Abstract 19207: The Third Time’s a Charm: Factor Analysis, Psychometric Testing, and Update of the Atlanta Heart Failure Knowledge Test
Background and Objective: Since first published in 2009, the Atlanta Heart Failure Knowledge Test (AHFKT) has been demonstrated to be a reliable and valid instrument, used in multiple studies and translated into more than 15 languages. Given advances in heart failure (HF) self-care, we proposed to reevaluate the psychometric properties of the AHFKTv2 in a larger sample and update the instrument.
Methods: The 30 questions of the AHFKT (at 5th grade reading level) are focused on 5 knowledge domains essential for HF self-care: pathophysiology, nutrition, behavior, medicine, and symptoms. Demographic, clinical, and baseline AHFKTv2 data from 4 intervention studies in persons with HF were combined for this analysis (N=284). Characteristics of the sample and by group were analyzed using descriptive statistics; validity testing with t tests and Pearson r correlations, Mann-Whitney two-group tests, and Spearman’s rho; and tetrachoric correlations computed as the basis for reliability calculations and factor analysis.
Results: Participants were 22 to 84 years of age, 66% African American, 63% male, and 94% NYHA class II-III. Participants had a mean AHFKT score of 80.6% (±11%). Hypotheses that higher education level would be associated with higher knowledge (t=-2.7, p<.001), and higher knowledge would predict less sodium consumption (rho=-.22, p=.03) measured by 24-hour urinary sodium were validated. Participants categorized as adherent (≤ 3000 mg/day) with sodium restriction answered more sodium knowledge questions correctly (Median 7.5, IQR [7, 8]) than those who were nonadherent (Median 7.0 IQR [6, 7]; Mann-Whitney (MW) test Z=-2.97, p<.01). Factor analysis revealed the 5 domain scores were positively correlated with one another when summed (p<.01) and Cronbach’s alpha was computed to be 0.87. The first 5 factors explained 53% of the variance with items loading of 0.3 and higher on at least 1 of the 5 factors. Finally, item analysis resulted in identification of individual questions requiring review and revision.
Conclusion: Comprehensive psychometric evaluation of the AHFKTv2 revealed confirmation of internal consistency reliability and validity, and provided direction for production of the AHFKTv3 available for use in research and clinical practice.
Author Disclosures: C.M. Reilly: None. B. Butts: None. M. Higgins: None. S.B. Dunbar: None.
- © 2016 by American Heart Association, Inc.