A six-part picture of health beliefs
The Cardiovascular Health Beliefs Scale, a questionnaire for cardiovascular health beliefs, showed a six-part structure in confirmatory testing, according to the study. The six areas were perceived susceptibility, perceived severity, health motivation, perceived benefits, perceived barriers and self-efficacy. They are scored separately, so the instrument does not produce one overall CHBS score.
The findings concern the scale's structure and item performance. They do not establish that CHBS scores predict cardiovascular outcomes or behavior.
How the questionnaire was tested
Researchers evaluated the scale in two stages. The first combined item analysis with exploratory factor analysis, while the second used confirmatory factor analysis to test the proposed structure.
Phase 1 included 150 participants for item generation and exploratory factor analysis. Phase 2 included 531 participants for confirmatory factor analysis.
In phase 1, participants had a mean age of 36.54 years; 44% were female and 56% male, and 55 had a confirmed cardiovascular disease diagnosis. In phase 2, the mean age was 38.79 years; 48% were female and 52% male, and 285 had diagnosed cardiovascular disease.
Before the main factor work, 10 university students took part in face-to-face cognitive-debriefing sessions lasting about 15 to 20 minutes. They reported no comprehension difficulties.
The CHBS uses five-point Likert responses. Each dimension is scored independently by summing its constituent responses; there are no reverse-scored items and no total score.
What the numbers show
The analysis included item-total correlations, principal components factor analysis with Varimax rotation, Cronbach's alpha and Pearson correlations. The researchers used the correlations to examine links among CHBS dimensions and with the Brief Symptom Inventory General Severity Index, or BSI-GSI.
The BSI-GSI was used as an external validity criterion. The report describes it as the total score of the Brief Symptom Inventory subscales divided by 53.
All item-total correlations were above .20. Communalities and primary-factor loadings, indicators of how strongly items fit their dimensions, exceeded .30, which the authors said supported a single-factor structure within each dimension.
The confirmatory results included some measures below the stated benchmark, although the authors described the overall fit as acceptable. The reported figures were a chi-square-to-degrees-of-freedom ratio of 3.268, a Goodness of Fit Index of 0.86, a Comparative Fit Index of 0.88, a Standardized Root Mean Square Residual of 0.06 and a Root Mean Square Error of Approximation of 0.06. The same results section listed a greater-than-.90 criterion for GFI and CFI, putting both measures below that stated benchmark.
Internal consistency, a check of whether items within each subscale work together, ranged from .70 to .84. Cronbach's alpha was .84 for perceived susceptibility, .80 for perceived severity, .74 for health motivation, .80 for perceived benefits, .72 for perceived barriers and .70 for self-efficacy.
The authors also reported that correlations involving the CHBS dimensions and BSI-GSI were at the expected level. But the available results do not preserve a complete mapping between each coefficient and each dimension, so the finding cannot be reported as a reliable list of pair-specific numbers.
What the findings do and do not say
Taken together, the findings support the CHBS as a six-subscale measurement tool with the reported item, factor and internal-consistency results. They do not show that using the questionnaire changes behavior or that its scores predict cardiovascular outcomes.
The study reported ethics-committee approval, compliance with the Declaration of Helsinki and written informed consent from all participants. It was supported by the Scientific Research Projects Coordination Unit of Istanbul Yeni Yuzyil University, and the authors declared no potential conflicts related to the research, authorship or publication. The study data are available from the corresponding author upon reasonable request.
Paper data and sources
Original title: Development and psychometric evaluation of cardiovascular health beliefs scale
Authors: Asaroğlu C, Sertel Berk H
Journal/Repository: Patient related outcome measures
Status: Peer-reviewed
First online: 2026-10-19
DOI: Not available
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