Psychometric evaluation of the ‘Attitudes and Beliefs about Cardiovascular Disease (ABCD) Risk Questionnaire’ with validation of a previously untested ‘Intentions and Beliefs around Smoking’ subscale

OBJECTIVES: To provide evidence of validity, reliability and generalisability of results obtained using the Attitudes and Beliefs about Cardiovascular Disease (ABCD) Risk Questionnaire with a sample of the English population surveyed within the ‘SPICES’ Horizon 2020 Project (Nottingham study site), and to specifically evaluate the psychometric and factor properties of an as-yet untested five-item subscale relating to smoking behaviours. DESIGN AND SETTING: Community and workplace-based cross-sectional study in Nottingham, UK. PARTICIPANTS: 466 English adults fitting inclusion criteria (aged 18+ years, without known history of cardiovascular disease, not pregnant, able to provide informed consent) participated in the study. INTERVENTION: We revalidated the ABCD Questionnaire on a sample of the general population in Nottingham to confirm the psychometric properties. Furthermore, we introduced five items related to smoking, which were dropped in the original study due to inadequate valid samples. PRIMARY AND SECONDARY OUTCOME MEASURES: 1. Psychometric and factor performance of untested five-item ‘smoking behaviours’ subscale. 2. Psychometric and factorial properties in combination with the remaining 18 items across 3 subscales. RESULTS: Analyses of the data largely confirmed the validity, reliability and factor structure of the original ABCD Risk Questionnaire. Sufficient participants in our study provided data against additional five smoking-related items to confirm their validity as a subscale and to advocate for their inclusion in future applications of the scale. Exploratory factor analysis and confirmatory factor analysis calculations support some minor changes to the remaining subscales, which may further improve psychometric performance and therefore generalisability of the instrument. CONCLUSIONS: An amended version of the ABCD Risk Questionnaire would provide public health researchers and practitioners with a brief, easy-to-use, reliable and valid survey tool. The amended tool may assist public health practitioners and researchers to survey patient or public intentions and beliefs around three key areas of individually modifiable risk (physical activity, diet, smoking). TRIAL REGISTRATION NUMBER: ISRCTN Registry (ISRCTN68334579).