Reliability and Validity of the LifeWindows Information–Motivation–Behavioral Skills Antiretroviral Therapy Adherence Questionnaire Among HIV+ Patients in Shanghai
Received 9 October 2019
Accepted for publication 1 February 2020
Published 5 March 2020 Volume 2020:14 Pages 507—515
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Naifeng Liu
Zihe Peng, 1,* Yuelin Yu, 1,* Wei Wei, 2 Yongchun Hou, 2 Zhenyu Sun, 3 Ying Wang, 4 Lin Zhang, 5 Ying Zhou, 5 Qian Wang, 1 Yong Cai 1
1School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China; 2Putuo District Center for Disease Control and Prevention, Shanghai, People’s Republic of China; 3Taopu Town Community Health Service Center, Shanghai, People’s Republic of China; 4Yichuan Street Community Health Service Center, Shanghai, People’s Republic of China; 5Shanghai Public Health Clinical Center, Shanghai, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Yong Cai; Qian Wang
School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
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Objective: The purpose of this article was to examine the validity and reliability of the LifeWindows Information–Motivation–Behavioral Skills Antiretroviral Therapy (ART) Adherence Questionnaire (LW-IMB-AAQ) among HIV+ patients in Shanghai.
Methods: We surveyed 426 HIV+ patients in Shanghai’s Putuo District to examine the validity and reliability of the questionnaire. The questionnaire includes self-reported demographic characteristics, the modified version of the Community Programs for Clinical Research on AIDS Antiretroviral Medication Self-Report (CPCRA) and LW-IMB-AAQ. CPCRA was used to calculate ART adherence. LW-IMB-AAQ, including the information section, the motivation section and the behavioral skills section, was used to analyze patients’ ART adherence. We analyzed data by means, standard deviation, critical ratio, and item-total correlation. Reliability was assessed by internal consistency, split-half reliability, and test–retest reliability. Validity was assessed by exploratory factor analysis (EFA), confirmatory factor analysis (CFA), convergent validity and discriminant validity.
Results: Item analysis showed that except for motivation item 1, all items were acceptable. For reliability, Cronbach’s alpha coefficients for the three sections and the total scale were all higher than 0.7, with interclass correlation coefficients (ICC) all higher than 0.6 (p< 0.001). The Spearman–Brown coefficient for the total scale was 0.825. For validity, results showed that the information section could be divided into two subscales, motivation section and behavioral skills section could be divided into three and two subscales, respectively. The final model demonstrated good validity (p=0.471, χ 2/df=0.960, CFI=1.000, GFI=0.994 and RMSEA< 0.001) without motivation item 4.
Conclusion: Excluding motivation items 1 and 4, the LifeWindows Information–Motivation–Behavioral Skills ART Adherence Questionnaire (LW-IMB-AAQ) demonstrated good validity and reliability among HIV+ patients in Shanghai.
Keywords: HIV, validity, reliability, IMB model, China
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