The Virtual Care Climate Questionnaire: Development and Validation of a Questionnaire Measuring Perceived Support for Autonomy in a Virtual Care Setting

Abstract

BackgroundWeb-based health behavior change interventions may be more effective if they offer autonomy-supportive communication facilitating the internalization of motivation for health behavior change. Yet, at this moment no validated tools exist to assess user-perceived autonomy-support of such interventions.ObjectiveThe aim of this study was to develop and validate the virtual climate care questionnaire (VCCQ), a measure of perceived autonomy-support in a virtual care setting.MethodsItems were developed based on existing questionnaires and expert consultation and were pretested among experts and target populations. The virtual climate care questionnaire was administered in relation to Web-based interventions aimed at reducing consumption of alcohol (Study 1; N=230) or cannabis (Study 2; N=228). Item properties, structural validity, and reliability were examined with item-response and classical test theory methods, and convergent and divergent validity via correlations with relevant concepts.ResultsIn Study 1, 20 of 23 items formed a one-dimensional scale (alpha=.97; omega=.97; H=.66; mean 4.9 [SD 1.0]; range 1-7) that met the assumptions of monotonicity and invariant item ordering. In Study 2, 16 items fitted these criteria (alpha=.92; H=.45; omega=.93; mean 4.2 [SD 1.1]; range 1-7). Only 15 items remained in the questionnaire in both studies, thus we proceeded to the analyses of the questionnaire’s reliability and construct validity with a 15-item version of the virtual climate care questionnaire. Convergent validity of the resulting 15-item virtual climate care questionnaire was confirmed by positive associations with autonomous motivation (Study 1: r=.66, P<.001; Study 2: r=.37, P<.001) and perceived competence for reducing alcohol intake (Study 1: r=.52, P<.001). Divergent validity could only be confirmed by the nonsignificant association with perceived competence for learning (Study 2: r=.05, P=.48).ConclusionsThe virtual climate care questionnaire accurately assessed participants’ perceived autonomy-support offered by two Web-based health behavior change interventions. Overall, the scale showed the expected properties and relationships with relevant concepts, and the studies presented suggest this first version of the virtual climate care questionnaire to be reasonably valid and reliable. As a result, the current version may cautiously be used in future research and practice to measure perceived support for autonomy within a virtual care climate. Future research efforts are required that focus on further investigating the virtual climate care questionnaire's divergent validity, on determining the virtual climate care questionnaire’s validity and reliability when used in the context of Web-based interventions aimed at improving nonaddictive or other health behaviors, and on developing and validating a short form virtual climate care questionnaire.

<p>Psychometric properties of the Persian Health Care Climate Questionnaire (HCCQ-P): assessment of type 2 diabetes care supportiveness in Iran</p>

“…As the distribution of the study attendants’ major sociodemographic characteristics was sought to be representative of the largest population of Iranian patients with type 2 diabetes, the study results demonstrate the applicability of the HCCQ-P as a suitable instrument for assessing the degree of health-care climate supportiveness for Iranian patients with type 2 diabetes. The psychometric analysis of the HCCQ-P on the studied Iranian patients produced similar results to the findings of previous studies on psychometric assessment of the HCCQ in France, 14 the USA, 30 the Netherlands18,24 and Germany. 19 …”

“…The Health Care Climate Questionnaire (HCCQ) was developed by Williams et al17 and measures the perceived needs of patients and extent of HCPs' support with regard to independence and success in motivating patients to accept greater responsibility for their own health 12,18–20…”

“…Other related scales have been developed based on the HCCQ, such as the Virtual Health Inventory Questionnaire,18 Important Other Climate Questionnaire for cigarette smoking30 and diet,30 and a modified HCCQ for breast cancer patients 31. The HCCQ has been validated for use in other languages, such as German,19 French14 and Dutch 24…”

Should or could? Testing the use of autonomy-supportive language and the provision of choice in online computer-tailored alcohol reduction communication

“…The primary outcome of this study was perceived autonomy-support , which was measured with the Virtual Care Climate Questionnaire (VCCQ). 46 The VCCQ consists of 15 items that can be answered on a seven-point Likert scale (where 1 = strongly agree and 7 = strongly disagree) and has been proven to be reasonably valid and highly reliable. 46 Participants were asked questions like ‘I feel that the intervention has provided me with choices and options’ and ‘I feel that the intervention provided me with effective possibilities to reduce my alcohol consumption’.…”

App-Delivered Self-Management Intervention Trial selfBACK for People With Low Back Pain: Protocol for Implementation and Process Evaluation

“…Quantitatively, we will collect data on effectiveness approximately 4 months after baseline using a web-based questionnaire including the 15-item version of the Virtual Care Climate Questionnaire (VCCQ), which evaluates how participants perceive the effectiveness of the autonomy-supportive communication for health behavior change offered in a virtual care setting [ 41 ].…”