Development and validation of a knowledge, attitude, and practice scale for healthy weight management among Chinese older adults

With advancing age, changes in body composition and metabolism may increase the risk of weight-related health problems in older adults. However, existing assessment instruments remain limited in terms of population applicability or dimensional coverage. This study aimed to develop and validate a scale for assessing knowledge, attitudes, and practices related to weight management among older adults. Guided by the Knowledge–Attitude–Practice framework and informed by self-regulation theory, an initial item pool was generated through a literature review, semi-structured interviews, and Delphi expert consultation. The scale was further refined through pilot testing and subsequently evaluated in a formal survey. A stratified random sampling method was used to recruit 487 older adults from Guangxi Zhuang Autonomous Region. Item analysis, as well as reliability and validity testing, were conducted to assess the psychometric properties of the scale. The final scale comprised 24 items across three domains: knowledge, attitudes, and practice. A five-factor structure comprising evaluative knowledge, management knowledge, attitudes toward weight management, executive behaviours, and regulatory behaviours was supported by exploratory factor analysis, accounting for 69.18% of the total variance. Confirmatory factor analysis indicated acceptable model fit. The overall Cronbach’s α was 0.94, indicating good internal consistency. This study developed a knowledge, attitude, and practice scale for healthy weight management in older adults with acceptable reliability and validity. The scale incorporates self-regulation theory and may support multidimensional assessment of weight management in older adults.