We aimed to examine the psychometric properties of a modified 16-item Attitudinal Index (AI), a measure of health beliefs in health prevention screenings among Chinese older adults. We used the 2013 Shanghai Longitudinal Survey of Elderly Life and Opinion data including 3418 respondents aged 60 and above. We examined the validity and reliability of the modified AI. Psychometric evaluation of the modified AI revealed good response patterns. The overall scale had good reliability (Cronbach’s alpha = 0.835) with four distinct dimensions: barriers, fatalism, unnecessary, and detects (Cronbach’s alpha = 0.815 to 0.908). Confirmatory factor analysis of the modified AI’s factor structure verified its 4-factor solution (CFI = 0.913, SRMR = 0.048, RMSEA=0.051). The validity and reliability of the modified AI support its cultural appropriateness in measuring health beliefs among Chinese older adults. Further psychometric evaluation should focus on testing concurrent and criterion validity