Validation Study

Nine primary schools and 480 children participated in the validation study. The validation study was conducted in Spanish primary schools during the 2022-2023 and 2023-2024 school years. Most children answered all 24 IHC assessment questions, and missing responses for each item were at most 7.7%. Children in the validation study had no prior knowledge of or contact with the IHC project. The validation used a strategic sample with substantial representation from one Spanish region, which may limit generalisability.