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Open Access Open Badges Research article

Development and psychometric properties of the health-risk behavior inventory for Chinese adolescents

Mengcheng Wang1, Jinyao Yi1, Lin Cai1, Muli Hu1, Xiongzhao Zhu1, Shuqiao Yao1* and Randy P Auerbach2

Author Affiliations

1 Medical Psychological Institute, Second Xiangya Hospital, Central South University, #139 Ren-Min Zhong Road, Changsha 410011, China

2 Child and Adolescent Mood Disorders Laboratory, McLean Hospital, Harvard Medical School, 115 Mill Street, Belmont, MA 02478, USA

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BMC Medical Research Methodology 2012, 12:94  doi:10.1186/1471-2288-12-94

Published: 7 July 2012



There is a growing body of research investigating adolescent risk behaviors in China, however, a comprehensive measure that evaluates the full spectrum of relevant risk behaviors is lacking. In order to address this important gap, the current study sought to develop and validate a comprehensive tool: the Health-Risk Behavior Inventory for Chinese Adolescents (HBICA).


Adolescents, ages 14–19 years (n = 6,633), were recruited from high schools across 10 cities in mainland China. In addition, a clinical sample, which included 326 adolescents meeting DSM-IV criteria for Conduct Disorder, was used to evaluate predictive validity of the HBICA. Psychometric properties including internal consistency (Cronbach’s alpha), test-retest reliability, convergent validity, and predictive validity were analyzed.


Based upon item analysis and exploratory factor analysis, we retained 33 items, and 5 factors explained 51.75% of the total variance: Suicide and Self-Injurious Behaviors (SS), Aggression and Violence (AV), Rule Breaking (RB), Substance Use (SU), and Unprotected Sex (US). Cronbach’s alphas were good, from 0.77 (RB) to 0.86 (US) for boys, and from 0.74 (SD) to 0.83(SS) for girls. The 8 weeks test–retest reliabilities were moderate, ranged from 0.66 (AV) to 0.76 (SD). External validities was strong, with Barratt Impulsiveness Scale-11 was 0.35 (p < 0.01), and with aggressive behavior and rule-breaking behavior subscales of the Youth Self Report were 0.54 (p < 0.01) and 0.68 (p < 0.01), respectively. Predictive validity analysis also provided enough discriminantity, which can distinguish high risky individual effectively (cohen’ d = 0.79 – 2.96).


These results provide initial support for the reliability and validity of the Health-Risk Behavior Inventory for Chinese Adolescents (HBICA) as a comprehensive and developmentally appropriate assessment instrument for risk behaviors in Chinese adolescents.

Adolescent; Health-Risk behavior; Reliability; Validity