2.3. Data Collection and Measures
obesity, Diabetes
OBESITY, BREAST CANCER, CREST, DIABETES
Data were collected at baseline, 3 months, and 6 months. The research assistants and a registered nurse conducted all measurements. The trained research assistant and registered nurse measured WC, weight, and height. Study participants completed all questionnaires in a separate room where a research assistant could answer questions. All measurements and survey items have been used in China and demonstrated adequate reliability and validity.Feasibility. The number of eligible participants, percentage of completed assessments, and module access were assessed.Usability and acceptance. The frequency of accessing the 12 modules and satisfaction of reviewing the modules were collected to measure the usability and acceptance of these modules.Demographic survey. The socio-demographic questionnaire assesses participants’ age, education level, parents’ occupation, residence, and household income.Waist circumference (WC). This study followed the waist circumference measurement protocol set by the National Institute of Health. Waist circumference was measured midway between the lowest rib and the superior border of the iliac crest. The circumferences were given as the mean of the 2 measurements to the nearest 0.1 cm. Central obesity is a waist circumference ≥ 80.0 cm for Chinese women [Body mass index BMI. BMI is determined by measuring weight and height (weight [kg]/height [m]Fruit/vegetable intake and physical activity. Two items measured vegetable and fruit intake (>5 servings/per day) and regular physical activity (a total of 150 min per week) were used in this study. These two items were from the Canadian Diabetes Risk Questionnaire for the Chinese population survey used in China (CHINARISK). Adequate reliability (test-retested reliability = 0.98) and validity (sensitivity = 0.73 and specificity = 0.63) have been reported [Physical activity/average daily steps. The average daily steps on the week we collected data were used. Previous studies indicated that the Fitbit step count outputs are stable at different speeds and substantial with observer counts (0.97–1.0) [Self-efficacy for diet and physical activity. The 8-item survey was used in the study. Participants were asked about their confidence level in engaging in activities related to a healthy diet and regular physical activities. Scoring was based on five points (0- not confident to 5- very confident), and a higher score indicates a higher level of self-efficacy. Reliabilities have been documented in the exercise domain (Cronbach’s alpha 0.87 to 0.97) and the diet domain (Cronbach’s alphas 0.93 to 0.95) [Social support for diet and physical activity. The social support scale consists of six items measuring social support for diet and physical activity from family members and friends. The survey includes three items to evaluate the support of diet and exercise from family members and three from friends. The diet social support scale is based on a 4-point scale: 0 (never), 1 (sometimes), 2 (frequently), or 3 (always), while the physical activity social support scale is rated on a 5-point scale: 0 (never) to 4 (always). Higher scores indicate more social support for the participant. The survey has adequate reliability, with Cronbach’s alpha ranging from 0.80 to 0.87 for the diet domain and 0.84 to 0.91 for the physical activity domain [Perceived stress scale (PSS). This 14-items survey measures the degree of perceived stress the mothers perceived in the past month. The survey asked participants to respond to 14 questions on how often they have felt (such as upset, nervous, angry, or having difficulties) over the past month. Participants report the frequency of these questions on a five-point Likert scale (0  =  never to 4  =  very often), with the higher the score reflecting the higher level of the perceived stress. This survey has been used in China and has good psychometric properties in the Chinese population [Breast cancer risk knowledge, attitude, and barriers questionnaire (CBCSBQ). A 12-item self-report questionnaire measures knowledge (4 items), attitude (4 items), and barriers to mammographic screening (4 items) [