title: The preventive services use self-efficacy (PRESS) scale in older women: development and psychometric properties.
abstract: BACKGROUND
  Preventive services offered to older Americans are currently under-utilized despite considerable evidence regarding their health and economic benefits. Individuals with low self-efficacy in accessing these services need to be identified and provided self-efficacy enhancing interventions. Scales measuring self-efficacy in the management of chronic diseases exist, but do not cover the broad spectrum of preventive services and behaviors that can improve the health of older adults, particularly older women who are vulnerable to poorer health and lesser utilization of preventive services. This study aimed to evaluate the psychometric properties of a new preventive services use self-efficacy scale, by measuring its internal consistency reliability, assessing internal construct validity by exploring factor structure, and examining differences in self-efficacy scores according to participant characteristics.
  
  
  METHODS
  The Preventive Services Use Self-Efficacy (PRESS) Scale was developed by an expert panel at the University of Pittsburgh Center for Aging and Population Health - Prevention Research Center. It was administered to 242 women participating in an ongoing trial and the data were analyzed to assess its psychometric properties. An exploratory factor analysis with a principal axis factoring approach and orthogonal varimax rotation was used to explore the underlying structure of the items in the scale. The internal consistency of the subscales was assessed using Cronbach's alpha coefficient.
  
  
  RESULTS
  The exploratory factor analysis defined five self-efficacy factors (self-efficacy for exercise, communication with physicians, self-management of chronic disease, obtaining screening tests, and getting vaccinations regularly) formed by 16 items from the scale. The internal consistency of the subscales ranged from .81 to .94. Participants who accessed a preventive service had higher self-efficacy scores in the corresponding sub-scale than those who did not.
  
  
  CONCLUSIONS
  The 16-item PRESS scale demonstrates preliminary validity and reliability in measuring self-efficacy in the use of preventive services among older women. It can potentially be used to evaluate the impact of interventions designed to improve self-efficacy in the use of preventive services in community-dwelling older women.
authors.affiliation: Graduate School of Public Health Department of Epidemiology, University of Pittsburgh, Pittsburgh, USA. mej49@pitt.edu.
authors.forename: Mini E
authors.initials: ME
authors.lastname: Jacob
authors.affiliation: College of Pharmacy Department of Pharmacy, University of Arizona, Tucson, USA. lociganic@pharmacy.arizona.edu.
authors.forename: Wei-Hsuan
authors.initials: WH
authors.lastname: Lo-Ciganic
authors.affiliation: Graduate School of Public Health Department of Epidemiology, University of Pittsburgh, Pittsburgh, USA. lrs@pitt.edu.
authors.forename: Laurey R
authors.initials: LR
authors.lastname: Simkin-Silverman
authors.affiliation: Graduate School of Public Health Department of Behavioral and Community Health Sciences, University of Pittsburgh, Pittsburgh, USA. smalbert@pitt.edu.
authors.forename: Steven M
authors.initials: SM
authors.lastname: Albert
authors.affiliation: Graduate School of Public Health Department of Epidemiology, University of Pittsburgh, Pittsburgh, USA. newmana@edc.pitt.edu.
authors.forename: Anne B
authors.initials: AB
authors.lastname: Newman
authors.affiliation: School of Health and Rehabilitation Sciences Department of Occupational Therapy, University of Pittsburgh, Pittsburgh, USA. lat15@pitt.edu.
authors.forename: Lauren
authors.initials: L
authors.lastname: Terhorst
authors.affiliation: Graduate School of Public Health Department of Epidemiology, University of Pittsburgh, Pittsburgh, USA. jov18@pitt.edu.
authors.forename: Joni Vander
authors.initials: JV
authors.lastname: Bilt
authors.affiliation: Graduate School of Public Health Department of Epidemiology, University of Pittsburgh, Pittsburgh, USA. edcjan@pitt.edu.
authors.forename: Janice C
authors.initials: JC
authors.lastname: Zgibor
authors.affiliation: School of Nursing Department of Health and Community Systems, University of Pittsburgh, Pittsburgh, USA. els100@pitt.edu.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Schlenk
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001168:Arthritis / Q000628:therapy*; D002908:Chronic Disease; D003142:Communication; D005081:Exercise Therapy / Q000706:statistics & numerical data; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D008875:Middle Aged; D010817:Physician-Patient Relations; D011314:Preventive Health Services / Q000706:statistics & numerical data*; D011594:Psychometrics; D015203:Reproducibility of Results; D012648:Self Care / Q000706:statistics & numerical data; D020377:Self Efficacy