Development and validation of Chinese compensatory health beliefs scale

Compensatory Health Beliefs (CHBs), the notion that healthy behaviors can offset the negative effects of unhealthy actions, have been widely explored in Western contexts. Yet, their relevance within the Chinese cultural milieu remains underexplored. The primary objective of this research was to develop and validate a Chinese version of the CHBs scale (CHBs-C), addressing the gap in the literature regarding the applicability of CHBs within the Chinese cultural context. A multi-stage translation (from English to Chinese) was first completed, and exploratory factor analysis was conducted (n = 476), yielding the 14-item scale (CHBs-C scale). Confirmatory factor analysis was conducted to assess the validity, and the 2-week test-retest reliability, internal consistency and convergent validity of the scale were also assessed (n = 308). Predict validity was verified through testing the relationships between CHBs and health behaviors and habits (n = 274). Factor analysis showed a different factor structure in Chinese context, with only one factor identical to the original version. The fitness index of the new factor structure was good. However, while the scale exhibited acceptable internal consistency and high test-retest reliability, its convergent validity and predictive validity was found to be limited on a general level. Despite this, significant correlations at the subscale level were identified, highlighting nuanced interactions between CHBs and specific health behaviors within the Chinese population. This study not only establishes the CHBs-C scale as a valid and reliable instrument for assessing compensatory health beliefs in China but also lays the groundwork for further exploration of its applications and the potential cultural adaptability of CHBs.