Validation of a susceptibility, benefits, and barrier scale for mammography screening among Peruvian women: a cross-sectional study

Abstract

BackgroundPerceived beliefs about breast cancer and breast cancer screening are important predictors for mammography utilization. This study adapted and validated the Champion's scale in Peru. This scale measures perceived susceptibility for breast cancer and perceived benefits and barriers for mammography.MethodsA cross-sectional study was conducted among women ages 40 to 65 attending outpatient gynecology services in a public hospital in Peru. A group of experts developed and pre-tested a Spanish version of the Champion's scale to assess its comprehensibility (N = 20). Factor analysis, internal consistency, and test-retest reliability analyses were performed (N = 285). Concurrent validity compared scores from participants who had a mammogram and those who did not have it in the previous 15 months. T-test and multiple regression analysis adjusting for socio-demographic factors, mammography knowledge and other preventive behaviors were performed.ResultsThe construct validity and reliability were optimal. Cronbach-Alpha coefficients were 0.75 (susceptibility), 0.72 (benefits) and 0.86 (barriers). Concurrent validity analysis showed an association between barriers and mammography screening use in bivariate (22.3 ± 6.7 vs. 30.2 ± 7.6; p < 0.001) and multiple regression analysis (OR = 0.28, 95% CI = 0.18-0.43). Ages 50-60 years (OR = 2.35, 95% CI = 1.19-4.65), history of prior Papanicolaou test (OR = 3.69, 95% CI = 1.84-7.40), and knowledge about breast cancer and mammography (OR = 3.69, 95% CI = 1.84-7.40) were also independently associated with mammography screening use.ConclusionConcurrent validity analysis showed that the Champion's scale has important limitations for assessing perceived susceptibility for breast cancer and perceived benefits for mammography among Peruvian women. There is still a need for developing valid and reliable instruments for measuring perceived beliefs about breast cancer and mammography screening among Peruvian women.

Maltese Translation and Adaptation of Champion’s Health Belief Model Scale and the Revised Illness Perception Questionnaire for Breast Screening Among Maltese Women

“…(Table 1). Such a result in excess of 0.80 shows high internal consistency (reliability) (Huaman, Kamimura-Nishimura, Kanamori, Siu & Lescano, 2011 …”

“…Champion developed and validated a scale in 1984 (Champion's Health Belief Model Scale -CHBMS), consisting of 36 items to measure perceived susceptibility to breast cancer, as well as perceived benefits and barriers to BS (Champion, 1984). In 1999, Champion revised CHBMS for Mammography Screening (CHBMS-MS), excluding the breast self-examination used in the original studies, showing significant correlation between mammography compliance and high scores in the susceptibility and benefit subscales, whereas perceived barriers were associated with lower screening compliance (Huaman, Kamimura-Nishimura, Kanamori, Siu & Lescano, 2011).…”

“…Items were answered on a five-point Likert scale ranging from 1 (strongly disagree) to 5 (strongly agree), similarly used in other studies (Yilmaz & Sayin, 2014;Huaman, Kamimura-Nishimura, Kanamori, Siu & Lescano, 2011).…”

“…Test-retest scores for each dimension were computed for the Maltese and English measures respectively using Pearson's correlations at both time points (T1, T2) for an estimation of reliability over time. Test-retest reliability refers to the correlation coefficient which should be at least 0.6 (Buyukozturk, 2012;Balci, 2011;Huaman, Kamimura-Nishimura, Kanamori, Siu & Lescano, 2011;Tekindal, 2009). Construct validity, a measure that confirms the Translation and adaptation of scales for breast screening among Maltese women 11 extent to which inferences can be made from scale scores in relation to the latent, theoretical construct of interest (Pruitt et al, 2010), was supported through Pearson's correlations to test the associations between subscales for each measure.…”

“…In particular, studies have demonstrated that beliefs about breast cancer and screening (Huaman, Kamimura-Nishimura, Kanamori, Siu & Lescano, 2011) as well as illness perceptions are important predictors of mammography compliance (ibid).…”