Validation of the Dutch-Flemish translated ABCD questionnaire to measure cardiovascular diseases knowledge and risk perception among adults

Abstract

Valid and reliable measurement of an individual’s knowledge and risk perception is pivotal to monitor and evaluate the effectiveness of interventions aimed at preventing cardiovascular diseases (CVDs). The recently developed Attitudes and Beliefs about Cardiovascular Disease (ABCD) knowledge and risk questionnaire is shown to be valid in England. In this study, we evaluated the psychometric properties of the modified and Dutch (Flemish)-translated ABCD questionnaire using both the classical test and item response theory (IRT) analysis. We conducted a community-based survey among 525 adults in Antwerp city, Belgium. We assessed the item- and scale-level psychometric properties and validity indices of the questionnaire. Parameters of IRT, item scalability, monotonicity, item difficulty and discrimination, and item fit statistics were evaluated. Furthermore, exploratory and confirmatory factorial validity, and internal consistency measures were explored. Descriptive statistics showed that both the knowledge and risk scale items have sufficient variation to differentiate individuals’ level of knowledge and risk perception. The overall homogeneity of the knowledge and risk subscales was within the acceptable range (> 0.3). The exploratory and confirmatory factor analyses of the risk scale supported a three-factor solution corresponding to risk perception (F1), perceived benefits and intention to change physical activity (F2), and perceived benefit and intention to change healthy dietary habit (F3). The two parametric logistic (2—PL) and rating scale models showed that the item infit and outfit values for knowledge and risk subscales were within the acceptable range (0.6 to 1.4) for most of the items. In conclusion, this study investigated the Dutch (Flemish) version of the ABCD questionnaire has good psychometric properties to assess CVD related knowledge and risk perception in the adult population. Based on the factor loadings and other psychometric properties, we suggested a shorter version, which has comparable psychometric properties.

Level of cardiovascular disease knowledge, risk perception and intention towards healthy lifestyle and socioeconomic disparities among adults in vulnerable communities of Belgium and England

“…We used the data collected in the baseline surveys of the SPICES project, particularly Antwerp and Nottingham. Details of the methods particularly the setting and procedures in the city of Antwerp is described elsewhere [ 24 ]. Nottingham is a city in Nottinghamshire, England, which has a total population around 330,000.…”

“…The study procedure in the Antwerp setting is available elsewhere [ 24 ]. A survey was conducted on a random sample of residents in selected districts using probability proportional to size (PPS) sampling.…”

“…The risk scale further comprised three sub-scales namely, risk perception, intention to PA, and healthy diet intention. The Dutch (Flemish) version of the questionnaire was validated and showed good psychometric properties, with reliability coefficient of the knowledge, risk perception, intention to PA, and healthy diet intention scale of 0.75, 0.93, 0.88 and 0.84 respectively [ 24 ].…”

Design and Validation of a Scale of Knowledge of Cardiovascular Risk Factors and Lifestyle after Coronary Event

“…This review highlighted a lack of validated instruments specifically for this issue. The published questionnaires focused mainly on the knowledge of CVD itself, its symptoms and awareness of the risk of suffering from it [ 8 , 9 , 10 ]. With this information, an exploration was begun of the concept of “knowledge and lifestyle” in people with CHD.…”

“…Several questionnaires testing the knowledge of CVD among the general population and patients with CVD have been developed and validated [ 8 , 9 , 10 ]. However, these focused more on the symptoms of the disease itself and awareness of the risk of suffering cardiovascular events than on knowledge and attitudes towards modifiable cardiovascular risk factors (CVRFs) and lifestyle in people that have suffered from a cardiac event.…”