthesis: the practice of cognitive interviewing","volume":"71","author":"Beatty","year":"2007","journal-title":"Public Opin Q"},{"key":"ref28","first-page":"399","article-title":"How performing PCA and CFA on the same data equals trouble: overfitting in the assessment of internal structure and some editorial thoughts on it","volume-title":"Eur J Psychol Assess","author":"Fokkema","year":"2017"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"84","DOI":"10.1037\/1082-989X.4.1.84","article-title":"Sample size in factor analysis","volume":"4","author":"MacCallum","year":"1999","journal-title":"Psychol Methods"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"899","DOI":"10.1080\/00273171.2024.2342324","article-title":"Determining sample size requirements in EFA solutions: a simple empirical proposal","volume":"59","author":"Lorenzo-Seva","year":"2024","journal-title":"Multivar Behav Res"},{"key":"ref31","first-page":"73","article-title":"Discriminant function analysis: concept and application","volume":"8","author":"B\u00fcy\u00fck\u00f6zt\u00fcrk","year":"2008","journal-title":"Egit Arastirmalari Eurasian J Educ Res"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1037\/h0057123","article-title":"The selection of upper and lower groups for the validation of test items","volume":"30","author":"Kelley","year":"1939","journal-title":"J Educ Psychol"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"270","DOI":"10.1186\/s12912-025-02921-4","article-title":"Psychometric properties of the chinese version of the quiet quitting scale","volume":"24","author":"Zhang","year":"2025","journal-title":"BMC Nurs"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1007\/s10803-009-0816-2","article-title":"Evaluating the use of exploratory factor analysis in developmental disability psychological research","volume":"40","author":"Norris","year":"2010","journal-title":"J Autism Dev Disord"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"219","DOI":"10.1177\/0095798418771807","article-title":"Exploratory factor analysis: a guide to best practice","volume":"44","author":"Watkins","year":"2018","journal-title":"J Black Psychol"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"3510","DOI":"10.1007\/s12144-019-00300-2","article-title":"Exploratory factor analysis: current use, methodological developments and recommendations for good practice","volume":"40","author":"Goretzko","year":"2021","journal-title":"Curr Psychol"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"619","DOI":"10.1177\/1474515120920472","article-title":"Development and psychometric testing of the self-care scale for patients with chronic atrial fibrillation (AF-SCS-10)","volume":"19","author":"Son","year":"2020","journal-title":"Eur J Cardiovasc Nurs"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"1004","DOI":"10.1016\/j.sapharm.2020.07.027","article-title":"Issues and recommendations for exploratory factor analysis and principal component analysis","volume":"17","author":"Schreiber","year":"2021","journal-title":"Res Soc Adm Pharm"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"179","DOI":"10.1007\/BF02289447","article-title":"A rationale and test for the number of factors in factor analysis","volume":"30","author":"Horn","year":"1965","journal-title":"Psychometrika"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"209","DOI":"10.1037\/a0023353","article-title":"Dimensionality assessment of ordered polytomous items with parallel analysis","volume":"16","author":"Timmerman","year":"2011","journal-title":"Psychol Methods"},{"key":"ref41","volume-title":"Development and Evaluation of Medical Scales: Theory, Methods, and Practical Examples","author":"Wang","year":"2020"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"354","DOI":"10.1037\/a0029315","article-title":"When can categorical variables be treated as continuous? A comparison of robust continuous and categorical SEM estimation methods under suboptimal conditions","volume":"17","author":"Rhemtulla","year":"2012","journal-title":"Psychol Methods"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"936","DOI":"10.3758\/s13428-015-0619-7","article-title":"Confirmatory factor analysis with ordinal data: comparing robust maximum likelihood and diagonally weighted least squares","volume":"48","author":"Li","year":"2016","journal-title":"Behav Res Methods"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"3891","DOI":"10.3758\/s13428-023-02193-3","article-title":"Why we need to abandon fixed cutoffs for goodness-of-fit indices: an extensive simulation and possible solutions","volume":"56","author":"Groskurth","year":"2024","journal-title":"Behav Res Methods"},{"key":"ref45","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1080\/10705519909540118","article-title":"Cutoff criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives","volume":"6","author":"Hu","year":"1999","journal-title":"Struct Equ Model Multidiscip J"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"490","DOI":"10.1037\/0033-2909.111.3.490","article-title":"Model modifications in covariance structure analysis: the problem of capitalization on chance","volume":"111","author":"MacCallum","year":"1992","journal-title":"Psychol Bull"},{"key":"ref47","doi-asserted-by":"publisher","first-page":"561","DOI":"10.1080\/10705510903203433","article-title":"Testing structural equation models or detection of misspecifications?","volume":"16","author":"Saris","year":"2009","journal-title":"Struct Equ Model Multidiscip J"},{"key":"ref48","volume-title":"The Practice of Questionnaire Statistical Analysis: Operation and Application of SPSS","author":"Minglong","year":"2011"},{"key":"ref49","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1177\/002224378101800104","article-title":"Evaluating structural equation models with unobservable variables and measurement error","volume":"18","author":"Fornell","year":"1981","journal-title":"J Mark Res"},{"key":"ref50","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1007\/s11747-014-0403-8","article-title":"A new criterion for assessing discriminant validity in variance-based structural equation modeling","volume":"43","author":"Henseler","year":"2015","journal-title":"J Acad Mark Sci"},{"key":"ref51","doi-asserted-by":"publisher","first-page":"21","DOI":"10.2307\/2955359","article-title":"Self-rated health and mortality: a review of twenty-seven community studies","volume":"38","author":"Idler","year":"1997","journal-title":"J Health Soc Behav"},{"key":"ref52","doi-asserted-by":"publisher","first-page":"307","DOI":"10.1016\/j.socscimed.2009.05.013","article-title":"What is self-rated health and why does it predict mortality? Towards a unified conceptual model","volume":"69","author":"Jylh\u00e4","year":"2009","journal-title":"Soc Sci Med"},{"key":"ref53","doi-asserted-by":"publisher","first-page":"399","DOI":"10.1111\/bjop.12046","article-title":"From alpha to omega: a practical solution to the pervasive problem of internal consistency estimation","volume":"105","author":"Dunn","year":"2014","journal-title":"Br J Psychol"},{"key":"ref54","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1016\/j.tjem.2018.08.001","article-title":"User\u2019s guide to correlation coefficients","volume":"18","author":"Akoglu","year":"2018","journal-title":"Turk J Emerg Med"},{"key":"ref55","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1177\/1094428120968614","article-title":"An updated guideline for assessing discriminant validity","volume":"25","author":"R\u00f6nkk\u00f6","year":"2022","journal-title":"Organ Res Methods"},{"key":"ref56","doi-asserted-by":"publisher","first-page":"412","DOI":"10.1037\/met0000144","article-title":"Thanks coefficient alpha, we\u2019ll take it from here","volume":"23","author":"McNeish","year":"2018","journal-title":"Psychol Methods"},{"key":"ref57","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1080\/19312458.2020.1718629","article-title":"Use omega rather than cronbach\u2019s alpha for estimating reliability. But\u2026","volume":"14","author":"Hayes","year":"2020","journal-title":"Commun Methods Meas"},{"key":"ref58","doi-asserted-by":"publisher","first-page":"357","DOI":"10.1016\/j.dr.2013.08.003","article-title":"Sampling in developmental science: situations, shortcomings, solutions, and standards","volume":"33","author":"Bornstein","year":"2013","journal-title":"Dev Rev: DR"},{"key":"ref59","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1016\/j.dr.2016.06.004","article-title":"Measurement invariance conventions and reporting: the state of the art and future directions for psychological research","volume":"41","author":"Putnick","year":"2016","journal-title":"Dev Rev: DR."},{"key":"ref60","doi-asserted-by":"publisher","first-page":"737","DOI":"10.1016\/j.jclinepi.2010.02.006","article-title":"The COSMIN study reached international consensus on taxonomy, terminology, and definitions of measurement properties for health-related patient-reported outcomes","volume":"63","author":"Mokkink","year":"2010","journal-title":"J Clin Epidemiol"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1957359\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T05:50:55Z","timestamp":1791352255000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1957359\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,7]]},"references-count":60,"alternative-id":["10.3389\/fpubh.2026.1957359"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2026.1957359","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,7]]},"article-number":"1957359"}}