Abstract
OBJECTIVE: The Roter Interaction Analysis System (RIAS) is widely used to assess communication in clinical settings but has not yet been applied in educational contexts. This study explores the psychometric properties of RIAS in Moroccan school health education, assessing its feasibility, reliability, and validity while examining its potential to improve communication strategies between health educators and students. METHODS: A cross-sectional study was conducted with 36 Moroccan primary school students. Health education session were recorded and analyzed using RIAS to evaluate communication patterns. Two trained raters independently coded the interactions into eight communication behavior categories. Psychometric analyses, including assessments of feasibility (coding versus session duration), inter-rater reliability (using correlation coefficients), and content validity (based on category usage), were conducted to evaluate RIAS's reliability and validity. RESULTS: RIAS demonstrated feasibility with extended coding times reflecting its comprehensive nature. High inter-rater reliability (ρ = 0.96-1.00, p < 0.01) validated its consistent application. Content validity confirmed adaptability, though challenges with social-emotional utterances and low-frequency categories suggest refinement to align with health education's unique dynamics.Conclusion: This pilot study demonstrates the feasibility, reliability, and validity of RIAS in Moroccan school health education, highlighting its potential to enhance educator-student communication and improve health education outcomes in diverse cultural settings. INNOVATION: This study pioneers the application of RIAS in Moroccan school health education, extending its use beyond clinical contexts. It highlights RIAS's adaptability to diverse, non-Western settings, bridging a gap in communication analysis. Findings provide a foundation for refining RIAS to align with health education and global health promotion strategies.