The compensatory health beliefs scale: psychometric properties of a cross-culturally adapted scale for use in The Netherlands

This study assesses the psychometric properties of a measuring scale for compensatory health beliefs (CHBs), culturally adapted for use in the Dutch context. CHBs refer to the idea that people can compensate for unhealthy (mostly pleasant) behaviours with healthy behaviours, e.g. 'It is OK to eat a chocolate bar, because I am going to the gym tonight'. We are critical towards such beliefs as they may also be an excuse to justify unhealthy behaviours. Before such effects can be studied, an appropriate tool to measure CHBs must be developed. We adapted a Canadian scale, consisting of four factors relating to beliefs about substance use, eating/sleeping habits, stress and weight regulation, translating it according to guidelines for cross-cultural adaptation and testing it among 145 Dutch students. Factor analysis showed that the structure was not entirely identical in the Dutch context, and the internal consistency of the four subscales was also low. The overall scale showed a high internal consistency (alpha = 0.78), indicating the existence of an underlying construct, and a high Pearson correlation between the first and second measurements (r = 0.82), showing good stability. We recommend using the overall scale and further studying its reliability among other subgroups as well as its validity.