# Telephone Administration of the Human Activity Profile Questionnaire in Patients With Cardiovascular Disease: Methodological Study

## TL;DR

This study shows that the HAP questionnaire can be reliably administered by phone to assess cardiovascular patients' functional capacity.

## Contribution

Validates telephone administration of the HAP questionnaire for cardiovascular disease patients, a novel remote assessment method.

## Key findings

- Telephone-administered HAP showed high reliability and strong agreement with face-to-face administration.
- Internal consistency was excellent (Cronbach α=0.919) and test-retest reliability was high for both MAS and AAS.

## Abstract

The Human Activity Profile (HAP) questionnaire is widely used to assess functional capacity in patients with chronic diseases. However, its remote administration via telephone has not been validated in individuals with cardiovascular disease (CVD), despite the increasing need for accessible assessment methods, particularly in contexts involving mobility limitations or reduced access to in-person care.

We aimed to validate administration of the HAP questionnaire via telephone in patients with CVD who were participating in a cardiovascular rehabilitation program.

This methodological study included 56 patients with CVD (36/56, 64% men; mean age 75.14, SD 10.28 years). Participants completed the HAP twice, once face-to-face and once by telephone, with a 3- to 14-day interval. Maximum activity score (MAS) and adjusted activity score (AAS) were analyzed. Internal consistency was assessed using Cronbach α, test-retest reliability was assessed using intraclass correlation coefficients (ICCs), and agreement between modalities was assessed using Bland-Altman plots. Paired comparisons between modes were performed using mean differences (MDs) and P values.

MAS values did not differ significantly between face-to-face and telephone administration (mean 79.11, SD 11.48 vs mean 82.71, SD 7.48; MD –3.61; P=.10). AAS values showed a similar pattern (mean 69.11, SD 14.18 vs mean 71.21, SD 13.43; MD –2.11; P=.05). Internal consistency was excellent (Cronbach α=0.919), and reliability was high (ICC=0.794 for MAS; ICC=0.910 for AAS). Bland-Altman analyses demonstrated acceptable limits of agreement for MAS (–19.3 to 12.1) and AAS (–17.6 to 13.4), with no systematic bias.

The HAP questionnaire administered by telephone demonstrates high reliability, excellent internal consistency, and strong agreement with face-to-face application. Telephone-based administration represents a valid, practical, and accessible alternative for assessing functional capacity in patients with cardiovascular disease, particularly when in-person evaluations are not feasible.