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Smit ES, Dima AL, Immerzeel SAM, et al. The Virtual Care Climate Questionnaire: Development and Validation of a Questionnaire Measuring Perceived Support for Autonomy in a Virtual Care Setting. J Med Internet Res. 2017;19(5):e155doi: 10.2196/jmir.6714.
Smit, E. S., Dima, A. L., Immerzeel, S. A. M., van den Putte, B., & Williams, G. C. (2017). The Virtual Care Climate Questionnaire: Development and Validation of a Questionnaire Measuring Perceived Support for Autonomy in a Virtual Care Setting. Journal of medical Internet research, 19(5), e155. https://doi.org/10.2196/jmir.6714
Smit, Eline Suzanne, et al. "The Virtual Care Climate Questionnaire: Development and Validation of a Questionnaire Measuring Perceived Support for Autonomy in a Virtual Care Setting." Journal of medical Internet research vol. 19,5 (2017): e155. doi: https://doi.org/10.2196/jmir.6714
Smit ES, Dima AL, Immerzeel SAM, van den Putte B, Williams GC. The Virtual Care Climate Questionnaire: Development and Validation of a Questionnaire Measuring Perceived Support for Autonomy in a Virtual Care Setting. J Med Internet Res. 2017 May 08;19(5):e155. doi: 10.2196/jmir.6714. PMID: 28483743; PMCID: PMC5705912.
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J Med Internet Res. 2017 May 08;19(5):e155. doi: 10.2196/jmir.6714.

The Virtual Care Climate Questionnaire: Development and Validation of a Questionnaire Measuring Perceived Support for Autonomy in a Virtual Care Setting.

Journal of medical Internet research

Eline Suzanne Smit, Alexandra Lelia Dima, Stephanie Annette Maria Immerzeel, Bas van den Putte, Geoffrey Colin Williams

Affiliations

  1. Amsterdam School of Communication Research/ASCoR, Department of Communication Science, University of Amsterdam, Amsterdam, Netherlands.
  2. Health Services and Performance Research (HESPER EA 7425), University Claude Bernard Lyon 1, Lyon, France.
  3. Trimbos Institute, Netherlands Institute for Mental Health and Addiction, Utrecht, Netherlands.
  4. Department of Clinical and Social Sciences in Psychology, University of Rochester, Rochester, NY, United States.
  5. Healthy Living Center, Center for Community Health, Department of Medicine, University of Rochester, Rochester, NY, United States.

PMID: 28483743 PMCID: PMC5705912 DOI: 10.2196/jmir.6714

Abstract

BACKGROUND: Web-based health behavior change interventions may be more effective if they offer autonomy-supportive communication facilitating the internalization of motivation for health behavior change. Yet, at this moment no validated tools exist to assess user-perceived autonomy-support of such interventions.

OBJECTIVE: The aim of this study was to develop and validate the virtual climate care questionnaire (VCCQ), a measure of perceived autonomy-support in a virtual care setting.

METHODS: Items were developed based on existing questionnaires and expert consultation and were pretested among experts and target populations. The virtual climate care questionnaire was administered in relation to Web-based interventions aimed at reducing consumption of alcohol (Study 1; N=230) or cannabis (Study 2; N=228). Item properties, structural validity, and reliability were examined with item-response and classical test theory methods, and convergent and divergent validity via correlations with relevant concepts.

RESULTS: In Study 1, 20 of 23 items formed a one-dimensional scale (alpha=.97; omega=.97; H=.66; mean 4.9 [SD 1.0]; range 1-7) that met the assumptions of monotonicity and invariant item ordering. In Study 2, 16 items fitted these criteria (alpha=.92; H=.45; omega=.93; mean 4.2 [SD 1.1]; range 1-7). Only 15 items remained in the questionnaire in both studies, thus we proceeded to the analyses of the questionnaire's reliability and construct validity with a 15-item version of the virtual climate care questionnaire. Convergent validity of the resulting 15-item virtual climate care questionnaire was confirmed by positive associations with autonomous motivation (Study 1: r=.66, P<.001; Study 2: r=.37, P<.001) and perceived competence for reducing alcohol intake (Study 1: r=.52, P<.001). Divergent validity could only be confirmed by the nonsignificant association with perceived competence for learning (Study 2: r=.05, P=.48).

CONCLUSIONS: The virtual climate care questionnaire accurately assessed participants' perceived autonomy-support offered by two Web-based health behavior change interventions. Overall, the scale showed the expected properties and relationships with relevant concepts, and the studies presented suggest this first version of the virtual climate care questionnaire to be reasonably valid and reliable. As a result, the current version may cautiously be used in future research and practice to measure perceived support for autonomy within a virtual care climate. Future research efforts are required that focus on further investigating the virtual climate care questionnaire's divergent validity, on determining the virtual climate care questionnaire's validity and reliability when used in the context of Web-based interventions aimed at improving nonaddictive or other health behaviors, and on developing and validating a short form virtual climate care questionnaire.

©Eline Suzanne Smit, Alexandra Lelia Dima, Stephanie Annette Maria Immerzeel, Bas van den Putte, Geoffrey Colin Williams. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 08.05.2017.

Keywords: Internet; health behavior; health promotion; personal autonomy; psychometrics; questionnaire design; self-determination theory; validation studies

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