title: Evaluation of the shortened Cholesterol-Lowering Diet Self-Efficacy Scale.
abstract: Specificity in the self-efficacy construct requires that instruments assess domain-specific behaviors. The objectives of the study were to (1) reexamine and shorten the original 57-item Cholesterol-Lowering Diet Self-Efficacy Scale (CLDSES), (2) estimate reliability and validity of the short form CLDSES (CLDSES-SF), (3) examine the dimensionality of the CLDSES-SF, (4) examine discriminant validity of the scale by its ability to differentiate between adherence and nonadherence to saturated fat intake guidelines, and (5) examine the CLDSES-SF's sensitivity and specificity. A sample of 238 patients being treated for hypercholesterolemia completed three instruments: the CLDSES, the Connor Diet Habit Survey (DHS) and a Three-Day Food Record. Internal consistency for the CLDSES-SF was .95. The inter-correlation coefficients among the seven sub-scales ranged from .28 to .62, and for the total to sub-scales .58 - .87, significant at p < .001. Evidence for criterion validity was shown in the correlations between the CLDSES-SF and the Connor DHS scores and between the CLDSES-SF and the Three-Day Food Record. Factor analysis showed a one-factor model that fits the data with a sufficient amount of total variance explained among the seven subscale items in each subscale, providing evidence of the uni-dimensionality of each subscale. Sensitivity (76%) and specificity (63%) for the CLDSES-SF were good with 88% positive predictive value for adherence. The shortened CLDSES retained its good psychometric properties and remains comprehensive in its assessment of self-efficacy for adherence to a cholesterol-lowering diet.
authors.affiliation: University of Pittsburgh, Health and Community Systems, Pittsburgh, PA, USA. Lbu100@pitt.edu
authors.forename: Lora E
authors.initials: LE
authors.lastname: Burke
authors.forename: Yookyung
authors.initials: Y
authors.lastname: Kim
authors.forename: Fisun
authors.initials: F
authors.lastname: Senuzun
authors.forename: Jina
authors.initials: J
authors.lastname: Choo
authors.forename: Susan
authors.initials: S
authors.lastname: Sereika
authors.forename: Edvin
authors.initials: E
authors.lastname: Music
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Dunbar-Jacob
mesh_terms: D000368:Aged; D002791:Cholesterol, Dietary / Q000008:administration & dosage; D018752:Diet, Fat-Restricted / Q000523:psychology*; D016002:Discriminant Analysis; D005163:Factor Analysis, Statistical; D005247:Feeding Behavior / Q000523:psychology; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D006937:Hypercholesterolemia / Q000178:diet therapy / Q000523:psychology; D008297:Male; D008875:Middle Aged; D009730:Nursing Assessment; D015403:Nursing Evaluation Research; D010349:Patient Compliance / Q000523:psychology*; D011594:Psychometrics; D012372:ROC Curve; D020377:Self Efficacy; D012680:Sensitivity and Specificity; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires / Q000592:standards*
chemical_list: D002791:Cholesterol, Dietary