Abstract
A Patient-Reported Outcome (PRO) measure titled Cuestionario para la Evaluación de la Adhesión al Tratamiento Antiretroviral (acronym CEAT-VIH) is currently available in paper-and-pencil and digital (online assessment) formats. Due to the advantages of online assessment, the main objective of this work was to evaluate psychometric properties of the online version, in an international sample, to accumulate evidence of its validity and provide score norms for the questionnaire. A psychometric study was performed with an international sample of 1,470 participants, from 30 countries, to accumulate evidence of CEAT-VIH validity regarding internal structure and related external criterion (e.g., viral load, number of pills, and AIDS-related symptoms). Descriptive statistics and normative data for scores are also presented. The majority of participants were men (72.4%), aged 15 to 78 years old ( M = 39.3, SD = 12.6). A unidimensional model with five facets occurred as the observed variables converged, which presented a good model fit (comparative fit index [CFI] = 1.000; Tucker–Lewis index [TLI] = 0.999; standardized root mean square residual [SRMR] = 0.027; and root mean square error of approximation [RMSEA] [90% confidence interval, CI] = 0.009 [0.000, 0.038], p = .995). There was a weak invariance for the CEAT-VIH structure for language versions and countries. Cronbach’s alpha values for the instrument (17 items) were acceptable across language versions (.88-.96). Evidence of validity related to external criteria was achieved by associations (e.g., Spearman and Mann–Whitney) between CEAT-VIH scores and relevant clinical (e.g., CD4+ cells, viral load, number of pills, and AIDS-related symptoms) and sociodemographic (e.g., gender, age, employment status, education level, place of residence, and participation at local AIDS association) variables. In conclusion, the overall data on the evaluated psychometric properties allow recommendation of the use of this instrument in research and applied settings.
Highlights
Adherence to HIV treatment is a complex and multifaceted behavior (Remor, 2013b), and can be understood as the extent to which one’s behavior coincides with the health recommendations he or she receives (Haynes, Taylor, & Sackett, 1979)
Nonadherence or low adherence to treatment is a threat to treatment effectiveness, and they contribute to elevated viral load, the incidence of opportunistic diseases, and an increase in the number of hospital admissions (e.g., Foresto et al, 2017)
The confirmatory factor analysis (CFA) was used to evaluate the goodness of fit of the theoretical model that supports the CEAT-VIH online version
Summary
Adherence to HIV treatment is a complex and multifaceted behavior (Remor, 2013b), and can be understood as the extent to which one’s behavior coincides with the health recommendations he or she receives (Haynes, Taylor, & Sackett, 1979). Associations between adherence levels and health outcomes are complex; many mediators may be implicated, including time in treatment, psychological variables, quality of the provided treatment, patient age, and viral load levels (Costa, Torres, Coelho, & Luz, 2018; Marks et al, 2015; Remor, Penedo, Shen, & Schneiderman, 2007). Nonadherence or low adherence to treatment is a threat to treatment effectiveness, and they contribute to elevated viral load, the incidence of opportunistic diseases, and an increase in the number of hospital admissions (e.g., Foresto et al, 2017).
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