Validating a Scale of Health Beliefs in Preventive Health Screenings Among Chinese Older Adults

Hanzhang Xu, Paulin Straughan, Wei Pan, Zhihong Zhen, Bei Wu

Research output: Contribution to journalArticlepeer-review


We aimed to examine the psychometric properties of a modified 16-item Attitudinal Index (AI), a measure of Chinese older adults’ beliefs about preventive health screenings. We used the 2013 Shanghai Elderly Life and Opinion data including 3,418 respondents age 60+ who were randomly split into training and validation samples. We examined the validity and reliability of the modified AI. Psychometric evaluation of the modified AI revealed good response patterns. The overall scale had good reliability (Cronbach’s α =.835). Exploratory factor analysis yielded four factors: barriers, fatalism, unnecessary, and detects (Cronbach’s α =.815-.908). Confirmatory factor analysis of the modified AI’s factor structure verified its four-factor structure (comparative fit index = 0.913, standardized root mean square residual = 0.048). The validity and reliability of the modified AI support its cultural appropriateness in measuring health beliefs among Chinese elderly. Further psychometric evaluation should focus on testing concurrent and criterion validity.

Original languageEnglish (US)
Pages (from-to)464-472
Number of pages9
JournalJournal of Transcultural Nursing
Issue number5
StatePublished - Sep 1 2017


  • China
  • clinical areas
  • gerontology
  • health belief
  • measurement
  • preventive health screenings

ASJC Scopus subject areas

  • General Nursing


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