Development and Psychometric Evaluation of the Cardiac Rehabilitation Adherence Tool (CRAT)

Abstract

Patients with cardiac diseases can achieve the greatest benefit from cardiac rehabilitation through modification of their unhealthy behaviors. This study aimed to develop and examine the psychometric properties of the Cardiac Rehabilitation Adherence Tool (CRAT), which was designed to assess patients’ adherence to cardiac rehabilitation. In this instrument development study, the items of the CRAT were extracted through a comprehensive literature review. The CRAT was assessed in terms of validity and reliability. Exploratory factor analysis was conducted to assess its construct validity, which led to the development of a tool containing 57 items and five dimensions including “acceptance of the rehabilitation center,” “being interested in health,” “feeling a need,” “personal control over the situation,” and “encouragement and advice.” These five factors accounted for 45.23% of the observed variance. The Cronbach’s alpha was 0.935. The test-retest method supported the stability of the instrument (r = 0.95). Health care professionals can use the CRAT to examine factors influencing the patient’s decision to leave cardiac rehabilitation and design strategies for improving their adherence to the rehabilitation program.

Cross-cultural adaptation and psychometric validation of the Persian version of the Cardiac Rehabilitation Barriers Scale (CRBS-P)

“…The CR adherence tool, while valid, does not consider factors that may impede initial enrolment. 20 The Cardiac Rehabilitation Barriers Scale (CRBS) is arguably the most widely administered, [21][22][23][24][25][26][27] comprehensive and psychometrically validated tool to assess patient barriers to CR enrolment and participation from the patient to health system levels. 28 It was developed following a review of the literature and revised with input from healthcare providers including CR staff.…”

Parents’ Knowledge, Attitudes, and Practices of Childhood Obesity in Singapore

“…Alpha values for the three dimensions of knowledge, attitudes, and practices are .55, .77, and .58 respectively. Although an alpha coefficient higher than .70 is recommended, values between .50 and .60 are still acceptable for preliminary social science studies especially when the scale contains a limited number of items (Chen & Xu, 2021; Hamedani et al, 2019; Nunnally et al, 1967; Peterson, 1994; Streiner, 2003; Xu, 2022; Xu & Chen, 2021). Consequently, the three-dimension KAP scale with nine items is deemed adequate.…”

“…The Knowledge, Attitudes, and Practices (KAP) survey, also referred to as the Knowledge, Attitudes, Belief, and Practices (KABP) survey, is a methodological instrument that was first developed as a means to understand family planning practices around the world (Cleland, 1973;Ratcliffe, 1976). The methodological model has, however, been widely used to understand health behavior and health-seeking practices (Hausmann-Muela et al, 2003;Manderson & Aaby, 1992).…”

“…The Application of the KAP Survey Framework. Scholars have utilized the KAP survey framework to understand a diverse range of health behaviors worldwide (Hausmann-Muela et al, 2003;Manderson & Aaby, 1992). Within its application in health studies, KAP surveys are predominantly used to ''collect data on what is known, believed and done about a particular topic.''…”

“…In the past few decades, the Knowledge, Attitude, and Practice (KAP) survey has been widely used to understand individuals' health-seeking behaviors and evaluate the effectiveness of public health programs (Hausmann-Muela et al, 2003;Launiala, 2009;Manderson & Aaby 1992). For example, Mabiala Babela et al (2016) use the KAP framework to assess parents' obesity-related KAP in Congo; Rausch et al (2015) examine the governmentled health intervention programs' impact on American parents' knowledge, attitudes, and behaviors of nutrition and physical activity.…”