Adapting a Cancer Literacy Measure for Use Among Navajo Women

Abstract

Purpose The authors designed a community-based participatory research study to develop and test a family-based behavioral intervention to improve cancer literacy and promote mammography among Navajo women. Methods Using data from focus groups and discussions with a community advisory committee, they adapted an existing questionnaire to assess cancer knowledge, barriers to mammography, and cancer beliefs for use among Navajo women. Questions measuring health literacy, numeracy, self-efficacy, cancer communication, and family support were also adapted. Results The resulting questionnaire was found to have good content validity, and to be culturally and linguistically appropriate for use among Navajo women. Conclusions It is important to consider culture and not just language when adapting existing measures for use with AI/AN populations. English-language versions of existing literacy measures may not be culturally appropriate for AI/AN populations, which could lead to a lack of semantic, technical, idiomatic, and conceptual equivalence, resulting in misinterpretation of study outcomes.

Andersen’s Behavioral Model to Identify Correlates of Breast Cancer Screening Behaviors among Indigenous Women

“…In contrast to our findings, other researchers have found evidence suggesting that traditionality may hinder participation in cancer screening (Canales et al, 2007;Solomon & Gottlieb, 1999;Yost et al, 2017). For example, Canales et al (2007), in their study with 115 Indigenous women in Vermont, reported an inverse relationship between traditionality (e.g., traditional Indian healer use) and mammogram screening.…”

Essential Qualitative Inquiry in the Development of a Cancer Literacy Measure for Immigrant Women

“…The resulting measure contains 129 items, including items measuring demographic variables, cancer history, screening behaviors, interactions with the health care system, experiences with interpreters, and beliefs, attitudes, emotions, and knowledge related to breast and cervical cancer. The measure has since been adapted for use with African American, Navajo, and Uruguayan women (Buki & Reich, 2011; Mayfield, 2012; Yost et al, 2016). A copy of the measure is available by request from Dr. Buki.…”

Development and Evaluation of a Cancer Literacy Intervention to Promote Mammography Screening Among Navajo Women: A Pilot Study

“…Home-based interviews were conducted in (written or oral) English, Navajo, or both. 9 Measures were adapted from English to Navajo with translations reviewed by the CAC and tested in focus groups. 9 Assessments included sociodemographics, a measure of BC literacy adapted by the research team 9 and open-ended questions about intervention helpfulness, and likes/dislikes.…”

“…The Navajo BC literacy measure, 15 administered at baseline for both participants and support persons, and among participants again at 3-months, measured: (1) mammography barriers, (2) cancer beliefs, (3) cancer knowledge, (4) health literacy, (5) numeracy, (6) self-efficacy, (7) cancer communication, (8) and family support for screening. 9…”

“…Despite home-based education visits, 60% (900) remain unscreened. Through Mayo Clinic and Diné College's 13-year-partnership, 8,9 we collaborated with a Community Advisory Committee (CAC) and NNBCCPP to develop and evaluate a mammography intervention incorporating Navajo language/ culture and social cognitive theory. 10…”