Research Article: Development of the Taiwanese version of the Health Enhancement Lifestyle Profile (HELP-T)

Date Published: June 26, 2018

Publisher: Public Library of Science

Author(s): Fiona Pei-Chi Su, Ling-Hui Chang, Hui-Fen Mao, Eric J. Hwang, Wenru Wang.


To develop and validate a Taiwanese version of the Health Enhancement Lifestyle Profile (HELP-T) for community-dwelling older Taiwanese adults (≥ 55 years).

The original Health Enhancement Lifestyle Profile (HELP) is a 56-item self-report questionnaire measuring various aspects of health-related lifestyles in older adults. The standard cultural-adaptation procedure was used for questionnaire translation and modification. A field test was conducted for culturally specific item selection, rating-scale analysis, and psychometric validation of the HELP-T in a sample of 274 community-dwelling older adults via classical test theory.

The 59-item HELP-T is culturally adapted from the original 56-item HELP. The original 6-point rating scale was modified to a 3-point scale for easy use by Taiwanese older adults. The HELP-T had good internal consistency (Cronbach’s alpha = 0.82). The test-retest reliability for the total score was high (0.92), and moderate to high (range: 0.57–0.92) for subscales. The construct validity was supported by the significant correlations between each subscale and the total score (Spearman’s rho = 0.41–0.67, p < 0.0001) and by the ability of the scores to significantly discriminate between participants with different levels of self-rated health (p = 0.0001). The HELP-T is a suitable clinical tool for assessing and monitoring lifestyle risk factors, establishing client-centered lifestyle intervention goals, and determining the outcomes of lifestyle interventions.

Partial Text

Taiwan is one of the world’s most rapidly aging nations. Between 1993 and 2018, the elderly population (≥ 65 years) almost doubled from 1.49 million (7% of the entire population) to 2.9 million (14%); this number is predicted to will reach approximately 4.4 million (20%) in 2026 [1]. National statistics for 2016 [2] showed mean life expectancy at 80.0 years but healthy life expectancy at only 71.0 years, which indicates an 8- to 9-year duration for healthcare services. On average, elderly Taiwanese have 2 or more chronic diseases, and 0.48 million of them are expected to require long-term care [3]. This will present a formidable challenge to families, healthcare providers, the government, and the entire community.

The 59-item HELP-T is the first health-related lifestyle assessment designed specifically for older Taiwanese adults. The HELP-T was culturally adapted from the original 56-item English version by adding two culturally specific items about family activities and by splitting one Leisure item into two. The original 6-point rating scale was modified to a 3-point scale to make it easier for older Taiwanese adults to use. The HELP-T total score had good internal consistency, and most HELP-T domains showed acceptable-to-good test-retest reliability and good construct validitythe HELP-T is suitable for measuring various aspects of lifestyle factors and behaviors in older Taiwanese adults.

This study adapted the HELP for cross-cultural use with older Taiwanese adults. We modified both the content and the rating scale to make HELP-T suitable for older Taiwanese adults. The HELP-T is a valid and useful tool that enables clinicians to understand the health-promoting habits and routines of older Taiwanese adults, helps them establish goals for lifestyle change, and yields client-centered lifestyle monitoring and recommendations.




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