For this scale, the prosocial neighborhood environment items were reverse coded.
Contextual measures include home environment items such as type of dwelling, location, and environmental obstacles such as steps or lighting.
Social-emotional well-being and some school environment items loaded on component 1, functional well-being items loaded strongly on component 2 with some school environment items, oral health items loaded on component 3, and self-image items loaded strongly on component 4 (Table 5).
The resulting summated scales have been termed "medical examination" (items 15 22), "hospital environment" (items 1, 3, 5, 8, 10), "comfort" (items 7, 9, 14) and "appointment time" (items 2, 4).
However, other validation studies of physical environment instruments on different target populations also showed low internal consistency on the factor level [ 32, 34, 35, 62], which may be related to the heterogeneity among the physical environment items.
In another St . Louisarea study that audited street segments for community indicators to improve physical activity, inter-rater reliability results were variable among measures of environmental attributes ranging from built environment items to social and aesthetic items [ 27].
As such, we report the percent of providers who "agreed" or "strongly agreed" (for work environment items) and who rated the service "good" or "very good" in the tables.
In our study, the principal-components factor analysis identified a four-dimensional structure of the questionnaire with the school environment items being spread in two different components related to socio-emotional and functional well-being.
In addition to baseline outcome measurements, as appropriate, the baseline questionnaire will include: Sociodemographic variables Work-related variables: hours of paid work, job type, physical work load (items from questionnaire developed by Bot et al [ 24]), psychosocial work environment (items from Job Content Questionnaire [ 25]).
In the bivariate analysis, in the intervention group, a statistically significant improvement occurred in five perceived work environment items, including an improvement in providers' views on adequacy of equipment and providers feeling safe from physical harm when working in the facility (Table 3).
