Validation of the instrument Life Conditions Scale (LifeCon Scale) in university students of health sciences degrees in Spain

Validation of the instrument Life Conditions Scale (LifeCon Scale) in university students of health sciences degrees in Spain | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Validation of the instrument Life Conditions Scale (LifeCon Scale) in university students of health sciences degrees in Spain Beatriz Sánchez-Hernando, Pedro José Satústegui-Dordá, Vicente Gea-Caballero, and 9 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6745156/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 7 You are reading this latest preprint version Abstract Background Health promotion in universities is a key approach supported by the World Health Organization (WHO), which integrates actions to improve the physical, mental and social well-being of the educational community. This study aims to analyse the psychometric properties of the LifeConScale tool adapted for university health science students in Spain, assessing its internal consistency and construct validity. Methods An observational, descriptive, cross-sectional and multicenter study was carried out with a sample of 567 students from 11 Spanish universities during the 2023–2024 academic year. Several sociodemographic variables, life habits and academic performance were used. Results Exploratory factor analysis identified six key dimensions in the questionnaire, which explained 88.4% of the variance. Construct validity was confirmed with a KMO index of 0.8621, and internal consistency was assessed using Cronbach's alpha, obtaining high levels of reliability in all dimensions. Conclusions The results highlight that the tool is useful for assessing university students' living conditions and habits, such as physical activity, substance use and psychosocial skills. This assessment can serve as a basis for implementing health promotion policies in universities, with a positive impact on both students' well-being and academic performance. It is concluded that the LifeConScale is a valid and reliable instrument to diagnose the health of the university population. Validation Study Habits Social Skills Personal Satisfaction Health Promotion Young Adult 1. Background The World Health Organisation (WHO) defines health as ‘a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity’( 1 ). More than 30 years ago, the WHO reflected in the Ottawa Charter that both health and health promotion could not be dealt with exclusively in the health sector ( 2 ). To be more specific, health promotion was defined at that Conference as ‘the process of enabling people to increase control over their health’ ( 2 ). One of the non-health settings is education; the educational setting, although of great importance for people's health, is not usually under the influence of the health sector. Health promotion in the educational environment is described as any activity that is undertaken to improve or protect the health of all people who work, learn and live together in that environment ( 3 ), this concept encompasses both early childhood and primary education as well as higher education levels. In this regard, the WHO highlights the importance of universities acting as health promoters, as students represent a young and dynamic population that, through education, can be sensitised to healthy behaviours. Health promotion in these settings goes beyond mere health education; it focuses on modifying the social determinants of health, creating a favourable environment that fosters healthy lifestyles, and promoting healthy lifestyles. This involves collaboration between different areas ( 4 , 5 ). The university is an institution in which people live, work and learn, which is conceived as a context for health promotion. Specifically, those universities that actively work to improve the health and well-being of the educational community are known as Health Promoting Universities ( 6 ). These are institutions that are committed to creating environments and undertaking actions that promote the holistic wellbeing of the entire university community. They are part of an international movement to integrate health into university life, considering that educational institutions have a major influence on the physical, mental, emotional and social development of individuals. These universities take a holistic approach to health, developing policies and environments that support health, promoting health and wellness education, encouraging the active participation of students and staff, and creating an environment that supports self-care and practices that maintain or improve the health of their members. The concept is based on the idea that health is a resource for everyday life, not just a goal ( 2 ). Therefore, universities that adopt this philosophy seek to involve the entire university community in health promotion, through programmes of physical activity, psychological support, disease prevention, and improvement of working and study conditions. In addition, they often collaborate with university networks and international organisations to exchange good practices and resources. This approach, endorsed by the World Health Organisation (WHO), recognises that education and health are interrelated. Health-promoting universities provide not only a lifestyle-friendly academic environment, but a holistic wellness space that appears to enhance the academic and personal success of students and staff ( 7 ). In order to be able to work actively in the university community, prioritise appropriate policies and carry out the necessary actions to improve the health and well-being of all people, it is necessary to have indicators to know what the characteristics of this population are and what elements exist to motivate change. These indicators can range from lifestyle data (diet, exercise, substance use) to information on psychological well-being, life skills, access to health services and the social and academic environment surrounding students. Collecting and analysing these data allows not only to understand the current health status of the community, but also to identify patterns of risk and areas of vulnerability ( 7 ). To do this, validated tools are needed to provide comprehensive and reliable information on students' living conditions. These may include surveys, questionnaires and statistical analyses that measure key indicators of health, emotional well-being and satisfaction with the academic environment. In addition, using validated instruments ensures that the data obtained are comparable and allow us to measure the impact of policies and actions implemented over time ( 7 ). Following this line of argument, the aim of this study was to analyse the psychometric properties, internal consistency and construct validity of the LifeConScale tool for university students of health sciences in Spain. 2. Methods 2.1. Design of the study An observational, descriptive, cross-sectional and multicenter study was carried out during the 2023–2024 academic year in Spanish universities. 2.2. Population and sample The population consisted of students of university degrees related to health sciences, in different Spanish universities, during the academic year 2023–2024. Participants who did not understand Spanish were excluded. The minimum estimated sample was 517 participants. Convenience sampling was used, sending the questionnaire to all students from different Spanish universities with which the authors had close contact. 2.3. Data collection instrument and study variables For the questionnaire, we used the ‘LifeConScale’ tool validated in adolescent secondary school students (8*), in which a series of adaptations were made for university age, in terms of socio-demographic variables. All Spanish universities, both private and public, were taken into account. The variables collected were: socio-demographic characteristics (gender, age, university, degree, year, population centre, usual residence, working day, parents' level of studies, weight, height and perceived level of health), life skills (self-efficacy, social skills and affective balance), daily habits (eating, sleeping, physical activity, use of screens and consumption of toxic substances) and academic performance (university entrance exam cut-off mark, credits enrolled, credits passed and overall average mark) [see Additional file 1]. 2.4. Data analysis As was done in the original tool for adolescents ( 8 ), a descriptive analysis of all the variables of the study was carried out in order to know the characteristics of the study population and the behaviour of the different variables used. For the validation of the instrument, an Exploratory Factor Analysis (EFA) of principal components was carried out to identify the dimensions into which the questionnaire was grouped. To ensure the applicability of the EFA in the study population, the Kaiser-Meyer-Olkin (KMO) sample size adequacy measure was considered to be greater than 0.75 ( 9 ). After performing such an analysis, we included factors with eigenvalues greater than 1( 10 ). Cronbach's Alpha was used to assess the internal consistency of the factors and also the overall consistency of the questionnaire. The SPSS 26 statistical package was used for the analyses. 2.5. Ethical aspects The questionnaire was completely anonymous. The data were treated confidentially, following the Organic Law on Data Protection 3/2018 and the European Regulation 2016/679. The authors declared that they had no legal, ethical or moral conflict of interest or financial compensation of any kind. Participation in the study was entirely voluntary and did not include any financial compensation. The study project was approved on March 30, 2023, by the Human Research Ethics Committee of the Experimental Research Ethics Committee at the University of Valencia. It complies with the Declaration of Helsinki and adheres to current biomedical research legislation. 3. Results A total of 567 participants from 11 Spanish universities from 7 degrees related to health sciences participated. The vast majority of participants were women, the mean age was 25.48 years (SD 9.65 range 17–68). More than two thirds of the participants lived in urban environments. Slightly more than half of the sample were not working. The mean body mass index (BMI) was 22.6 (range 15.4–37.5). More than 80% of the participants considered themselves to be in good or excellent health (Table 1 ). Table 1 Characteristics of the study population N (%) Sex Male 93 (16.49) Female 463 (82.09) Grade Nursing 375 (66.1) Psychology 127 (22.4) Medicine 26 (4.6) Speech Therapy 24 (4.2) Occupational Therapy 6 (1.05) Podiatry 5 (0.9) Physiotherapy 3 (0.6) Usual dwelling in an urban environment Urban 406 (71.73) Rural 160 (28.27) You work No 318 (56.58) Yes, full-time 107 (19.04) Yes, part-time 137 (24.38) Level of health Excellent 110 (19.4) Good 384 (67.72) Fair 63 (11.11) Poor 9 (1.59) 3.1. Psychometric properties of the questionnaire The instrument showed a correct sample size adequacy (KMO = 0.8621) which confirms its construct validity. As a solution to the exploratory factor analysis, 6 dimensions were selected, with an eigenvalue greater than unity, complying with the Kaiser rule. This 6-dimensional model explained 88.4% of the variance. The factors were clearly delimited with the following denominations: Factor 1: Self-efficacy. Factor 2: Social skills. Factor 3: Emotional well-being. Factor 4: Eating. Factor 5: Leisure activities. Factor 6: Substance use. Table 2 shows the variance explained by each of the factors, as well as their cumulative variance. To analyse the internal consistency of the instrument, Cronbach's alpha was used for each of the dimensions obtained in the factor analysis. The same table shows the values obtained for the factor, obtaining values high and above unity, which indicates that each of the factors obtained through this analysis is consistent, the items that form it are stable in this dimension. Table 2 Exploratory Factor Analysis Factor Own value % Factor variance % Total variance Cronbach´s alpha Factor1 8.17 38.26 38.26 0.8363 Factor2 3.36 15.75 54.01 0.8513 Factor3 2.55 11.94 65.95 0.8369 Factor4 2.26 10.61 76.56 0.7409 Factor5 1.49 7.00 83.56 0.7943 Factor6 1.04 4.86 88.42 0.7381 TOTAL - - - 0.8388 3.2. Usefulness of the instrument The mean time required to complete the questionnaire was 11.5 minutes with a standard deviation of 1.4. The instrument, like the original tool for adolescents ( 8 ), was easy to use as it does not require any training, professional qualifications or prior instructions. In addition, this tool provides a wealth of information on the different spheres of a person's life by assessing different determinants of health. This will provide a very complete picture of the living conditions and social determinants of the university students to whom it is applied. The tool provides qualitative information on the different socio-demographic characteristics of the student, as well as their daily habits. In the academic performance section, averages and percentages can be obtained thanks to the information on credits passed, enrolled and the overall average mark. In the psychosocial sphere, the tool allows a qualitative and quantitative assessment to be made thanks to the assignment of the different scores allowed by the scales of origin ( 11 , 12 , 13 ). 4. Discussion The aim of this study was to determine the construct validity and psychometric properties of the LifeCon Scale tool in university students, and its ability to assess the living conditions of university students, taking into account life skills, daily living habits and academic performance. The analysis yielded good results in terms of the application of the tool in the study population, and also in terms of construct validity. As a main result, an instrument has emerged with 6 factors that were named self-efficacy, social skills, emotional well-being, eating, leisure time activities and substance use. The psychometric properties of the tool were slightly higher than those of the source tool ( 8 ). In the adolescent version, the questionnaire items were grouped into two factors related to life skills and four factors related to daily habits. In the current version, the grouping was different, with 3 factors related to life skills (one for each skill) and three factors related to daily habits. The fact of having a factor for each of the skills studied (self-efficacy, social skills and emotional well-being) allows us to assess them independently, gaining a deeper understanding of the socio-emotional development of the people we are studying. On the other hand, the items related to physical activity and screen use were grouped together, which would justify that the increase in screen use is related to a decrease in the time dedicated to physical activity. Nowadays, the digital sphere and the use of screens are part of the reality of university students, which often leads to a reduction in the time spent on physical activity. In the medium and long term, this reduction in exercise time could lead to a sedentary lifestyle in young adults, which is associated with an increase in cardiovascular risk factors and a multitude of preventable diseases ( 14 ). Moreover, sedentary habits are not only related to physical health markers, but decreased physical activity has also been linked to a higher rate of disease or mental health problems ( 15 ). The use of this tool will allow us to correctly assess the physical activity carried out by university students, whether there is a decrease in the time dedicated to physical activity, and whether this decrease in physical activity is conditioned by the use or abuse of screens. Finally, the fact of having a new factor on substance use projects sufficient importance to the use of intoxicants in the study population and the urgent need to address it. The use of intoxicants such as alcohol, tobacco and other drugs in university students could condition their health in the short, medium and long term. Substance abuse is associated with a multitude of mental health problems, such as anxiety and depression ( 16 ). In this line, substance abuse and its effects on the brain could lead to significant cognitive impairment ( 17 ), which could, in turn, have a negative impact on students' academic performance. Comparing the results of the factors obtained with other tools that study the same concepts, we can observe that the internal consistency of factor 1 (self-efficacy) was somewhat lower than that of the General Self-Efficacy Scale (0.89) ( 11 ) and the LifeCon Scale for adolescents (0.8491) (8*). As for factor 2 (social skills), the internal consistency was also slightly lower than the Goldstein Social Skills Scale (0.905) ( 12 ), although it was higher than the adolescent version (0.8491) ( 8 ). Regarding factor 3 (emotional well-being), the internal consistency was higher than both the Affective Balance Scale (0.47) ( 13 ) and the LifeCon version for adolescents (0.7377) ( 8 ). Concerning daily habits, the results of the analysis were slightly better than the psychometric properties of the source tool (8*) on all factors analysed. Similar publications that had addressed the same issue, such as the HBSC Spain 2014 study ( 18 ), do not have data on the validation of their questionnaire. This instrument will be useful for diagnosing the health of students at the different universities, given that the questionnaire addresses the different spheres of the individuals. This is a key element for carrying out the WHO recommendations on health promotion in universities ( 4 ). The availability of validated and reliable tools will provide us with information with which to implement university measures and policies aimed at health promotion, working directly in the areas where there is a deficit or where there is the greatest need. This tool will also allow the evaluation of proposals for education and health promotion among university students. Educational and university policies should be aimed at maintaining and improving the health of the educational community, not only to improve health outcomes and well-being, but also to improve health indicators that could improve students' academic performance ( 19 ). Finally, we cannot lose sight of the fact that the participants in the study are students of health science degrees. These people will in the future also be involved in the health education of individuals and communities, so it is necessary that they know and value the benefits of healthy living conditions. 5. Conclusions In view of the above, the construct is valid and applicable to the population for which it has been adapted. This tool will provide sufficient information about the living conditions of university students, which will enable a complete health diagnosis to be made. All this information will enable health and university institutions to apply healthy policies aimed at improving health and alleviating or reinforcing areas where shortcomings or improvement actions are identified. Declarations Ethics approval and consent to participate Participation in the study was entirely voluntary and anonymous. Prior to taking part, all individuals reviewed the participant information sheet and gave their informed consent. The study project was accepted by the Human Research Ethics Committee of the Experimental Research Ethics Committee of the University of Valencia (30th March of 2023). Consent for publication Not applicable. Availability of data and materials The dataset used during the current study are available from the coresponding author on reasonable request. Competing interests The authors declare that they have no competing interests. Funding No funding. Author contributions Conceptualization, BS-H and AM-S.; methodology, BS-H and RJ-V.; software, PJS-D; validation, BS-H, RJ-V and EE-S.; formal analysis, RJ-V.; investigation, VG-C, LG-S and PM-M; resources, AM-S; data curation AC-R, RJ-V and PS-D; writing—original draft preparation, BS-H, RJ-V and AM-S; writing—review and editing, RJ-V and NN-E.; visualization, AM-S and EE-S; supervision, PJS-D, JJA-L, SP-C; project administration, SP-C. All authors have read and agreed to the published version of the manuscript. Acknowledgements We would like to express our acknowledgment to the SAPIENF research group, the University of Zaragoza and the Government of Aragon. References World Health Organization. Constitution of the World Health Organization. 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Determinants of academic achievement among higher education student found in low resource setting, A systematic review. PLoS One;18(11):e0294585. Available from: https://doi.org/10.1371/journal.pone.0294585 Additional Declarations No competing interests reported. Supplementary Files Additionalfile1.docx Cite Share Download PDF Status: Under Review Version 1 posted Reviewers agreed at journal 25 Jul, 2025 Reviewers agreed at journal 15 Jul, 2025 Reviewers invited by journal 15 Jul, 2025 Editor invited by journal 23 Jun, 2025 Editor assigned by journal 27 May, 2025 Submission checks completed at journal 27 May, 2025 First submitted to journal 25 May, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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19:48:41","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":698089,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6745156/v1/2b107e6e-0378-4c34-9500-1b25cb5aa422.pdf"},{"id":86972703,"identity":"60014f6c-6b87-4ec4-9acc-48356daea89d","added_by":"auto","created_at":"2025-07-17 19:40:36","extension":"docx","order_by":0,"title":"","display":"","copyAsset":false,"role":"supplement","size":39598,"visible":true,"origin":"","legend":"","description":"","filename":"Additionalfile1.docx","url":"https://assets-eu.researchsquare.com/files/rs-6745156/v1/de315a92b1237b2dbe992883.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Validation of the instrument Life Conditions Scale (LifeCon Scale) in university students of health sciences degrees in Spain","fulltext":[{"header":"1. Background","content":"\u003cp\u003eThe World Health Organisation (WHO) defines health as \u0026lsquo;a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity\u0026rsquo;(\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e). More than 30 years ago, the WHO reflected in the Ottawa Charter that both health and health promotion could not be dealt with exclusively in the health sector (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e). To be more specific, health promotion was defined at that Conference as \u0026lsquo;the process of enabling people to increase control over their health\u0026rsquo; (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e). One of the non-health settings is education; the educational setting, although of great importance for people's health, is not usually under the influence of the health sector. Health promotion in the educational environment is described as any activity that is undertaken to improve or protect the health of all people who work, learn and live together in that environment (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e), this concept encompasses both early childhood and primary education as well as higher education levels. In this regard, the WHO highlights the importance of universities acting as health promoters, as students represent a young and dynamic population that, through education, can be sensitised to healthy behaviours. Health promotion in these settings goes beyond mere health education; it focuses on modifying the social determinants of health, creating a favourable environment that fosters healthy lifestyles, and promoting healthy lifestyles. This involves collaboration between different areas (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eThe university is an institution in which people live, work and learn, which is conceived as a context for health promotion. Specifically, those universities that actively work to improve the health and well-being of the educational community are known as Health Promoting Universities (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e). These are institutions that are committed to creating environments and undertaking actions that promote the holistic wellbeing of the entire university community. They are part of an international movement to integrate health into university life, considering that educational institutions have a major influence on the physical, mental, emotional and social development of individuals. These universities take a holistic approach to health, developing policies and environments that support health, promoting health and wellness education, encouraging the active participation of students and staff, and creating an environment that supports self-care and practices that maintain or improve the health of their members. The concept is based on the idea that health is a resource for everyday life, not just a goal (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e). Therefore, universities that adopt this philosophy seek to involve the entire university community in health promotion, through programmes of physical activity, psychological support, disease prevention, and improvement of working and study conditions. In addition, they often collaborate with university networks and international organisations to exchange good practices and resources. This approach, endorsed by the World Health Organisation (WHO), recognises that education and health are interrelated. Health-promoting universities provide not only a lifestyle-friendly academic environment, but a holistic wellness space that appears to enhance the academic and personal success of students and staff (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eIn order to be able to work actively in the university community, prioritise appropriate policies and carry out the necessary actions to improve the health and well-being of all people, it is necessary to have indicators to know what the characteristics of this population are and what elements exist to motivate change. These indicators can range from lifestyle data (diet, exercise, substance use) to information on psychological well-being, life skills, access to health services and the social and academic environment surrounding students. Collecting and analysing these data allows not only to understand the current health status of the community, but also to identify patterns of risk and areas of vulnerability (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e). To do this, validated tools are needed to provide comprehensive and reliable information on students' living conditions. These may include surveys, questionnaires and statistical analyses that measure key indicators of health, emotional well-being and satisfaction with the academic environment. In addition, using validated instruments ensures that the data obtained are comparable and allow us to measure the impact of policies and actions implemented over time (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eFollowing this line of argument, the aim of this study was to analyse the psychometric properties, internal consistency and construct validity of the LifeConScale tool for university students of health sciences in Spain.\u003c/p\u003e"},{"header":"2. Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\u003ch2\u003e2.1. Design of the study\u003c/h2\u003e\u003cp\u003eAn observational, descriptive, cross-sectional and multicenter study was carried out during the 2023\u0026ndash;2024 academic year in Spanish universities.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec4\" class=\"Section2\"\u003e\u003ch2\u003e2.2. Population and sample\u003c/h2\u003e\u003cp\u003eThe population consisted of students of university degrees related to health sciences, in different Spanish universities, during the academic year 2023\u0026ndash;2024. Participants who did not understand Spanish were excluded.\u003c/p\u003e\u003cp\u003eThe minimum estimated sample was 517 participants. Convenience sampling was used, sending the questionnaire to all students from different Spanish universities with which the authors had close contact.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec5\" class=\"Section2\"\u003e\u003ch2\u003e2.3. Data collection instrument and study variables\u003c/h2\u003e\u003cp\u003eFor the questionnaire, we used the \u0026lsquo;LifeConScale\u0026rsquo; tool validated in adolescent secondary school students (8*), in which a series of adaptations were made for university age, in terms of socio-demographic variables. All Spanish universities, both private and public, were taken into account.\u003c/p\u003e\u003cp\u003eThe variables collected were: socio-demographic characteristics (gender, age, university, degree, year, population centre, usual residence, working day, parents' level of studies, weight, height and perceived level of health), life skills (self-efficacy, social skills and affective balance), daily habits (eating, sleeping, physical activity, use of screens and consumption of toxic substances) and academic performance (university entrance exam cut-off mark, credits enrolled, credits passed and overall average mark) [see Additional file 1].\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec6\" class=\"Section2\"\u003e\u003ch2\u003e2.4. Data analysis\u003c/h2\u003e\u003cp\u003eAs was done in the original tool for adolescents (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e), a descriptive analysis of all the variables of the study was carried out in order to know the characteristics of the study population and the behaviour of the different variables used. For the validation of the instrument, an Exploratory Factor Analysis (EFA) of principal components was carried out to identify the dimensions into which the questionnaire was grouped. To ensure the applicability of the EFA in the study population, the Kaiser-Meyer-Olkin (KMO) sample size adequacy measure was considered to be greater than 0.75 (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e). After performing such an analysis, we included factors with eigenvalues greater than 1(\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e). Cronbach's Alpha was used to assess the internal consistency of the factors and also the overall consistency of the questionnaire. The SPSS 26 statistical package was used for the analyses.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec7\" class=\"Section2\"\u003e\u003ch2\u003e2.5. Ethical aspects\u003c/h2\u003e\u003cp\u003eThe questionnaire was completely anonymous. The data were treated confidentially, following the Organic Law on Data Protection 3/2018 and the European Regulation 2016/679. The authors declared that they had no legal, ethical or moral conflict of interest or financial compensation of any kind. Participation in the study was entirely voluntary and did not include any financial compensation. The study project was approved on March 30, 2023, by the Human Research Ethics Committee of the Experimental Research Ethics Committee at the University of Valencia. It complies with the Declaration of Helsinki and adheres to current biomedical research legislation.\u003c/p\u003e\u003c/div\u003e"},{"header":"3. Results","content":"\u003cp\u003e A total of 567 participants from 11 Spanish universities from 7 degrees related to health sciences participated. The vast majority of participants were women, the mean age was 25.48 years (SD 9.65 range 17\u0026ndash;68). More than two thirds of the participants lived in urban environments. Slightly more than half of the sample were not working. The mean body mass index (BMI) was 22.6 (range 15.4\u0026ndash;37.5). More than 80% of the participants considered themselves to be in good or excellent health (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eCharacteristics of the study population\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"2\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eN (%)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSex\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e93 (16.49)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e463 (82.09)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eGrade\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNursing\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e375 (66.1)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePsychology\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e127 (22.4)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMedicine\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e26 (4.6)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSpeech Therapy\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e24 (4.2)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOccupational Therapy\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e6 (1.05)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePodiatry\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e5 (0.9)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePhysiotherapy\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e3 (0.6)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eUsual dwelling in an urban environment\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eUrban\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e406 (71.73)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRural\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e160 (28.27)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eYou work\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e318 (56.58)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes, full-time\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e107 (19.04)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes, part-time\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e137 (24.38)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eLevel of health\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eExcellent\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e110 (19.4)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eGood\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e384 (67.72)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFair\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e63 (11.11)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePoor\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e9 (1.59)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cdiv id=\"Sec9\" class=\"Section2\"\u003e\u003ch2\u003e3.1. Psychometric properties of the questionnaire\u003c/h2\u003e\u003cp\u003eThe instrument showed a correct sample size adequacy (KMO\u0026thinsp;=\u0026thinsp;0.8621) which confirms its construct validity. As a solution to the exploratory factor analysis, 6 dimensions were selected, with an eigenvalue greater than unity, complying with the Kaiser rule. This 6-dimensional model explained 88.4% of the variance. The factors were clearly delimited with the following denominations:\u003c/p\u003e\u003cp\u003e\u003cul\u003e\u003cli\u003e\u003cp\u003eFactor 1: Self-efficacy.\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003eFactor 2: Social skills.\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003eFactor 3: Emotional well-being.\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003eFactor 4: Eating.\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003eFactor 5: Leisure activities.\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003eFactor 6: Substance use.\u003c/p\u003e\u003c/li\u003e\u003c/ul\u003e\u003c/p\u003e\u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e shows the variance explained by each of the factors, as well as their cumulative variance. To analyse the internal consistency of the instrument, Cronbach's alpha was used for each of the dimensions obtained in the factor analysis. The same table shows the values obtained for the factor, obtaining values high and above unity, which indicates that each of the factors obtained through this analysis is consistent, the items that form it are stable in this dimension.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eExploratory Factor Analysis\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"5\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFactor\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eOwn value\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003e% Factor variance\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003e% Total variance\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eCronbach\u0026acute;s alpha\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFactor1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e8.17\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e38.26\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e38.26\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.8363\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFactor2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e3.36\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e15.75\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e54.01\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.8513\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFactor3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e2.55\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e11.94\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e65.95\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.8369\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFactor4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e2.26\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e10.61\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e76.56\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.7409\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFactor5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1.49\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e7.00\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e83.56\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.7943\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFactor6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1.04\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e4.86\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e88.42\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.7381\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTOTAL\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.8388\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec10\" class=\"Section2\"\u003e\u003ch2\u003e3.2. Usefulness of the instrument\u003c/h2\u003e\u003cp\u003eThe mean time required to complete the questionnaire was 11.5 minutes with a standard deviation of 1.4.\u003c/p\u003e\u003cp\u003eThe instrument, like the original tool for adolescents (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e), was easy to use as it does not require any training, professional qualifications or prior instructions. In addition, this tool provides a wealth of information on the different spheres of a person's life by assessing different determinants of health. This will provide a very complete picture of the living conditions and social determinants of the university students to whom it is applied.\u003c/p\u003e\u003cp\u003eThe tool provides qualitative information on the different socio-demographic characteristics of the student, as well as their daily habits. In the academic performance section, averages and percentages can be obtained thanks to the information on credits passed, enrolled and the overall average mark. In the psychosocial sphere, the tool allows a qualitative and quantitative assessment to be made thanks to the assignment of the different scores allowed by the scales of origin (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e).\u003c/p\u003e\u003c/div\u003e"},{"header":"4. Discussion","content":"\u003cp\u003eThe aim of this study was to determine the construct validity and psychometric properties of the LifeCon Scale tool in university students, and its ability to assess the living conditions of university students, taking into account life skills, daily living habits and academic performance. The analysis yielded good results in terms of the application of the tool in the study population, and also in terms of construct validity. As a main result, an instrument has emerged with 6 factors that were named self-efficacy, social skills, emotional well-being, eating, leisure time activities and substance use.\u003c/p\u003e\u003cp\u003eThe psychometric properties of the tool were slightly higher than those of the source tool (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e). In the adolescent version, the questionnaire items were grouped into two factors related to life skills and four factors related to daily habits. In the current version, the grouping was different, with 3 factors related to life skills (one for each skill) and three factors related to daily habits. The fact of having a factor for each of the skills studied (self-efficacy, social skills and emotional well-being) allows us to assess them independently, gaining a deeper understanding of the socio-emotional development of the people we are studying.\u003c/p\u003e\u003cp\u003eOn the other hand, the items related to physical activity and screen use were grouped together, which would justify that the increase in screen use is related to a decrease in the time dedicated to physical activity. Nowadays, the digital sphere and the use of screens are part of the reality of university students, which often leads to a reduction in the time spent on physical activity. In the medium and long term, this reduction in exercise time could lead to a sedentary lifestyle in young adults, which is associated with an increase in cardiovascular risk factors and a multitude of preventable diseases (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e). Moreover, sedentary habits are not only related to physical health markers, but decreased physical activity has also been linked to a higher rate of disease or mental health problems (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e). The use of this tool will allow us to correctly assess the physical activity carried out by university students, whether there is a decrease in the time dedicated to physical activity, and whether this decrease in physical activity is conditioned by the use or abuse of screens.\u003c/p\u003e\u003cp\u003eFinally, the fact of having a new factor on substance use projects sufficient importance to the use of intoxicants in the study population and the urgent need to address it. The use of intoxicants such as alcohol, tobacco and other drugs in university students could condition their health in the short, medium and long term. Substance abuse is associated with a multitude of mental health problems, such as anxiety and depression (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e). In this line, substance abuse and its effects on the brain could lead to significant cognitive impairment (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e), which could, in turn, have a negative impact on students' academic performance.\u003c/p\u003e\u003cp\u003eComparing the results of the factors obtained with other tools that study the same concepts, we can observe that the internal consistency of factor 1 (self-efficacy) was somewhat lower than that of the General Self-Efficacy Scale (0.89) (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e) and the LifeCon Scale for adolescents (0.8491) (8*). As for factor 2 (social skills), the internal consistency was also slightly lower than the Goldstein Social Skills Scale (0.905) (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e), although it was higher than the adolescent version (0.8491) (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e). Regarding factor 3 (emotional well-being), the internal consistency was higher than both the Affective Balance Scale (0.47) (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e) and the LifeCon version for adolescents (0.7377) (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e). Concerning daily habits, the results of the analysis were slightly better than the psychometric properties of the source tool (8*) on all factors analysed. Similar publications that had addressed the same issue, such as the HBSC Spain 2014 study (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e), do not have data on the validation of their questionnaire.\u003c/p\u003e\u003cp\u003eThis instrument will be useful for diagnosing the health of students at the different universities, given that the questionnaire addresses the different spheres of the individuals. This is a key element for carrying out the WHO recommendations on health promotion in universities (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e). The availability of validated and reliable tools will provide us with information with which to implement university measures and policies aimed at health promotion, working directly in the areas where there is a deficit or where there is the greatest need. This tool will also allow the evaluation of proposals for education and health promotion among university students. Educational and university policies should be aimed at maintaining and improving the health of the educational community, not only to improve health outcomes and well-being, but also to improve health indicators that could improve students' academic performance (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eFinally, we cannot lose sight of the fact that the participants in the study are students of health science degrees. These people will in the future also be involved in the health education of individuals and communities, so it is necessary that they know and value the benefits of healthy living conditions.\u003c/p\u003e"},{"header":"5. Conclusions","content":"\u003cp\u003eIn view of the above, the construct is valid and applicable to the population for which it has been adapted.\u003c/p\u003e\u003cp\u003eThis tool will provide sufficient information about the living conditions of university students, which will enable a complete health diagnosis to be made. All this information will enable health and university institutions to apply healthy policies aimed at improving health and alleviating or reinforcing areas where shortcomings or improvement actions are identified.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eParticipation in the study was entirely voluntary and anonymous. Prior to taking part, all individuals reviewed the participant information sheet and gave their informed consent. The study project was accepted by the Human Research Ethics Committee of the Experimental Research Ethics Committee of the University of Valencia (30th March of 2023).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe dataset used during the current study are available from the coresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNo funding.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eConceptualization, BS-H and AM-S.; methodology, BS-H and RJ-V.; software, PJS-D; validation, BS-H, RJ-V and EE-S.; formal analysis, RJ-V.; investigation, VG-C, LG-S and PM-M; resources, AM-S; data curation AC-R, RJ-V and PS-D; writing\u0026mdash;original draft preparation, BS-H, RJ-V and AM-S; writing\u0026mdash;review and editing, RJ-V and NN-E.; visualization, AM-S and EE-S; supervision, PJS-D, JJA-L, SP-C; project administration, SP-C.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAll authors have read and agreed to the published version of the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe would like to express our acknowledgment to the SAPIENF research group, the University of Zaragoza and the Government of Aragon.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eWorld Health Organization. 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Available from: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1371/journal.pone.0294585\u003c/span\u003e\u003cspan address=\"10.1371/journal.pone.0294585\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-medical-education","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"meed","sideBox":"Learn more about [BMC Medical Education](http://bmcmededuc.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/meed/default.aspx","title":"BMC Medical Education","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Validation Study, Habits, Social Skills, Personal Satisfaction, Health Promotion, Young Adult","lastPublishedDoi":"10.21203/rs.3.rs-6745156/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6745156/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e\u003cp\u003eHealth promotion in universities is a key approach supported by the World Health Organization (WHO), which integrates actions to improve the physical, mental and social well-being of the educational community. This study aims to analyse the psychometric properties of the LifeConScale tool adapted for university health science students in Spain, assessing its internal consistency and construct validity.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e\u003cp\u003eAn observational, descriptive, cross-sectional and multicenter study was carried out with a sample of 567 students from 11 Spanish universities during the 2023\u0026ndash;2024 academic year. Several sociodemographic variables, life habits and academic performance were used.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eExploratory factor analysis identified six key dimensions in the questionnaire, which explained 88.4% of the variance. Construct validity was confirmed with a KMO index of 0.8621, and internal consistency was assessed using Cronbach's alpha, obtaining high levels of reliability in all dimensions.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e\u003cp\u003eThe results highlight that the tool is useful for assessing university students' living conditions and habits, such as physical activity, substance use and psychosocial skills. This assessment can serve as a basis for implementing health promotion policies in universities, with a positive impact on both students' well-being and academic performance. It is concluded that the LifeConScale is a valid and reliable instrument to diagnose the health of the university population.\u003c/p\u003e","manuscriptTitle":"Validation of the instrument Life Conditions Scale (LifeCon Scale) in university students of health sciences degrees in Spain","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-07-17 19:40:32","doi":"10.21203/rs.3.rs-6745156/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"reviewerAgreed","content":"336415642610323752532606469828827439657","date":"2025-07-25T04:39:12+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"61186236864650364218485243611785162769","date":"2025-07-15T13:03:13+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-07-15T12:50:45+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-06-23T11:50:37+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-05-27T11:42:35+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-05-27T11:37:02+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Medical Education","date":"2025-05-25T17:50:29+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-medical-education","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"meed","sideBox":"Learn more about [BMC Medical Education](http://bmcmededuc.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/meed/default.aspx","title":"BMC Medical Education","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"41c2533c-7843-4702-8176-12d8cff2506b","owner":[],"postedDate":"July 17th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2025-07-17T19:40:32+00:00","versionOfRecord":[],"versionCreatedAt":"2025-07-17 19:40:32","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6745156","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6745156","identity":"rs-6745156","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}