Validity and reliability of a short self-efficacy instrument for hypertension treatment adherence among adults with uncontrolled hypertension.

Matthew Zhao, Maria A Rodriguez, Binhuan Wang, Elizabeth J Santa Ana, Jennifer Friedberg, Yixin Fang, John P Allegrante, Sundar Natarajan

Journal: Patient education and counseling 2021;104(7):1781-1788

PMID: 33516592

Abstract

OBJECTIVE

To establish the reliability and validity of a self-report measure designed to assess self-efficacy for hypertension treatment adherence.

METHODS

This investigation was embedded within a six-month randomized clinical trial (RCT), which demonstrated that a tailored, stage-matched intervention was more effective at improving hypertension control than usual care among individuals (n = 533) with repeated uncontrolled hypertension. The instrument used to assess self-efficacy for hypertension treatment adherence (SE-HTA) comprised three subscales that assessed diet self-efficacy (DSE), exercise self-efficacy (ESE), and medication self-efficacy (MSE). To determine SE-HTA validity and reliability, we assessed internal consistency using Cronbach's α coefficients, conducted exploratory factor analysis, and evaluated convergent and discriminant validity, as well as test-retest reliability using Spearman's ρ correlation coefficients.

RESULTS

Cronbach's α (internal consistency) values for DSE, ESE, and MSE were 0.81, 0.82 and 0.74. Factor analysis and the scree plot demonstrated three distinct factors, which correspond to the three subscales contained in the SE-HTA instrument. SE-HTA possessed good convergent and discriminant validity, and moderate test-retest reliability.

CONCLUSION

The SE-HTA instrument containing diet, exercise, and medication adherence subscales is valid and reliable in adults with uncontrolled hypertension.

PRACTICE IMPLICATIONS

This SE-HTA instrument measures self-efficacy and could help facilitate behavior change in hypertension.

Published by Elsevier B.V.

Address: VA New York Harbor Healthcare System, New York, NY, USA; David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.; VA New York Harbor Healthcare System, New York, NY, USA; Northcentral University, La Jolla, CA, USA.; VA New York Harbor Healthcare System, New York, NY, USA; New York University Grossman School of Medicine, New York, NY, USA.; Medical University of South Carolina, Charleston, SC, USA; Ralph H. Johnson VA Medical Center, Charleston, SC, USA.; New York University Grossman School of Medicine, New York, NY, USA.; Teachers College, Columbia University, New York, NY, USA; Mailman School of Public Health, Columbia University, New York, NY, USA.; VA New York Harbor Healthcare System, New York, NY, USA; New York University Grossman School of Medicine, New York, NY, USA. Electronic address: [email protected].
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