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Development and validation of a measure for intention to adhere to HIV treatment.

ABSTRACT: We present the development and validation of a theory-derived scale measuring patients' behavioral intention to adhere to HIV care. Adherence to HIV care includes attendance at appointments and adherence to highly active antiretroviral therapy (HAART) regimens. These two components have been independently associated with long-term HIV outcomes. Items were chosen to reflect behavioral intention as defined by the Health Action Process Approach to health-seeking behavior. Items reflecting self-reported HIV knowledge were also included after expert panel review. The study took place from October 2009 to April 2010 at two HIV clinics in Houston, Texas. Participants were 287 adults with HIV/AIDS (10.1% female, mean age 50.8); 56.5% were African-American and 17% were Hispanic. Of the total, 87.1% were on HAART at enrollment. Factor analysis of survey items resulted in the retention of two domains, knowledge and intention, based on scree plot analysis of eigenvalues. Questions with factor loadings >0.4 were retained, yielding 4 knowledge questions and 10 intention questions. The survey had good internal consistency for knowledge (Cronbach's ?=0.83) and for intention (Cronbach's ?=0.81). In multivariate analysis, intention was associated with HIV viral suppression, defined as HIV-1 viral load <400 RNA copies/mL, (odds ratio [OR]=1.75, 95% .confidence interval [CI]=1.00-3.07). Knowledge was also associated with HIV suppression (OR=1.55, 95%, CI=1.09-2.12). The resulting study describes the development and preliminary validation of an HIV treatment-seeking intention measure. Additional studies are needed to validate this instrument in other populations.

SUBMITTER: Nelsen A

PROVIDER: S-EPMC3412581 | biostudies-literature | 2012 Jun

REPOSITORIES: biostudies-literature

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Development and validation of a measure for intention to adhere to HIV treatment.

Nelsen Andrea A Trautner Barbara W BW Petersen Nancy J NJ Gupta Sunita S Rodriguez-Barradas Maria M Giordano Thomas P TP Naik Aanand D AD

AIDS patient care and STDs 20120601 6

We present the development and validation of a theory-derived scale measuring patients' behavioral intention to adhere to HIV care. Adherence to HIV care includes attendance at appointments and adherence to highly active antiretroviral therapy (HAART) regimens. These two components have been independently associated with long-term HIV outcomes. Items were chosen to reflect behavioral intention as defined by the Health Action Process Approach to health-seeking behavior. Items reflecting self-repo ...[more]

PMID: 22680281

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Project description:BackgroundTo capture the broad range of treatment burden issues experienced by adolescent and adult people with hemophilia (PWH), the Hemophilia Treatment Experience Measure (Hemo-TEM) was developed. We describe the development of this new hemophilia-specific patient-reported outcome (PRO) measure including concept elicitation, cognitive debriefing, and psychometric validation.ResultsConcept elicitation interviews were conducted with 5 clinical experts and 30 adult PWH in the United States (US). The qualitative analysis of these interviews and a review of the literature informed the PRO measure development. The project team reviewed concept endorsement rates and generated a 27-item preliminary version of the Hemo-TEM. Cognitive debriefing interviews were conducted to ensure participant understanding and item relevance in samples of (adolescent (n = 20) and adult (n = 14)) PWH in the US. The refined, validation-ready version of the Hemo-TEM included 30 items. Lastly, data from 3 clinical trials comprised the 4 analysis sets used for the psychometric validation with a sample size of N = 88. Item reduction dropped 4 items resulting in a final 26-item measure. Factor analysis generated 5 domains in the Hemo-TEM [injection difficulties (3 items), physical impact (6 items), treatment bother (7 items), interference with daily life (4 items), and emotional impact (6 items)] and a total score. All scores were reliable [internally consistent (0.84-0.88)]. For convergent validity, with the exception of one domain, all hypothesized associations were met. Preliminary sensitivity to change effect sizes were between - 0.30 and - 0.70. Meaningful change thresholds ranged from 6 points (physical impact and emotional impact) to 10 points (treatment bother) with 8 points for the Hemo-TEM total score.ConclusionsFindings from the concept elicitation, cognitive debriefing, and psychometric validation phases provide evidence that the Hemo-TEM is a well-designed, valid, and reliable measure of the burden of hemophilia treatment, including treatment impact on adolescent and adult PWH.

Project description:IntroductionThe aim of this study is to establish reliability and validity of the Diabetes Burnout Scale (DBS) among adults with type 1 diabetes (T1D).MethodsWe used a multi-stage, mixed methods approach to developing the DBS. First, the research team identified twenty-eight candidate items through a review of the literature and 117 qualitative narratives from adults living with T1D. Next, items were revised based on the expert (n = 20) and individual with T1D (n = 10) feedback. The resulting 18-item DBS measure along with validated measures of diabetes distress, depressive symptoms, and questions related to diabetes outcomes (i.e., last reported hemoglobin A1c [HbA1c] and Time-in-Range [TiR]) were completed by 1099 adults with T1D across the U.S. The sample was randomly divided into two subsets (n1 = 561, n2 = 538) for exploratory and confirmatory factor analyses (EFA/CFA) to determine the underlying structure of the DBS. Regression analyses examined the relationships of the DBS with self-reported glycemic control and socio-demographic characteristics.ResultsBased on the EFA three factors are identified and the DBS demonstrated strong internal consistency with Cronbach alphas (≥0.80). The validation and confirmatory analysis for the structure of the DBS provided consistent results with EFA. Higher burnout (overall DBS) was positively associated with diabetes distress (b = 0.74; p < 0.01) and depressive symptoms (b = 0.61; p < 0.01). Overall DBS, however was the strongest predictor for poorer HbA1c (r2 = 0.19; p < 0.01) and lower TiR (r2 = 0.17; p < 0.01) compared to diabetes distress and depressive symptoms.ConclusionThe 12-item DBS is a reliable and valid scale to measure diabetes burnout in adults with diabetes. The results provide a weak to strong degree of association between the validated DBS scale, T1-DDS and PHQ-8. The DBS can contribute to advancement of diabetes science by measuring diabetes burnout and informing clinical interventions to improve psychosocial care in individuals with diabetes.

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Development and validation of a measure for intention to adhere to HIV treatment.

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Development and validation of a measure for intention to adhere to HIV treatment.

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