Content Validation of the Proactive Health Intentions Scale for Pre‐Frailty Older Adults: A Delphi Study

OBJECTIVES: Pre-frail older adults are at high risk for adverse health outcomes. Enhancing their proactive health behaviours is crucial for healthy ageing. This study aimed to develop and establish the content validity of a theory-driven Proactive Health Intention Scale for this population. METHODS: A two-round Delphi study was conducted. Of the 36 experts invited, 16 completed the first round. Fifteen experts proceeded to complete the second round. The study was grounded in the Theory of Planned Behaviour (TPB). Content validity was assessed using the expert consensus criterion, defined as an item receiving a rating of 4 (relevant) or 5 (very relevant) from ≥ 70% of the panel. RESULTS: The expert panel demonstrated strong engagement (a 44.4% response rate in Round 1 and a 93.8% retention rate in Round 2) and high authority (Cr = 0.88). After two rounds, a high consensus was achieved, with 49 out of 52 assessed items (94.2%) meeting the predefined validity criterion. The final scale encompasses five TPB dimensions: past behaviour, behavioural intention, attitude, subjective norms and perceived behavioural control. CONCLUSIONS: The Delphi process resulted in a 50-item Proactive Health Intention Scale with excellent content validity. This study provides a robust, theory-informed scale for measuring proactive health intentions in pre-frail older adults. PRACTICE IMPLICATIONS: The scale can be used by researchers and clinicians to assess intentions, identify barriers and facilitators, and inform the development of targeted interventions to promote proactive health behaviours in this vulnerable group.