Reliability and validity of the Lifestyle Hypertension Cognitive Representations scale

Lifestyle behaviors are thought to be guided by cognitive or mental representations that function to structure knowledge related to behaviors and goals. The Lifestyle Hypertension Cognitive Representations (LHCR) scale was developed to measure cognitions about hypertension-related behaviors on three cognitive dimensions. Items were derived from a literature and content analysis of qualitative data from 124 hypertensive patients. The three dimensions based on cognitive research generated subscales for perceptions (recognition), preferences (importance), and possibilities (future usefulness). Internal consistency reliability was adequate with alpha coefficients near .80 for composite and subscales in two independent culturally diverse samples. The total-to-total correlation with a related construct was low. One-way ANOVA demonstrated the expected results for known group differences by severity of blood pressure state for the composite, perceptions and possibilities subscales of the LHCR. Multiple regression revealed that the perceptions and possibilities subscales interacted to predict diastolic blood pressure. Together with socio-demographic variables explained the variance for a total of 25%. Further work is indicated to determine the instrument's usefulness as a basis for interventions to reduce blood pressure.