[Development of a "self efficacy for health promotion scale" in community-dwelling elderly]

The purpose of this study is to develop a Japanese version of a self efficacy scale for health promotion activities by the elderly. In September to October 1997, we asked all of 1758 persons aged 65 and over who were living in a village in Nagano Prefecture to answer a questionnaire. The questionnaire included 15 self efficacy items for health promotion, Activities of Daily Living (ADL), general self efficacy, health behavior, and community activities. The present study examined reliability and validity of the scale by investigating the correlation to other factors. 1173 of the subjects completed the answer sheet by themselves. The mean age of the subjects was 72.9 +/- 6.1, and 54.7% were female, the education level of 52.2% was middle school, 54.0% worked as a laborers, and 41 persons (3.5%) needed help in instrumental ADL. Almost half of the subjects participated in various community activities. When applied to the 1173 subjects, the first principal component accounted for 53.9% of variance. We considered a self efficacy scale for health promotion by using the sum of 15 items. Alpha coefficient of the scale was 0.93 and test-retest reliability was 0.68, showing the reliability of the scale. Criterion-related validity was demonstrated by the significant relationship between the self efficacy scale and general self efficacy (r = 0.42). The score of the 15-item version did not correlate with age and sex but ADL and health behavior (r = 0.29, 0.21, p < 0.001). High self efficacy was found among those who had high self rated health, and participated in health counseling, health screening, golden-age community center activity, and volunteer activities. This scale can be used to measure personal belief for health promotion as well as the effects of interventions to alter health behaviors. To standardize the scale, further study of urban dwelling elderly and the disabled elderly is necessary.