The Cultural Health Attributions Questionnaire (CHAQ): Reliability, Validity, and Refinement

This study describes the reliability and validity of scores on the Cultural Health Attributions Questionnaire (CHAQ), and proposes a refined short form. Murgu a, Zea, Reisen, and Peterson (2000) developed the 24-item CHAQ to assess health beliefs among Latinos/Hispanics. The CHAQ incorporates two 12-item subscales: Equity Attributions (EA) and Behavioral-Environmental Attributions (BEA). Although the CHAQ has been published in Spanish and English, psychometric properties have only been evaluated for scores on the Spanish-language version. Participants in the present study were 436 Latinos/Hispanics, half of whom completed the CHAQ in Spanish, and half in English. Multigroup confirmatory factor analysis indicated that the proposed two-factor structure did not fit the data for either language. Subsequent exploratory factor analyses revealed different best-fitting models for the two languages. A common two-factor (EA/BEA) structure was derived from items that loaded univocally in both languages. Additional items were removed to produce a 10-item revised version (CHAQ-R). The two factors were negatively correlated and had good internal consistency reliability. Expected relationships of CHAQ-R scores to acculturation and health locus of control strongly supported convergent validity. The relationship of EA to ethno-medical services usage marginally supported criterion validity. Overall, the results support the reliability and validity of CHAQ-R scores to measure cultural health attributions in Latinos/Hispanics, but further psychometric evaluation is needed.