Psychometric evaluation of the Pittsburgh Sleep Quality Index among South African women participating in the Bukhali trial: Healthy Life Trajectories Initiative
Abstract
Purpose: We examined the psychometric properties of the Pittsburgh Sleep Quality Index (PSQI) in a large sample of young women in Soweto, South Africa, to assess its reliability and structural validity in this context.
Methods: Data were collected from 7182 women enrolled in the Bukhali randomized controlled trial, part of the Healthy Life Trajectories Initiative (HeLTI). Sociodemographic information and PSQI data were collected through interviewer-administered surveys. Internal consistency was assessed using Cronbach's alpha, McDonald's omega and item-level correlations. Confirmatory factor analysis (CFA) evaluated the original one-factor and established two- and three-factor multidimensional models. Model fit was examined using Root Mean Square Error of Approximation (RMSEA), Comparative Fit Index (CFI), and Tucker-Lewis Index (TLI).
Results: Most women (57.4%) reported good sleep quality (PSQI ≤ 5). Poor sleep quality was associated with higher household socioeconomic status (assets score), higher education, and single relationship status. Average sleep was 7.8 hours, characterized by prolonged onset latency and high fragmentation, suggesting that continuity disruptions rather than opportunity shortage drove poor sleep. The PSQI had modest internal consistency (α = .57; ω = .57; item-total r = .33 - .65). The one-factor model demonstrated poor fit (χ2(14) = 1677.70; CFI = .65; TLI = .48; RMSEA = .13) whereas fit was good for the two-factor (χ2(13) = 291.46; CFI = .94; TLI…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 7,182 participants or records.
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