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

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 a coefficients, conducted exploratory factor analysis, and evaluated convergent and discriminant validity, as well as test-retest reliability using Spearman's r correlation coefficients. Results: Cronbach's a (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.

Automated summary

The study aimed to verify the reliability and validity of a self-report measure for assessing self-efficacy in hypertension treatment adherence. Through a six-month randomized clinical trial, the tailored intervention showed greater effectiveness in improving hypertension control compared to usual care. The self-efficacy for hypertension treatment adherence (SE-HTA) instrument comprised three subscales and demonstrated good validity and reliability.