An active health behavior scale for hypertensive patients: development and reliability and validity evaluation

  Objective  To develop an active health behavior scale (AHBS) for hypertensive patients and to evaluate reliability and validity of the AHBS.

  Methods  The initial AHBS for hypertensive patients was developed by means of literature research and focus group discussion. Then, the initial scale was tested with two rounds of interview survey among 120 and 720 community hypertensive patients recruited with simple random sampling at 18 towns in 2 prefectures and one county of 3 provinces (Sichuan, Hunan and Hubei) during October – December 2021. After preliminarily screening with dispersion degree, discrimination, correlation coefficient analysis and Cronbach′s alpha coefficient, the items of the initial scale were randomly divided into two parts using random number generator: the one for exploratory factor analysis of further item screening and factor model construction and the other for validity evaluation with confirmatory factor analysis and reliability evaluation based on Cronbach′s alpha coefficients. Chi-square value/degree of freedom (χ²/df), root mean square error of approximation (RMSEA), comparative fit index (CFI), incremental fit index (IFI), normed fit index (NFI), and Tucker-Lewis index (TLI) were adopted in the analyses.

  Results  Valid responses were collected from 84 participants (aged 67.54 ± 10.26 years) in the first round of survey and 525 participants (67.42 ± 8.99) in the second round of survey. The finally developed health behavior scale for hypertensive patients consists of 30 items in 5 dimensions of health responsibility, diet, physical exercise, labor and emotion, and illness management, explaining 73.72% of the total variance. Confirmatory factor analysis shows that the established model fits the data well (χ²/df = 2.279, NFI = 0.866, CFI = 0.919, IFI = 0.920, TLI = 0.909, RMSEA = 0.052). The Cronbach′s α coefficient for the total scale is 0.948 and the Cronbach′s α coefficients for each subscale of the AHBS are between 0.724 – 0.975, indicating a good reliability of the scale developed.

  Conclusion  The developed AHBS for hypertensive patients covers five dimensions of health responsibility, diet, physical exercise, labor and emotion, and illness management and is of good reliability and validity; the scale could be used to assess active health behaviors of hypertensive patients in China.