Psychometric properties of the Chinese version of Attitudes and Beliefs about Cardiovascular Disease Risk Perception Questionnaire

Abstract

Cardiovascular disease (CVD) is the leading cause of global mortality and disease burden. The perceived risk of CVD, a central psychological construct, may affect health behavior change and maintenance, such as lifestyle modification and medication adherence. Risk perception varies based on the knowledge of risk in the context of cultural health-world views. Little is known about CVD-related knowledge and risk perception in China. The aim of this study is to cross-culturally translate, adapt, and evaluate the psychometric properties of the Attitudes and Beliefs about Cardiovascular Disease (ABCD) Risk Perception Questionnaire in Chinese. The translation and cross-cultural adaptation process followed established guidelines. A cross-sectional study of 318 adults between April and May 2022 was conducted in Zhejiang province. The study evaluated the item- and scale-level psychometric properties and validity indices of the ABCD risk perception questionnaire. The exploratory and confirmatory factor analyses of the risk scale supported a three-factor solution that accounts for 69.63% of the total variance, corresponding to risk perception (F1), perceived benefits and intention to change physical activity (F2), and perceived benefits and intention to change dietary habits (F3). Adequate content validity (I-CVI = 0.852–1.00, S-CVI = 946) was ensured by expert panel. The internal consistency of the dimensions showed good results ranging from 0.801 to 0.940 for Cronbach's α, and 0.853 to 0.952 for McDonald’s ω. The item analysis of knowledge dimension indicated that the item difficulty index was 0.440 to 0.852, the item discrimination index was 0.572 to 0.707. This study confirmed that the Chinese version of the ABCD risk perception questionnaire has good psychometric properties in terms of measuring CVD-related knowledge and risk perception in the Chinese adult population, which can lead to the development of individually tailored CVD-risk reduction intervention programs or risk communication programs by health providers.

Effects of message framing and risk perception on health communication for optimum cardiovascular disease primary prevention: a protocol for a multicenter randomized controlled study

“…The risk perception categories (correct perceived, under-perceived or over-perceived CVD risk) are determined by comparing risk perception level (CVD risk perception assessed using ABCD-C) ( 49 ) and 10-year CVD risk level (10-year CVD absolute risk calculated using China-PAR) ( 50 , 51 ) with cross-tabulation using the baseline data, and the details were described in our previous study ( 19 ).…”

“…CVD risk perception, efficacy belief and CVD related knowledge will be evaluated using the Chinese version of Attitude and Beliefs about Cardiovascular Disease Risk Questionnaire (ABCD-C) ( 49 ), which comprises 26 items across four dimensions. Efficacy belief will be assessed using the item 19, 20, 22, and 24, following the recommendation by Rimal and Juon ( 61 ).…”

Cardiovascular disease risk perception among community adults in South China: a latent profile analysis

“…The Attitude and Beliefs about Cardiovascular Disease (ABCD) Risk Questionnaire was employed to measure people's CVD risk perception, which has confirmed validity in a variety of populations ( 20 – 22 ). The original English questionnaire was developed by Woringer et al ( 7 ); we translated and modified the questionnaire into a Chinese version (ABCD-C) in an earlier study ( 23 ). The scale contains 26 items and has four dimensions: CVD-related knowledge (8 items), risk perception (8 items), perceived benefits and intention to change physical activity (6 items), and perceived benefits and intention to change dietary habits (4 items).…”

Associations among risk perception, health efficacy, and health behaviors for cardiovascular disease: an application of risk perception attitude framework

“…The Attitude and Beliefs about Cardiovascular Disease (ABCD) Risk Questionnaire ( 52 ) was employed to measure people's CVD risk perception, which has confirmed validity in the Chinese population (ABCD-C) ( 53 ). The scale contains 26 items of four dimensions: CVD-related knowledge (8 items), risk perception (8 items), perceived benefits and intention to change physical activity (6 items), and perceived benefits and intention to change dietary habits (4 items).…”

“…Answer options for both constructs used a 4-point Likert scale (1 = strongly disagree to 4 = strongly agree). These items were extracted from ABCD-C ( 53 ). Efficacy beliefs were calculated as the average of self-efficacy and response efficacy.…”