Development, piloting and validation of the Recommending Cardiac Rehabilitation (ReCaRe) instrument

Chantal F. Ski, Martin Jones, Carolyn Astley, Lis Neubeck, David R. Thompson, Robyn Gallagher, Huiyun Du, Robyn A. Clark

Research output: Contribution to journalArticle

1 Citation (Scopus)


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.

Original languageEnglish
Pages (from-to)405-413
Number of pages9
JournalHeart and Lung
Issue number5
Publication statusPublished - 1 Sep 2019


  • Cardiac rehabilitation
  • Psychometrics
  • Referral
  • Scale development

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Ski, C. F., Jones, M., Astley, C., Neubeck, L., Thompson, D. R., Gallagher, R., ... Clark, R. A. (2019). Development, piloting and validation of the Recommending Cardiac Rehabilitation (ReCaRe) instrument. Heart and Lung, 48(5), 405-413.