Development and Testing of the Hill‐Bone Compliance to High Blood Pressure Therapy Scale
Abstract
The Hill‐Bone Compliance to High Blood Pressure Therapy Scale assesses patient behaviors for three important behavioral domains of high blood pressure treatment: 1) reduced sodium intake; 2) appointment keeping; and 3) medication taking. This scale is comprised of 14 items in three subscales. Each item is a four point Likert type scale. The content validity of the scale was assessed by a relevant literature review and an expert panel, which focused on cultural sensitivity and appropriateness of the instrument for low literacy. Internal consistency reliability and predictive validity of the scale were evaluated using two community based samples of hypertensive adults enrolled in clinical trials of high blood pressure care and control. The standardized a for the total scale were 0.74 and 0.84, and the average interitem correlations of the 14 items were 0.18 and 0.28, respectively. The construct and predictive validity of the scale was assessed by factor analysis and by testing of theoretically derived hypotheses regarding whether the scale demonstrated consistent and expected relationships with related variables. In this study, high compliance scale scores predicted significantly lower levels of blood pressure and blood pressure control. Moreover, high compliance scale scores at the baseline were significantly associated with blood pressure control at both baseline and at follow up in the two independent samples. This brief instrument provides a simple method for clinicians in various settings to use to assess patients' self reported compliance levels and to plan appropriate interventions.
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A total of 120 people (60 per group) were calculated to be needed to achieve 80% power to detect at least a 5-score (SD = 10) difference on the Hill-Bone Compliance to High Blood Pressure Scale using a two-sided T test at 5% significance.
“We calculated that a total of 120 people (60 in each group) would be needed to achieve a power of 80 (1−β) to detect at least a 5-score (SD = 10) difference on the Hill-Bone Compliance to High Blood Pressure Scale [24] using the two-sided T test at the significance level of 5% (α).”
From The effect of the mobile “blood pressure management application” on hypertension self-management enhancement: a randomized controlled trial (2021) · cites this paper as [24]
Indirect methods, including patient self-report medication adherence assessment tools such as the Morisky Medication Adherence Scale and the Hill-Bone Compliance Scale, have demonstrated predictive validity in a variety of hypertensive populations and identify adherence risk factors that can be used to tailor messages targeting improved adherence.
“Indirect methods, including patient self-report medication adherence assessment tools such as the Morisky Medication Adherence Scale107 and the Hill-Bone Compliance Scale,108 have demonstrated predictive validity in a variety of hypertensive populations and identify adherence risk factors that can be used to tailor messages targeting improved adherence.”
From Resistant Hypertension: Detection, Evaluation, and Management: A Scientific Statement From the American Heart Association (2018) · cites this paper as [108]
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- Authors
- Kim, M. T., Hill, M. N., Bone, L. R., & Levine, D. M.
- Affiliations
- Johns Hopkins University (US)
- Corresponding author
- Kim, Miyong T.
- Venue
- Progress in Cardiovascular Nursing
- Publisher
- Wiley
- Published
- 2000-06
- Volume
- 15
- Issue
- 3
- Pages
- 90-96
- ISSN
- 0889-7204 (ISSN-L)
- 1751-7117
- OpenAlex
- W2020458018
- Cited by
- 514
- References
- 12
- Citations by year
- 2026: 33 · 2025: 35 · 2024: 32 · 2023: 54 · 2022: 36 · 2021: 47 · 2020: 37 · 2019: 32 · 2018: 22 · 2017: 17 · 2016: 17 · 2015: 16 · 2014: 19 · 2013: 18 · 2012: 14
- FWCI
- 1.41
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Progress in Cardiovascular Nursing (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5r01hl051111-04)
- National Heart, Lung, and Blood Institute (R01HL51111-02)
- National Institute of Nursing Research (R01NR004119)
- National Center for Research Resources (M01RR000052)
- Topics
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Social Sciences › Education › Health Education and Validation
- Keywords
- hypertension, medication adherence, sodium intake, appointment keeping, blood pressure control, scale development, content validity, internal consistency, predictive validity, low literacy, cultural sensitivity, self-reported behavior
- MeSH terms
- Adult, Black or African American, Factor Analysis, Statistical, Female, Humans, Hypertension, Male, Middle Aged, Patient Acceptance of Health Care, Patient Compliance, Poverty Areas, Psychometrics, Surveys and Questionnaires, Baltimore, Reproducibility of Results
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