Validity and reliability of parent assessments of pubertal maturation among adolescent girls in Isfahan, Iran

Nafiseh Mozafarian; Mahin Hashemipour; Mohammad Reza Maracy; Seyed Ali Madineh; Raheleh Farahi; Roya Kelishadi

doi:10.1515/jpem-2023-0409

Article

Validity and reliability of parent assessments of pubertal maturation among adolescent girls in Isfahan, Iran

Nafiseh Mozafarian , Mahin Hashemipour , Mohammad Reza Maracy , Seyed Ali Madineh , Raheleh Farahi and Roya Kelishadi

Published/Copyright: January 11, 2024

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From the journal Journal of Pediatric Endocrinology and Metabolism Volume 37 Issue 2

Abstract

Objectives

The current paper presents the steps considered for validation of a questionnaire for assessment of sexual maturity among Iranian adolescent girls.

Methods

This cross-sectional study was performed in 2022 in Isfahan, Iran. Based on the Growth and Development Questionnaire that included both the Pubertal Development Scale (PDS) and Sexual Maturation Scale (SMS), two Persian questionnaires were prepared. The face validity, content validity, criterion validity, and reliability of the questionnaire were assessed. We compared agreement of two parent-reported measures of puberty, SMS and PDS, with clinical Tanner stages (TSs) as the gold standard. Percent agreement, Cohen’s kappa coefficient, and Kendall’s τ b were used to assess the agreement between maternal assessments with clinical TS. The intraclass correlation coefficient (ICC) and the Cronbach’s α coefficient were also calculated to evaluate the reliability of the questionnaire.

Results

A total of 150 students aged 6–17 years with mean (SD) age of 10 (2.04) completed this study. The percentages of agreement for the mother-reported SMS in relation to clinical TS for breast stage and pubic hair stage were 60 % and 53.8 %, respectively. The percentages of agreement of the mother-reported PDS in relation to clinical TS for breast stage and pubic hair stage were 55.8 and 66 %, respectively. The weighted kappa coefficients showed moderate agreement, with weighted kappa ranging from 0.52 to 0.61. The mother-reported SMS and PDS showed high reliability. The Cronbach’s alpha of the PDS and the SMS was 0.88 and 0.83, respectively. The ICC of the mother-reported SMS and the mother-reported PDS was 0.95 (0.92–0.98) and 0.97 (0.94–0.98), respectively.

Conclusions

This study indicated that a maternal assessment of sexual maturity using the PDS or SMS can reliably estimate pubertal development in adolescent girls in an Iranian population.

Keywords: validity; puberty; pubertal development scale; sexual maturation scale; girls

Corresponding authors: Mahin Hashemipour, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Noncommunicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran; and Metabolic Liver Disease Research Center, Isfahan University of Medical Sciences, Isfahan, Iran, E-mail: mahin.hashemipour@gmail.com; and Mohammad Reza Maracy, Department of Biostatistics and Epidemiology, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran; and Environment Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran, E-mail: maracy@med.mui.ac.ir

Funding source: Isfahan University of Medical Sciences, Isfahan, Iran

Award Identifier / Grant number: Approval code: IR.MUI.MED.REC.1399.176 research p

Acknowledgments

We wish to thank of the physicians at Isfahan University of Medical Sciences who participated in the study for their support and assistance. We are also grateful to Mrs. Ghane for her assistance as well as the participants and their families.

Research ethics: The study was conducted in accordance with the Declaration of Helsinki and approved by the research Ethics Committee of Isfahan University of Medical Sciences (Approval code: IR.MUI.MED.REC.1399.176 research project number 398986).
Informed consent: After explaining the purpose of the research, informed consent was obtained from mother’s or guardians’ students. Notably, the participants were assured that their information would be kept confidential.
Author contributions: The authors have accepted responsibility for the entire content of this manuscript and approved its submission.
Competing interests: The authors have no conflicts of interest to declare.
Research funding: The study was supported by a grant from Isfahan University of Medical Sciences. (Approval code: IR.MUI.MED.REC.1399.176 research project number 398986).
Data availability: The raw data can be obtained on request from the corresponding author.

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Supplementary Material

This article contains supplementary material (https://doi.org/10.1515/jpem-2023-0409).

Received: 2023-09-12

Accepted: 2023-12-21

Published Online: 2024-01-11

Published in Print: 2024-02-26

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Keywords for this article

validity; puberty; pubertal development scale; sexual maturation scale; girls