title: Assessing medication adherence self-efficacy among low-literacy patients: development of a pictographic visual analogue scale.
abstract: Health behavior interventions are often grounded in Social Cognitive Theory, but instruments used to assess self-efficacy rely on verbal skills and yield scores that are highly positively skewed. Based on a review of the research literature and qualitative research with key informants, a pictographic medication adherence self-efficacy scale was developed. Two studies were conducted to test the pictographic and color visual analogue scale for assessing self-efficacy for medication adherence. Study 1 (N = 81) demonstrated that the pictographic self-efficacy scale was internally consistent (alpha = 0.68), time stable (2-week test-re-test r = 0.63), and showed evidence for convergent and divergent construct validity. Study 2 (N = 64) further supported the reliability of the pictographic self-efficacy scale with additional data supporting its convergent, divergent and criterion-related validity, including associations with medication adherence and HIV viral load. Distributions of self-efficacy scores approximated normal. This newly developed pictographic scale may be useful in assessing medication adherence self-efficacy in lower-literacy populations.
authors.affiliation: Department of Psychology, University of Connecticut, Storrs, CT 06269, USA. seth.k@uconn.edu
authors.forename: Seth C
authors.initials: SC
authors.lastname: Kalichman
authors.forename: Demetria
authors.initials: D
authors.lastname: Cain
authors.forename: Andrea
authors.initials: A
authors.lastname: Fuhrel
authors.forename: Lisa
authors.initials: L
authors.lastname: Eaton
authors.forename: Kari
authors.initials: K
authors.lastname: Di Fonzo
authors.forename: Thom
authors.initials: T
authors.lastname: Ertl
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D004522:Educational Status; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D020377:Self Efficacy; D011795:Surveys and Questionnaires; D019562:Viral Load
chemical_list: D019380:Anti-HIV Agents