Reliability and Validity of the Amharic Version of the Hill-Bone Adherence to High Blood Pressure Therapy Scale Among Ethiopian Hypertensive Patients.

Background: Hypertension is the leading cause of death from cardiovascular disease. Non-adherence to treatment and lifestyle modification are the key drivers of suboptimal blood pressure control and cardiovascular events.

Objective: To assess the reliability and validity of the Amharic version of the Hill-Bone Adherence to High Blood Pressure Therapy Scale (HBTS) among Ethiopian hypertensive patients.

Methods: A cross-sectional study was conducted among 294 hypertensive patients at two health facilities from 1 October to 30 December 2021 using the culturally adapted HBTS. Psychometric properties were assessed in terms of acceptability, internal consistency, construct validity, and predictive validity. Statistical Package for Social Sciences version 26 was used to perform statistical tests at a significance level of p-value <0.05. The Statistical Package for Social Sciences AMOS version 26 was used for the confirmatory factor analysis.

Results: Cronbach of the 14-item HBTS was initially 0.801. After excluding one item from the appointment-keeping subscale, Cronbach of the modified 13-item HBTS was 0.806. The initial principal component analysis revealed four constructs for the 14-item and three for the 12-item with a total explained variance of 58.65% and 55.73%, respectively. The confirmatory factor analysis failed to fit the observed items with the latent subscales. The predictive validity test showed that the modified 12-item Amharic version was correlated (r= 0.118;p<0.043) with systolic blood pressure.

Conclusion: The modified 13-item Amharic version of the HBTS is a reliable and valid tool with adequate psychometric properties. It can be used to assess adherence to antihypertensive medications in Amharic-speaking patients in Ethiopia.