Development, piloting and validation of the Recommending Cardiac Rehabilitation (ReCaRe) instrument Academic Article uri icon


  • BACKGROUND:Health practitioners' values, attitudes and beliefs largely determine their referrals to cardiac rehabilitation (CR). OBJECTIVE:To develop and test the Recommending Cardiac Rehabilitation scale (ReCaRe), designed to assess health professionals attitudes, values and beliefs to CR referral. METHODS:ReCaRe was appraised for: content validity (Delphi method, expert panel); interpretability and face validity (interview, health professionals); factor structure and internal consistency (survey, health professionals); and test-retest reliability (survey, health professionals). Normative scores were collated. RESULTS:ReCaRe initially comprised 75 items. Initially, a Content Validity Index (CVI) was calculated for ratings of item relevance (CVI range; 0.27-1.0), which resulted in the removal of 19 items. After preliminary validation and psychometric testing, 34 items were factor-analysed (n = 24) providing a 17-item, four-factor scale: perceived severity and susceptibility (α = 0.93, κ = 0.37); perceived service accessibility (α = 0.91, κ = 0.67); perceived benefit (α = 0.97, κ = 0.47); perceived barriers and attitudes (α = 0.82, κ = 0.49). ReCaRe normative scores (n = 75) are reported. CONCLUSIONS:This psychometric analysis found ReCaRe to demonstrate good face validity, internal consistency and fair to substantial test-retest reliability. The next step is to validate these initial findings on a larger sample size to confirm whether ReCaRe can enable identification of factors impacting CR referral.


  • Ski, CF
  • Jones, Martin
  • Astley, C
  • Neubeck, L
  • Thompson, DR
  • Gallagher, R
  • Du, H
  • Clark, RA

publication date

  • 2019