Validity and Reliability Assessment of the Health Behaviour Inventory (Hbi-20) Among Iranian Women Publisher



Hosseini SA ; Feizi A ; Yaghoubizadeh F
Source: International Journal of Women's Health Published:2026

Abstract

Objective: This study aimed to examine the psychometric properties of the Persian version of the Health Behavior Inventory (HBI-20) among Iranian women by investigating its factor structure, internal consistency, test–retest reliability, and criterion validity. Participants and Methods: A total of 265 Iranian women completed the HBI-20. Construct validity was assessed through both exploratory and confirmatory factor analyses. Internal consistency was measured with Cronbach’s alpha, and test–retest reliability was calculated using intraclass correlation coefficients (ICC) along with their 95% confidence intervals. Criterion validity was further evaluated by correlating the HBI-20 dimensions with corresponding scales from the Health-Promoting Lifestyle Profile II (HPLP II). Results: Exploratory factor analysis identified a four-factor model consisting of the Diet, Angerand Stress, Proper Use of Health Care Resources and Preventive Self-Care, and Substance Use dimensions, which together accounted for 52.33% of the total variance. Confirmatory factor analysis supported this four-factor model with acceptable indices (CMIN/DF = 2.391; GFI = 0.959; AGFI = 0.920; CFI = 0.934; RMSEA = 0.073). Reliability analyses demonstrated robust internal consistency with Cronbach’s alpha values of 0.704 (Diet), 0.665 (Anger and Stress), 0.793 (Proper Use of Health Care Resources and Preventive Self-Care), and 0.726 (Substance Use), and an overall alpha of 0.902. Test–retest reliability was also strong, with ICC values of 0.840 (95% CI: 0.755–0.898) for Diet, 0.781 (95% CI: 0.669–0.858) for Anger and Stress, 0.853 (95% CI: 0.773–0.906) for Proper Use of Health Care Resources and Preventive Self-Care, and 0.703 (95% CI: 0.561–0.804) for Substance Use. Additionally, correlation analyses with HPLP II dimensions confirmed the criterion validity. Conclusions: The Persian HBI-20 is a psychometrically sound, reliable, and valid tool for assessing health behaviors in Iranian women. Its clear dimensions, high internal consistency and test–retest reliability support its use in health and clinical practice. © 2026 Hosseini et al.