The virtual care climate questionnaire: development and validation

Abstract

Background: E-health interventions are more effective if they offer autonomy-supportive communication facilitating the internalization of health behaviour change motivation. As no validated measures yet exist to measure autonomy-support offered by e-health interventions, our aim was to develop and validate the Virtual Climate Care Questionnaire (VCCQ); a questionnaire measuring perceived autonomy-support in a virtual care setting. Methods: Items were developed based on existing questionnaires and expert consultation, and pre-tested among experts and target populations. The VCCQ was administered concerning e-health interventions aimed at alcohol (Study 1; N=230) and cannabis (Study 2; N=228). Item properties, structural validity, and reliability were examined with item-response and classical test theory methods, as were the questionnaire’s convergent and divergent validity. Findings: In study 1, 20 of 23 items formed a one-dimensional scale (α=.97; H=.66; ω=.97; mean(SD)=4.9(1.0); range 1-7) that met the assumptions of monotonicity and invariant item ordering; in study 2, 16 items fit these criteria (α=.92; H=.45; ω=.93; mean (SD)=4.2(1.1); range 1-7). Convergent validity was confirmed by positive associations with autonomous motivation and integrated and identified regulation subscales (study 1: r=.65, .47, .67, p<.001; study 2: r=.35; .35; .34, p <.001), and perceived competence for reducing alcohol intake (study 1: r=.53, p<.001). Divergent validity could only be confirmed by the non-significant association with perceived competence for studying behaviour (study 2: r=-.01, p=.83). Discussion: VCCQ items accurately assessed participants’ perceived autonomy-support offered by two e-health interventions. The scale showed the expected properties and relationships with relevant constructs, though its divergent validity requires attention in further research.