Ovarian and cervical cancer awareness: development of two validated measurement tools

Abstract

BackgroundThe aim of the study was to develop and validate measures of awareness of symptoms and risk factors for ovarian and cervical cancer (Ovarian and Cervical Cancer Awareness Measures).MethodsPotentially relevant items were extracted from the literature and generated by experts. Four validation studies were carried out to establish reliability and validity. Women aged 21–67 years (n=146) and ovarian and cervical cancer experts (n=32) were included in the studies. Internal reliability was assessed psychometrically. Test-retest reliability was assessed over a 1-week interval. To establish construct validity, Cancer Awareness Measure (CAM) scores of cancer experts were compared with equally well-educated comparison groups. Sensitivity to change was tested by randomly assigning participants to read either a leaflet giving information about ovarian/cervical cancer or a leaflet with control information, and then completing the ovarian/cervical CAM.ResultsInternal reliability (Cronbach's α=0.88 for the ovarian CAM and α=0.84 for the cervical CAM) and test-retest reliability (r=0.84 and r=0.77 for the ovarian and cervical CAMs, respectively) were both high. Validity was demonstrated with cancer experts achieving higher scores than controls [ovarian CAM: t(36)= –5.6, p<0.001; cervical CAM: t(38)= –3.7, p=0.001], and volunteers who were randomised to read a cancer leaflet scored higher than those who received a control leaflet [ovarian CAM: t(49)=7.5, p<0.001; cervical CAM: t(48)= –5.5, p<0.001].ConclusionsThis study demonstrates the psychometric properties of the ovarian and cervical CAMs and supports their utility in assessing ovarian and cervical cancer awareness in the general population.

Increasing Awareness of Gynecological Cancer Symptoms and Reducing Barriers to Medical Help Seeking: Does Health Literacy Play a Role?

“…Research is ongoing to explore the levels of gynecological cancer awareness in the U.K. female population (e.g., Low et al, in press;Simon et al, 2012), and this study adds to our knowledge. At baseline, women were able to recognize fewer than six symptoms of gynecological cancer and cited at least three barriers to medical help seeking.…”

Ovarian cancer symptom awareness and anticipated time to help-seeking for symptoms among UK women

“…Synovate does not record the number of people approached in order to fulfill quota samples.] Respondents were interviewed for approximately 15 minutes using the Ovarian Cancer Awareness Measure (Ovarian CAM) 16. The Ovarian CAM is a site-specific version of the generic Cancer Awareness Measure 17.…”

Statistical methods used in the development of a health measurement scale

“…A health measurement scale is a tool designed for a particular purpose: to quantify some attitude (say ‘acceptability’ of sterilisation), or to screen for those with a high-risk status (say, practising unsafe sex) in order to offer them additional counselling, or to assess cancer knowledge (as in the Simon et al1 article).Any such tool needs to be fit for purpose or, preferably, best for purpose 2. The main statistical methods available for application in psychometric work have subtly differing objectives, and they are couched in terms of concepts such as reliability, validity and ‘responsiveness to change’.…”

“…In the Simon et al study1 what was to be assessed was ‘public awareness of ovarian and cervical cancer’. An initial stage (and sample) to refine a pool of items was not required, since the health aspect being measured is knowledge about ovarian and cervical cancer, and the scale being developed is an adaptation of an existing generic Cancer Awareness Measure (CAM).…”

“…Various psychometric statistical methods have been used in a paper by Simon et al1 in this issue of the Journal. These notes are intended to provide some additional explanation of the methods employed in developing a health measurement scale.…”