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OBJECTIVE/BACKGROUND: Insomnia is common in children with autism spectrum disorder (ASD). We recently developed and validated the 21-item Pediatric Autism Insomnia Rating Scale (PAIRS). This report explores the associations and agreements between actigraphy and PAIRS. PARTICIPANTS METHODS: Children with ASD, with and without sleep problems, were assessed with a battery of parent-rated and clinician measures (N = 134). In a subset (n = 70), a wrist-worn actigraph measured sleep for five consecutive nights. Parents completed logs for scoring sleep intervals. Spearman correlations evaluated associations with the PAIRS and actigraphy indices (sleep onset latency = SOL, wake after sleep onset = WASO, total sleep time = TST, sleep efficiency = SE%). Agreements on "poor sleepers" based on PAIRS total score (≥33) and conventional thresholds for TST and SE% were evaluated with Cohen's Kappa and McNemar's test. RESULTS: Actigraphy data were averaged over 4.64 ± 0.68 nights in 70 children (mean age = 7.3 ± 2.9, 74.3 % male). There were no significant correlations between PAIRS and any actigraphy indices. On TST, 48.6 % (n = 34) and on SE% 52.9 % (n = 37) were classified as "poor sleepers" compared to 32.9 % (n = 23) on PAIRS (kappa = 0.11 for TST and 0.27 for SE%). P-values on McNemar's Chi square test for PAIRS with TST and with SE% were 0.072 and 0.011, respectfully. CONCLUSIONS: These results suggest that actigraphy and PAIRS do not agree. Actigraphy TST captures movement and an estimate of specific sleep parameters. PAIRS is a broader measure that incorporates sleep disturbance and sleep-related impairment.

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Background: Despite the prevalence and negative outcomes associated with simultaneous alcohol and cannabis use (i.e., marijuana [SAM] use; i.e., so that the effects of both alcohol and cannabis overlap) among college students, there is no comprehensive measure of SAM use, with past research relying on single items. The present studies aimed to develop the Alcohol and Cannabis Simultaneous Use Scale (ACSUS), a comprehensive self-report measure of SAM use frequency, quantity, and problems in college students. Methods: College students at two Midwestern universities who used alcohol and cannabis (Study 1: N=534; Mean age=19; 71% female; 88% White; Study 2: N=258; Mean age=21; 81% female; 85% White) completed the newly developed ACSUS. Results: Exploratory factor analysis (Study 1) revealed the ACSUS fit best with 9-items representing two factors: Factor 1 measures frequency and quantity of SAM use, and Factor 2 measures associated problems with SAM use. Confirmatory factor analysis (Study 2) supported the two-factor structure of the ACSUS which was positively associated with measures of alcohol use, cannabis use, simultaneous use motives, and impulsivity. Conclusions: These data provide initial support for the ACSUS, developed to investigate the frequency, quantity, and associated problems with SAM use in college students.

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BACKGROUND: Compassionate care is a fundamental component of healthcare today; yet, many measures of compassionate care are subjective in focus and lack clarity around what compassionate care looks like in practice. Measures mostly relate to physical healthcare settings, neglecting mental healthcare. They also lack significant involvement of people with lived experience (PLE) of healthcare delivery in their development. This study aimed to begin the process of developing a new patient-reported measure, one that captures the observable actions of compassionate care delivery or 'compassionate healthcare in action' by any healthcare professional working in any care setting. The study involves PLE of healthcare delivery, both patients and staff, throughout. METHODS: A multistage mixed-methods scale development process was followed. First, items were derived inductively from reflexive thematic analysis of patient and clinician interviews about what compassionate care meant to them (n = 8), with additional items derived deductively from a literature review of existing measures. Next, a panel of patient, clinician and researcher experts in compassionate care was recruited (Round 1: n = 33, Round 2: n = 29), who refined these items in a two-round modified online Delphi process. RESULTS: Consensus was reached on 21 items of compassionate care in action relating to six facets: understanding, communication, attention, action, emotional sensitivity and connection. These items will form the basis for further scale development. CONCLUSIONS: This item development work has laid the foundation of a potential new tool to systematically measure what compassionate healthcare in action looks like to patients. Further research is underway to produce a valid and reliable version of this proposed new measure. We have outlined these initial stages in detail in the hope of encouraging greater transparency and replicability in measure development, as well as emphasising the value of involving PLE throughout the process. PATIENT OR PUBLIC CONTRIBUTION: This study involved PLE of both physical and mental healthcare (as staff, patients and service users) throughout the development of the new measure, including initial project conceptualisation and participation in item generation and refinement stages.

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There are few reliable and feasible quality assurance methods to support scaling up of psychological interventions delivered by non-specialist providers. This paper reports on the phased development and validation of a digitally administered Knowledge of Problem Solving (KOPS) measure to assess competencies associated with a "task-shared" problem-solving intervention for adolescents with diverse mental health problems in India. Phase 1 established key competencies required to deliver the intervention, followed by item generation for a corresponding knowledge-based competency measure that could be administered efficiently through e-learning systems. In phase 2, items were refined based on responses from an "experienced" reference sample comprising 17 existing counsellors with direct experience of the problem-solving intervention, and a "novice" sample with 14 untrained university students and NGO staff. In phase 3, we evaluated two parallel versions of the measure in a validation sample (N = 277) drawn from universities and NGOs. The resulting 17-item measure was structured around a hypothetical case, followed by multiple-choice questions that asked about the most appropriate response to a practice-based scenario. The difficulty level of the test items was well matched to the ability level of participants (i.e. most items being of moderate difficulty and few items being easy or difficult). Only one item showed a negative discrimination index and was removed from the 17-item forms. The final 16-item version of the KOPS measure provides a scalable digital method to assess key psychotherapeutic competencies among non-specialists, particularly in relation to a transdiagnostic problem-solving intervention. Similar formats could be deployed more widely alongside e-learning programmes to expand the global workforce capable of delivering evidence-based psychological interventions. Supplementary Information: The online version contains supplementary material available at 10.1007/s41347-023-00356-9.

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Background: Electronic nicotine delivery systems ("e-cigarettes") are the nicotine product most commonly used by adolescents. Research, treatment, and policy could benefit from measures of adolescent e-cigarette beliefs about outcomes of use (ie, expectancies). In the current study, we developed and tested an adolescent electronic nicotine vaping expectancy measure. Methods: A focus group with adolescents evaluated potential e-cigarette expectancy items. A panel of national experts assisted in revision of these items. Finally, items were administered to a sample of adolescents 14-17 years old (N = 267, Mean age 15.6, SD = 1.1, 50.9% Female, 50.2% Non-Hispanic White, 22.5% Non-Hispanic Black, 14.2% Hispanic) in a large Southeastern metropolitan area in the United States. Results: Exploratory Factor Analysis revealed a four factor solution: Negative Consequences (Cronbach's α = .92); Positive Reinforcement (α = .83); Negative Affect Reduction (α = .95); and Weight Control (α = .89). Subscales were significantly correlated with vaping susceptibility and lifetime vaping. Subscales successfully differentiated susceptible adolescents from confirmed non-susceptible adolescents, with susceptible adolescents reporting more positive expectancies, eg, Positive Reinforcement, M = 5.0, SD = 2.0 vs M = 3.0, SD = 2.1, P < .001, η2 = 0.19, and less negative expectancies, M = 5.5, SD = 2.3 vs M = 6.5, SD = 2.6, P = .001, η2 = 0.04. Similar results were found comparing adolescents who have never vaped nicotine with those who have vaped nicotine. Hierarchical linear regression demonstrated subscales were significant predictors of lifetime vaping after controlling for demographics, vaping ad exposure, and peer/family vaping. Conclusions: A preliminary version of an adolescent expectancy measure appears reliable and valid based on expert input and pilot testing with adolescents. Promising results were found in the domains of concurrent validity, discriminant validity, and incremental validity. Future research and evaluation efforts will be able to use this tool to further prevention and treatment goals.

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BACKGROUND: There is growing interest in client engagement in pediatric rehabilitation. This article investigated the psychometric properties of a measure of service providers' perceptions of the affective, cognitive and behavioural engagement of both children with disabilities and their parents in pediatric rehabilitation therapy sessions. METHODS: Test-retest reliability of the Pediatric Rehabilitation Intervention Measure of Engagement-Service Provider version (PRIME-SP) was examined using engagement ratings made by 60 service providers for 77 children and 73 parents. Construct validity was examined using the known-group validity technique, utilizing service providers' ratings of the engagement of parents and their children attending the same session with the service provider. We hypothesized that there would be significantly different, yet moderately correlated engagement ratings for children and their parents. RESULTS: There was evidence of moderate test-retest reliability for the child ratings, indicative of dynamicity across occasions, but also a degree of consistency, as aligned with our expectations. Service providers' ratings of parent and child engagement were not significantly correlated and paired t-tests indicated significantly higher engagement scores for parents than children. CONCLUSIONS: The study provides preliminary evidence to support the reliability and validity of the PRIME-SP as a tool for service providers to document, reflect on and monitor child and/or parent engagement.

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BACKGROUND: Camouflaging of autistic traits involves hiding or compensating for autistic characteristics, often due to stigma or a desire to fit in with others. This behaviour has been associated with mental health issues in autistic individuals. The 2 5-item Camouflaging Autistic Traits Questionnaire (CAT-Q) is the most commonly used self-report measure of camouflaging. In this study, a 9-item short form version was developed for use in clinical and research settings. AIMS: To construct and psychometrically validate a brief self-report measure of camouflaging. METHOD: The Camouflaging Autistic Traits Questionnaire - Short Form (CATQ-SF) was developed and its factor structure and psychometric properties were evaluated in two studies. Study 1 used a large, online sample of autistic and non-autistic adults (N = 832) to evaluate the factor structure, psychometric properties, and measurement invariance of the CATQ-SF. Study 2 used an independent sample of autistic and non-autistic adults (N = 80) to test Study 1's findings. RESULTS: In Study 1, evidence for a three-factor structure was observed, with good internal consistency (combined autistic & non-autistic α = 0.84). In addition, the instrument demonstrated measurement invariance, and reliably predicted higher levels of autistic traits. In Study 2, the 3-factor structure was replicated, and good internal consistency was again observed (combined autistic and non-autistic α = 0.89). In both studies, psychometric properties were of similar or higher validity compared to the full-form CAT-Q. CONCLUSIONS: The CATQ-SF can be used by clinicians and researchers to measure camouflaging in autistic and non-autistic adults quickly and reliably.

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BACKGROUND: There is a critical need for the development of dependable and valid anxiety assessment tools suitable for people with moderate to severe intellectual disabilities, particularly those who speak few or no words. Distinguishing anxiety from distress caused by physical discomfort (pain) or characteristics associated with autism, prevalent in this population, necessitates specialised assessment tools. This study (a) developed a parent-report anxiety questionnaire tailored for individuals with severe to moderate intellectual disabilities, potentially with a co-diagnosis of autism, and (b) evaluated the psychometric attributes of this novel measure. METHODS: A comprehensive approach involving literature reviews, inspection of existing tools, and interviews with clinicians and parents guided the creation of the Clinical Anxiety Scale for People with Intellectual Disabilities. The tool was completed by parents or caregivers (N = 311) reporting on individuals aged 4 or older with intellectual disabilities. RESULTS: Exploratory factor analysis indicated a four-factor structure encompassing anxiety, pain, low energy/withdrawal, and consolability. The anxiety factor explained the most variance in scores (26.3%). The anxiety, pain, low energy/withdrawal subscales demonstrated robust internal consistency (α = 0.81-0.92), and convergent, divergent, and discriminant validity. Robustness of these subscales was further evidenced by test-retest reliability (ICC = 0.79-0.88) and inter-rater reliability (ICC = 0.64-0.71). Subgroup analyses consistently demonstrated strong psychometric properties among individuals diagnosed with non-syndromic autism (N = 98), children (N = 135), adults (N = 175), and across diverse communication abilities within the sample. Moreover, individuals diagnosed with both autism and anxiety exhibited significantly higher scores on the anxiety subscale compared to those without an anxiety diagnosis, while showing no difference in autism characteristic scores. CONCLUSIONS: The findings indicate that the Clinical Anxiety Scale for People with Intellectual Disabilities is a promising measure for use across diverse diagnostic groups, varying communication abilities, and with people with moderate to severe intellectual disabilities.

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(1) Background: A significant proportion of cancer survivors report experiencing a cognitive 'fog' that affects their ability to think coherently and quickly, and reason with clarity. This has been referred to as cancer-related cognitive impairment (CRCI). CRCI has extensive impacts on the daily lives of people living with or beyond cancer, including occupational, social, and psychological functioning. Oncology health professionals report feeling under-resourced to effectively assess the needs of an individual with CRCI and then provide optimal care and referral. (2) Methods: The objective of this project is to develop and provide an initial validation of the first purpose-built unmet needs assessment for CRCI: the Unmet Needs Assessment of Cancer-Related Cognitive Impairment Impact (COG-IMPACT). We will use a multiple-stage, co-design, mixed-methods approach to develop and provide an initial validation of the COG-IMPACT. (3) Results: The primary anticipated result of this research is the production of the COG-IMPACT, the first purpose-built unmet needs assessment for CRCI. The assessment could be used by health professionals to understand the unmet needs and facilitate optimal care and referral for cancer survivors, by survivors to elucidate their supportive needs and advocate for their care, and by researchers to examine the correlates of unmet needs relating to CRCI, as well as how best to support people with CRCI.

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This multi-methods study describes the development of a pediatric rehabilitation telehealth intervention fidelity checklist, estimates its inter-rater reliability, and documents raters' implementation experience. A literature scan and expert consultation identified eighteen key behaviors and categorized them into three subdomains, measured using a 5-point measurement system. To estimate the checklist's inter-rater reliability, three raters scored 33 video recordings. A Shrout and Fleiss Class 1,1 intraclass correlation (ICC)) and 95% confidence intervals (CI) calculated ICCs = 0.5 (CI: 0, 0.9) for both the Therapist and the Parent-Therapists subdomains, and the Parent subdomain an ICC = 0.3 (CI: 0, 0.8). In the implementation surveys, raters reported high levels of satisfaction (100%), ease of use (84% to 88%), and confidence in their video ratings (87% to 100%). Changes in procedures and scoring were recommended. Capturing raters' implementation experiences is crucial in the early evaluation of the fidelity checklists for telehealth.

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OBJECTIVE: Racially minoritized youth with T1D are made vulnerable to disproportionately adverse health outcomes compared to White peers due to enduring systems of oppression. Thus, understanding modifiable psychosocial factors associated with diabetes-related outcomes in racially minoritized youth may help to buffer deleterious effects of racism. One factor meriting exploration is racial-ethnic identity. There is currently limited research on measures fit to assess ethnic identity in youth with chronic illnesses. This study's purpose is to examine the factor structure, reliability, and validity of the revised Multigroup Ethnic Identity Measure (MEIM-R) in a racially- and income-diverse sample of youth with T1D across sociodemographic and illness-related proxies for one's positionality in oppressive systems. METHOD: As part of a larger study examining resilience, 142 youth with T1D ages 12-18 (Mage = 14.66, SDage = 1.62, 55.6% Black/African-American, 44.4% White) completed the MEIM-R and various psychosocial measures. HbA1c levels and illness duration were extracted from medical records and caregivers reported income information. Confirmatory factor analyses compared the structural validity of competing MEIM-R models, and uniform and non-uniform differential item functioning (DIF) was explored across sociodemographic and illness-related factors. RESULTS: While a bifactor structure was supported, the MEIM-R was found to exhibit DIF by race and gender on multiple MEIM-R items and did not demonstrate linear bivariate relations with other psychosocial factors. CONCLUSIONS: Since different MEIM-R item response patterns were observed across racial/ethnic and gender groups, caution is warranted in using this measure in racially and gender diverse youth with T1D.

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OBJECTIVES: Real relationship (RR) refers to a genuine human relationship between client and therapist, that has been found to be positively related to treatment outcome, and to predict unique variance in outcome over and above the working alliance. However, thus far, the measurement of RR has been limited to self-report. We aimed to develop an observer-rated version of the RR measure (RR-O) to assess RR in therapy sessions. METHODS: We adapted items from the self-report measures to an observer rated measure, which was reviewed by RR experts. The final 24-item RR-O was rated in 540 session transcripts from 27 psychoanalytic treatments that already had existing process and outcome scores. RESULTS: The RR-O showed good internal consistency and good interrater reliability. In hierarchical EFA, items clustered into a general RR factor, and client realism, client genuineness, therapist genuineness, and therapist realism group factors. In addition, the RR-O was positively related to another RR measure and to the therapeutic alliance. CONCLUSION: The RR-O shows initial reliability and validity as an observer-rated measure of the RR to be used in post-hoc psychotherapy research. Future research should clarify the relation between RR-O and treatment outcome.

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BACKGROUND: A gap exists in measures available to assess levels of motivation, desire, and value associated with connecting with others. Moreover, few social connection scales have been developed with a goal of including autistic individuals in the sample to create a measure that has utility across neurodiverse populations. This study aims to develop a measure to assess different facets of social connection that is valid among both autistic and non-autistic adults. METHODS: The sample consisted of 200 participants recruited online. Participants completed an initial set of 35 items. Exploratory factor analyses and confirmatory factor analyses were performed. Four-factor models were produced by the EFAs. RESULTS: Item reduction resulted in the development of two 8-item scales: the Connections with Others Scale (CWOS) intended for the general population and the CWOS-Autistic Version (CWOS-AV) intended for autistic populations (CWOS-AV). Autistic participants had significantly greater motivation/desire to connect with others compared to non-autistic participants (t(195) = 3.39; p < 0.001). CONCLUSIONS: These measures will allow for greater ability to assess the motivation to connect with others, resulting in improved ability to produce research that clarifies theories and describes psychological phenomena.

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LAY ABSTRACT: The American Academy of Pediatrics recommends universal screening to identify children at higher likelihood for autism at 18- and 24-month well-child visits. There are many children, however, that are missed during this toddler age who do not get diagnosed until much later in development, delaying access to autism-specific interventions. Currently, brief measures for universal autism screening for school-age children, however, are lacking. In this project, we adapted a commonly used autism screener for toddlers, the Modified Checklist for Autism in Toddlers, Revised, with Follow-Up (M-CHAT-R/F), to be used for school-age children. This measure, called the M-CHAT-School (M-CHAT-S), is a parent- and teacher-report questionnaire to be used to screen for autism in school-age children aged 4 to 8 years of age. M-CHAT-S was developed through feedback from autism experts, as well as interviews with parents and teachers to provide input on the items. Two versions of M-CHAT-S were developed, one for verbally fluent and one for minimally verbal school-age children. M-CHAT-S is a brief measure, with updated items to reflect changes in the way experts think and talk about autism, making it a useful measure to use for autism screening in elementary aged children. The next steps include further testing to ensure that M-CHAT-S performs well in identifying children with increased likelihood of autism, after which it will be made available to parents, educators, and other professionals.

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OBJECTIVE: To identify constructs that are critical in shaping Veterans' experiences with Veterans Health Administration (VA) women's healthcare, including any which have been underexplored or are not included in current VA surveys of patient experience. DATA SOURCES AND STUDY SETTING: From June 2022 to January 2023, we conducted 28 semi-structured interviews with a diverse, national sample of Veterans who use VA women's healthcare. STUDY DESIGN: Using VA data, we divided Veteran VA-users identified as female into four groups stratified by age (dichotomized at age 45) and race/ethnicity (non-Hispanic White vs. all other). We enrolled Veterans continuously from each recruitment strata until thematic saturation was reached. DATA COLLECTION/EXTRACTION METHODS: For this qualitative study, we asked Veterans about past VA healthcare experiences. Interview questions were guided by a priori domains identified from review of the literature, including trust, safety, respect, privacy, communication and discrimination. Analysis occurred concurrently with interviews, using inductive and deductive content analysis. PRINCIPAL FINDINGS: We identified five themes influencing Veterans' experiences of VA women's healthcare: feeling valued and supported, bodily autonomy, discrimination, past military experiences and trauma, and accessible care. Each emergent theme was associated with multiple of the a priori domains we asked about in the interview guide. CONCLUSIONS: Our findings underscore the need for a measure of patient experience tailored to VA women's healthcare. Existing patient experience measures used within VA fail to address several aspects of experience highlighted by our study, including bodily autonomy, the influence of past military experiences and trauma on healthcare, and discrimination. Understanding distinct factors that influence women and gender-diverse Veterans' experiences with VA care is critical to advance efforts by VA to measure and improve the quality and equity of care for all Veterans.

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People with dementia vary in awareness of difficulties. Evaluating awareness could facilitate personalized care. However, current research measures are unsuitable for practical clinical application. We aimed to develop a brief multidimensional awareness interview for clinical use. Informed by available evidence about awareness of dementia, items suitable for both in-person and remote administration were modified from validated measures or developed for clinical application. The interview was administered via telephone or videoconference to 31 community-dwelling people with mild-to-moderate dementia. An informant completed a corresponding questionnaire. A multidimensional profile of awareness was created using self-report of symptoms, and discrepancies between self-rating and either informant rating or objective memory task performance. Feedback from participants and informants and discussions with clinical advisory and patient and public involvement groups helped finalize the interview. Remote administration was straightforward taking on average under 11 min. Awareness profiles showed a spectrum of awareness across domains. Feedback indicated that the items were acceptable and understandable. Certain aspects could be mildly upsetting where current difficulties were highlighted. Subject to further validation, the Healthcare Awareness Profile Interview (HAPI) shows potential as an evidence-based brief clinical tool for assessing awareness in people with mild-to-moderate dementia.

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Background: Transnormativity refers to the accountability structure that regulates the acceptable gender presentations, narratives, and ways of being of trans and nonbinary (TNB) individuals.Aims: The present research extends prior qualitative research on transnormativity to develop and validate the Transnormativity Measure (TM). Methods: The initial developed pool of potential items was presented to a focus groups and three content experts for review. In Study 1 (N = 497), the 69 initial items of the TM hypothesized to underly a six-factor structure were analyzed using Exploratory Factor Analysis (EFA) and construct and discriminant validity were assessed. In Study 2 (N = 540), an independent sample of TNB participants' TM responses were subjected to Confirmatory Factor Analysis (CFA), invariance testing, and construct and predictive validity. Finally, in Study 3 (N = 107), an Interclass Correlation Coefficients 2-way mixed-effects model of the TM was assessed.Results: EFAs conducted in Study 1 revealed a two-factor structure as the best fit with 50 items removed. Conceptually there was considerable overlap in the items comprising the two factors and it was decided that one general factor should be utilized. Study 1 also provided preliminary construct and discriminant validity due to expected relations between the TM and existing measures of heteronormativity and internalized transphobia. In Study 2 findings from correlational tests of the remaining items revealed that four items were highly correlated and were removed. Subsequent CFA indicated that the one factor model fit the data well. Configural invariance was supported however metric noninvariance was found. Additionally, Study 2 results supported construct and predictive validity through correlations between the TM and measures of TNB community belonginess and mental health outcomes. Finally, Study 3 provided support for test-retest reliability. Discussion: Across three studies, the TM was found to be a valid measure of transnormativity.

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Relational theories of human development explain how stereotypes and their underlying ideologies thwart social connections that are fundamental for individuals to thrive, especially in early adolescence. Intervention research to address this crisis of connection is still emergent and active listening is one promising strategy to this end; however, its efficacy has not been examined in part because no validated measures of active listening for this population exist. This validation study is the first to examine whether the behavioral dimensions of one form of active listening can be captured using a coding scheme to assess adolescents' engagement in a live interviewing task (N = 293). Importantly, the measure was developed within the context of a theory-driven intervention to train adolescents in transformative curiosity and listening to enhance connection. Findings indicate that two dimensions underlie the measure as hypothesized, open-ended questions and follow-up questions, with acceptable internal consistency. The measure is sensitive to change in adolescents' questioning skills before and after the intervention. Further, asking follow-up questions was positively related to empathy and also predicted a respondent's perception of their interviewer as a good listener. The effect for asking open-ended questions was moderated by dyad-level tendencies to elicit disclosure from others. The current measure not only examines question asking as a more nuanced behavioral dimension of active listening than previous measures, it is also the first to do so among a sample of early adolescents. The measure will be useful in assessing active listening interventions' efficacy to address the crisis of connection.

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OBJECTIVE: The purpose of this study was to evaluate the psychometric properties of the Couples' Sleep Conflict Scale, a new measure designed to identify the extent of conflict around sleep in romantic relationships. METHODS: Data from an individual sample (N = 158) and dyadic sample (N = 143 mixed-gender couples) in romantic relationships were used to examine the psychometric properties of the Couples' Sleep Conflict Scale, including internal consistency, convergent and divergent validity, and whether the factor structure differed between couples with concordant and discordant chronotypes. RESULTS: Results revealed that the Couples' Sleep Conflict Scale fit a 1-factor solution of 5 items, a summed or mean score can be used, and that it is reliable for both men and women. In addition, more relational sleep conflict was associated with both their own and their partners' poorer sleep hygiene, worse sleep quality, and more daytime sleepiness as well as more general relationship conflict, lower relationship satisfaction, and higher anxious and avoidant attachment. Finally, we found partial measurement invariance for factor loadings, intercepts, and latent variable variances between couples with concordant vs. discordant chronotypes. CONCLUSION: The Couples' Sleep Conflict Scale is a brief measure that can be used in both research and in health care settings to examine how sleep-related conflict can affect both sleep and relationship quality among couples.

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OBJECTIVE: To develop a consumer nutrition environment assessment tool to assess policy, systems, and environmental initiatives that are implemented in food pantries, which incorporates recent national guidance, and evaluate its validity and reliability. SETTING: Illinois, US. DESIGN: This study had 4 phases: (1) tool revision, (2) pilot testing, (3) content validity assessment, and (4) interrater and test-retest reliability assessment. The original Nutrition Environment Food Pantry Assessment Tool (NEFPAT) was revised to incorporate evidence from updated guidelines and evidence. The NEFPAT+ was pilot-tested by 9 professionals at 5 food pantries. After revisions, 18 experts rated the content validity. Interrater and test-retest reliability was based on 2-4 professionals completing independent evaluations at 21 food pantries twice, 1 month apart. ANALYSIS: Content validity indices and intraclass correlation (ICC) coefficients for reliability estimates were compared with established thresholds. RESULTS: The NEFPAT+ was rated content valid by 94% of experts. The ICC for NEFPAT+ scores indicated excellent interrater reliability (ICC, 0.96; 99% confidence interval, 0.75-0.97) and good test-retest reliability (ICC: 0.80; 99% confidence interval, 0.60-0.92). CONCLUSIONS: Evidence supports the content validity, interrater reliability, and test-retest reliability of the NEFPAT+. Future studies can assess how NEFPAT+ scores relate to intervention outcomes and dietary behaviors.

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