Measuring health activation among foreign students in South Korea: initial evaluation of the feasibility, dimensionality, and reliability of the Consumer Health Activation Index (CHAI)

Foreign students in South Korea face important challenges when they try to maintain their health. As a measure of their motivation to actively build skills for overcoming those challenges, we evaluated the 10-item Consumer Health Activation Index (CHAI), testing its feasibility, dimensionality, and reliability. There were no missing data, there was no floor effect, and for the total scores the ceiling effect was trivial (< 2%). Results of the Kaiser-Meyer-Olkin test and Bartlett's test of sphericity indicated that the data were suitable for the detection of structure by factor analysis. The results of parallel analysis and the shape of the scree plot supported a two-factor solution. One factor had 3 items concerning "my doctor" and the other factor had the 7 remaining items. Reliability was high for the 10-item CHAI (alpha = 0.856), for the 3-item subscale (alpha = 0.838), and for the 7-item subscale (alpha = 0.857). Reliability could not be improved by deletion of any items. Use of the CHAI to gather data from these foreign students is feasible, and reliable results can be obtained whether one uses the total score from all 10 items or scores from the proposed 7-item and 3-item subscales.