title: The English and Spanish Self-Efficacy to Manage Chronic Disease Scale measures were validated using multiple studies.
abstract: OBJECTIVE
  Self-efficacy theory, as developed by Bandura, suggests that self-efficacy is an important predictor of future behavior. The Chronic Disease Self-Management Program was designed to enhance self-efficacy as one approach to improving health behaviors and outcomes for people with varying chronic diseases. The six-item Self-Efficacy to Manage Chronic Disease Scale (SEMCD) and the four-item Spanish-language version (SEMCD-S) were developed to measure changes in self-efficacy in program participants and have been used in a numerous evaluations of chronic disease self-management programs. This study describes the development of the scales and their psychometric properties.
  
  
  METHODS
  Secondary analyses of questionnaire data from 2,866 participants in six studies are used to quantify and evaluate the SEMCD. Data from 868 participants in two studies are used for the SEMCD-S. Subjects consisted of individuals with various chronic conditions, who enrolled in chronic disease self-management programs (either small group or Internet based). Subjects came from United States, England, Canada, Mexico, and Australia. Descriptive statistics are summarized, reliability tested (Cronbach alpha), and principal component analyses applied to items. Baseline and change scores are correlated with baseline and change scores for five medical outcome variables that have been shown to be associated with self-efficacy measures in past studies.
  
  
  RESULTS
  Principal component analyses confirmed the one-dimensional structure of the scales. The SEMCD had means ranging from 4.9 to 6.1 and the SEMCD-S 6.1 and 6.2. Internal consistency was high (Cronbach alpha, 0.88-0.95). The scales were sensitive to change and significantly correlated with health outcomes.
  
  
  CONCLUSIONS
  The SEMCD and SEMCD-S are reliable and appear to be valid instruments for assessing self-efficacy for managing chronic disease. There was remarkable consistency across a range of studies from varying countries using two languages.
authors.affiliation: Stanford Patient Education Research Center, School of Medicine, Stanford University, 1000 Welch Road, Suite 204, Palo Alto, CA 94306, USA. Electronic address: philr@stanford.edu.
authors.forename: Philip L
authors.initials: PL
authors.lastname: Ritter
authors.affiliation: Stanford Patient Education Research Center, School of Medicine, Stanford University, 1000 Welch Road, Suite 204, Palo Alto, CA 94306, USA.
authors.forename: Kate
authors.initials: K
authors.lastname: Lorig
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002170:Canada; D002908:Chronic Disease / Q000523:psychology* / Q000628:therapy*; D019468:Disease Management; D004739:England; D005260:Female; D015438:Health Behavior; D006801:Humans; D007802:Language; D008297:Male; D008800:Mexico; D008875:Middle Aged; D025341:Principal Component Analysis; D011594:Psychometrics; D016032:Randomized Controlled Trials as Topic; D015203:Reproducibility of Results; D012648:Self Care / Q000379:methods* / Q000523:psychology; D020377:Self Efficacy; D011795:Surveys and Questionnaires; D014481:United States; D055815:Young Adult
keywords: Chronic disease; Patient education; Scale psychometrics; Self-efficacy; Self-management; Spanish-language scales