Abstract

BackgroundPreventive 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.MethodsThe 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.ResultsThe 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.ConclusionsThe 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.

Highlights

  • Preventive services offered to older Americans are currently under-utilized despite considerable evidence regarding their health and economic benefits

  • Despite clear guidelines set by the U.S Preventive Services Task Force and recent legislative and policy measures intended to improve access to health care, there are significant gaps in the utilization of preventive services by older Americans [1]

  • A uniform increase in the utilization of 9 clinical preventive services to levels achieved by high performing health systems could prevent 50,000 to 100,000 deaths every year in the population aged less than 80 years [2]

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Summary

Introduction

Preventive services offered to older Americans are currently under-utilized despite considerable evidence regarding their health and economic benefits. Despite clear guidelines set by the U.S Preventive Services Task Force and recent legislative and policy measures intended to improve access to health care, there are significant gaps in the utilization of preventive services by older Americans [1]. Increasing the use of these services from current levels to 90 % would result in total savings of $3.7 billion [3]. Closing this gap for older populations will require concerted action by the forces of public health infrastructure, community-based organizations, and aging services network. Efforts should target older women who comprise 56 % of this population, and are vulnerable to poorer health and lesser utilization of preventive services [4]

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