Development and validation of the Health Belief Scale for Sarcopenia Prevention and Management (HBSPM): a pilot study among older adults in Guangdong, China

The prevalence of sarcopenia among older adults is rising annually, highlighting the importance of enhancing awareness and self-management in sarcopenia prevention as a critical public health priority. This study aimed to develop and validate the Health Belief Scale for Sarcopenia Prevention and Management (HBSPM) in older adults and to assess its reliability and validity. This study was conducted in two phases. Guided by the Health Belief Model (HBM), the HBSPM was developed through a comprehensive literature review, expert consultation, and cognitive interviews. In May 2024, 701 older adults were recruited through stratified convenience sampling across from cities classified into three tiers according to their 2023 GDP levels in Guangdong Province. The validity of the HBSPM was assessed using item analysis, exploratory factor analysis (EFA), and confirmatory factor analysis (CFA). The scale consists of 30 items across six dimensions: Susceptibility (5 items), Seriousness (6 items), Benefits (4 items), Barriers (5 items), Cues for Action (5 items), and Self-Efficacy (5 items). EFA revealed that these six factors accounted for 60.42% of the total variance. Factor loadings for the 30 items ranged from 0.615 to 0.759. The scale demonstrated good validity (χ²/df = 1.466, RMSEA = 0.045, TLI = 0.965, IFI = 0.961, NFI = 0.897, CFI = 0.965, GFI = 0.852, I-CVI > 0.86, S-CVI = 0.989) and reliability (Cronbach’s alpha = 0.935). This study demonstrates that the HBSPM is an effective tool for measuring health belief regarding sarcopenia prevention and management among older adults and provides a robust foundation for targeted health education and behavioral interventions.