Translation and Testing of a Scale to Assess Hypertension Self-Care Activities among Latinos

Latinos in the US are less likely to have their blood pressure controlled as compared to Blacks or Whites. We previously developed a self-report scale to measure adherence to the self-care activities recommended for managing hypertension (medication, healthy diet, physical activity, weight management, reduced smoking and alcohol intake). The purpose of this study is to describe the translation process and pilot testing of the Spanish version of the Hypertension Self-Care Activity Level Effects (H-SCALE). We report on the prevalence of hypertension self-care behaviors among Latinos with hypertension living in Charlotte, NC.

Methods: We implemented a modified version of the World Health Organization process for translation and adaptation of instruments, which uses forward and backward translation in conjunction with an expert panel review. The resulting survey was then piloted in a primary care clinic serving Latinos.

Results: Participants (n=124) were predominantly female, under age 50, with limited education; one-third reported having hypertension. The internal consistency of the 6 subscales was within limits (α ≥ .70) and item analyses indicated no floor or ceiling effects. Among participants with hypertension, only 33% were adherent to medication regimens; one-third practiced weight management behaviors; over 80% were non-smoking and/or alcohol abstinent; 36.8% were physically active. Less than 16% reported eating a healthy diet.

Conclusion: The Spanish version of the H-SCALE demonstrates basic psychometric properties. Spanish speaking individuals with hypertension report low rates of adherence to important activities for managing blood pressure. Future studies will validate the Spanish version of the H-SCALE against clinical blood pressure.