Factorial invariance found in survey instrument measuring arthritis-related health beliefs among African-Americans and Whites

Abstract

Objective Reliable and valid instruments for measuring health beliefs related to arthritis and total joint arthroplasty (TJA) are lacking. The present study examined the factorial invariance of an Arthritis-related Health Belief Instrument (AHBI) that measures four constructs: severity of arthritis, susceptibility of arthritis to get worse, and perceived benefits and barriers of TJA. Study Design and Setting In an urban primary care clinic setting, African-American (AA) and White (W) patients ( n = 664) with at least a moderately severe degree of osteoarthritis completed the AHBI. For the cross-sectional data on the first 120 enrolled participants, exploratory factor analysis was performed to derive the initial factor structures. For the remaining 544 participants, single-group and multi-group confirmatory factor analyses (CFA) were performed to assess factorial invariance. Results The CFA analyses revealed that a four-factor model was invariant across race. Conclusion The findings of invariance across race support the use of the AHBI to measure ethnic group differences in health beliefs as they relate to arthritis and TJA. Future analyses should continue to assess other aspects of reliability and validity of the AHBI.