See the published version of this preprint at Health and Quality of Life Outcomes.
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Research
Shambhu Prasad Adhikari
Kathmandu University
Corresponding Author
ORCiD: https://orcid.org/0000-0002-2635-6844
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Background: The Exercise Adherence Rating Scale (EARS) is a commonly used outcome tool, which helps to identify the adherence rate of exercises and reasons for adherence and non-adherence. There is no evidence of the availability of any measurement tools to assess exercise adherence in the Nepalese context and cultural background. Therefore, we conducted a cross-cultural adaptation of the EARS into the Nepali language and investigated its reliability and validity.
Methods: Cross-cultural adaptation of the EARS was done based on Beaton guidelines. Psychometric properties were evaluated among 18 participants aged 18 years or older with pre-diabetes or confirmed diagnosis of any disease who were prescribed with home exercises by physiotherapists. Any disease that limited participants from doing exercise and individuals unwilling to participate were excluded. Reliability was evaluated through internal consistency, using Cronbach’s alpha. Exploratory Factor Analysis (EFA) was performed to explore construct validity and confirm its unidimensionality. Receiver Operating Characteristic (ROC) curve was analyzed to identify cut-off score, sensitivity and specificity of the tool.
Results: The Cronbach’s alpha was 0.94 for EARS-adherence behavior. The EFA of 6-items adherence behavior revealed the presence of one factor with an eigenvalue exceeding one. The scree-plot suggested for extraction of only one factor with strong loading (75.84%). The Area Under the Curve was 0.91 with 95% confidence interval 0.77 to 1.00 at p = 0.004. The cutoff score was found 17.5 with 89% sensitivity and 78% specificity.
Conclusions: The EARS was cross-culturally adapted to the Nepali language. The reliability and construct validity of the Nepali version of the EARS were acceptable to assess exercise adherence in Nepali-speaking individuals. This validated tool might facilitate the evaluation of exercise-related interventions. Future studies could investigate other psychometric properties of the Nepali EARS.
Keywords
Cross-cultural adaptation, Exercise Adherence Rating Scale, reliability, validity
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Peer Review Timeline
CURRENT STATUS: Published
View the published article at Health and Quality of Life Outcomes.
No community comments so far
Editorial decision: Accept
On 29 Sep, 2020
Review #2 received
Received 19 Sep, 2020
Reviewer #2 agreed
On 12 Sep, 2020
Reviewers invited
Invitations sent on 11 Sep, 2020
Reviewer #1 agreed
On 11 Sep, 2020
Review #1 received
Received 11 Sep, 2020
Editor assigned
On 12 Aug, 2020
Submission checks complete
On 11 Aug, 2020
Editor invited
On 11 Aug, 2020
Version 2
Posted 29 Jul, 2020
No comments provided
Editorial decision: Minor Revision
On 06 Aug, 2020
Review #1 received
Received 05 Aug, 2020
Review #2 received
Received 04 Aug, 2020
Reviewer #2 agreed
On 25 Jul, 2020
Editor assigned
On 23 Jul, 2020
Reviewers invited
Invitations sent on 23 Jul, 2020
Reviewer #1 agreed
On 23 Jul, 2020
Submission checks complete
On 22 Jul, 2020
Editor invited
On 22 Jul, 2020
No comments provided
Review #1 received
Received 15 Jul, 2020
Editorial decision: Major Revision
On 15 Jul, 2020
Review #4 received
Received 10 Jul, 2020
Review #3 received
Received 09 Jul, 2020
Review #2 received
Received 09 Jul, 2020
Reviewer #5 agreed
On 27 Jun, 2020
Reviewer #4 agreed
On 27 Jun, 2020
Reviewer #2 agreed
On 26 Jun, 2020
Reviewer #3 agreed
On 26 Jun, 2020
Reviewer #1 agreed
On 24 Jun, 2020
Reviewers invited
Invitations sent on 23 Jun, 2020
Editor assigned
On 26 May, 2020
Submission checks complete
On 25 May, 2020
Editor invited
On 25 May, 2020
First submitted
On 21 May, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Health Economics & Outcomes Research
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A new preprint design is coming!
We have improved readability, clarity, accessibility, and opportunities for engagement.
See the published version of this preprint at Health and Quality of Life Outcomes.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research
Shambhu Prasad Adhikari
Kathmandu University
Corresponding Author
ORCiD: https://orcid.org/0000-0002-2635-6844
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at Health and Quality of Life Outcomes.
No community comments so far
Editorial decision: Accept
On 29 Sep, 2020
Review #2 received
Received 19 Sep, 2020
Reviewer #2 agreed
On 12 Sep, 2020
Reviewers invited
Invitations sent on 11 Sep, 2020
Reviewer #1 agreed
On 11 Sep, 2020
Review #1 received
Received 11 Sep, 2020
Editor assigned
On 12 Aug, 2020
Submission checks complete
On 11 Aug, 2020
Editor invited
On 11 Aug, 2020
Version 2
Posted 29 Jul, 2020
No comments provided
Editorial decision: Minor Revision
On 06 Aug, 2020
Review #1 received
Received 05 Aug, 2020
Review #2 received
Received 04 Aug, 2020
Reviewer #2 agreed
On 25 Jul, 2020
Editor assigned
On 23 Jul, 2020
Reviewers invited
Invitations sent on 23 Jul, 2020
Reviewer #1 agreed
On 23 Jul, 2020
Submission checks complete
On 22 Jul, 2020
Editor invited
On 22 Jul, 2020
No comments provided
Review #1 received
Received 15 Jul, 2020
Editorial decision: Major Revision
On 15 Jul, 2020
Review #4 received
Received 10 Jul, 2020
Review #3 received
Received 09 Jul, 2020
Review #2 received
Received 09 Jul, 2020
Reviewer #5 agreed
On 27 Jun, 2020
Reviewer #4 agreed
On 27 Jun, 2020
Reviewer #2 agreed
On 26 Jun, 2020
Reviewer #3 agreed
On 26 Jun, 2020
Reviewer #1 agreed
On 24 Jun, 2020
Reviewers invited
Invitations sent on 23 Jun, 2020
Editor assigned
On 26 May, 2020
Submission checks complete
On 25 May, 2020
Editor invited
On 25 May, 2020
First submitted
On 21 May, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Health Economics & Outcomes Research
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at Health and Quality of Life Outcomes.
Background: The Exercise Adherence Rating Scale (EARS) is a commonly used outcome tool, which helps to identify the adherence rate of exercises and reasons for adherence and non-adherence. There is no evidence of the availability of any measurement tools to assess exercise adherence in the Nepalese context and cultural background. Therefore, we conducted a cross-cultural adaptation of the EARS into the Nepali language and investigated its reliability and validity.
Methods: Cross-cultural adaptation of the EARS was done based on Beaton guidelines. Psychometric properties were evaluated among 18 participants aged 18 years or older with pre-diabetes or confirmed diagnosis of any disease who were prescribed with home exercises by physiotherapists. Any disease that limited participants from doing exercise and individuals unwilling to participate were excluded. Reliability was evaluated through internal consistency, using Cronbach’s alpha. Exploratory Factor Analysis (EFA) was performed to explore construct validity and confirm its unidimensionality. Receiver Operating Characteristic (ROC) curve was analyzed to identify cut-off score, sensitivity and specificity of the tool.
Results: The Cronbach’s alpha was 0.94 for EARS-adherence behavior. The EFA of 6-items adherence behavior revealed the presence of one factor with an eigenvalue exceeding one. The scree-plot suggested for extraction of only one factor with strong loading (75.84%). The Area Under the Curve was 0.91 with 95% confidence interval 0.77 to 1.00 at p = 0.004. The cutoff score was found 17.5 with 89% sensitivity and 78% specificity.
Conclusions: The EARS was cross-culturally adapted to the Nepali language. The reliability and construct validity of the Nepali version of the EARS were acceptable to assess exercise adherence in Nepali-speaking individuals. This validated tool might facilitate the evaluation of exercise-related interventions. Future studies could investigate other psychometric properties of the Nepali EARS.
Figure 1
Figure 2
This is a list of supplementary files associated with this preprint. Click to download.
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