Psychometric Properties of the Iranian version of Champion’s Revised Health Belief Scale for Breast Cancer screening Model

Alireza Didarloo, Masoumeh Akhgar, Fatemeh Moghaddam-Tabrizi, Rasool Gharaaghaji, Siamak Sheikhi

Abstract


Background: Women’s beliefs regarding breast cancer and its screening approaches were considered antecedents of their behavioral changes. Understanding of these beliefs in women requires a valid and reliable instrument. The present study seeks to translate the English version of the Champion’s Revised Health Belief Model Scale (CRHBMS) into the Persian language and assess its psychometric properties.

Materials and Methods: The study was conducted on 334 students at Urmia University of Medical Sciences, Iran, 2016. The 57‑item CRHBMS was translated to Persian language, back translated, and tested. To test the face and content validity of the Persian version; item analysis, Content Validity Ratio (CVR), and Content Validity Index (CVI) were applied, respectively. Construct validity of the Persian scale was performed by Exploratory and Confirmatory Factor Analyses (EFA, CFA) using Kaiser‑Meyer‑Olkin and Bartlett’s tests in SPSS 16 and LISREL8.72 software. The reliability of the translated scale was evaluated using Cronbach’s alpha and test‑retest approaches.

Results: In the EFA, eight factors were extracted concerning breast cancer screening, and each item was loaded on its specific factor. These factors were self‑efficacy, health motivation, benefits‑mammography, benefits‑Breast Self‑Examination (BSE), barriers‑mammography, barriers‑BSE, susceptibility, and severity. The final 42‑item scale was confirmed by the CFA, and all goodness of fit indices showed a proper fit of the model. Cronbach’s alpha coefficient and test‑retest correlation of the subscales ranged from 0.72–0.89 and 0.67–0.93, respectively.

Conclusions: The study suggests that the Persian version of CRHBMS is a feasible scale for evaluating women’s health beliefs regarding breast cancer and its screening behaviors.


Keywords


Breast cancer screening, champion health belief model, Iran, Persian, psychometrics

Full Text:

PDF

References


Berek JS, Novak E, ed. Berek and Novak's gynecology: Female Genital Disease. Philadelphia, PA: Williams & Wilkins, Lippincott; 2012.

Mousavi SM, Gouya MM, Ramazani R, Davanlou M, Hajsadeghi N, Seddighi Z. Cancer incidence and mortality in Iran. Ann Oncol 2009;20:556 63.

Mehrabani D, Tabei TS, Heydari ST, Shamsina S, Shokrpour N, Amini M, et al. Cancer occurrence in Fars Province, Southern Iran. Iran Red Cres Med J 2008;10:314 22.

Hosseinzadeh M, Eivazi Ziaei J, Mahdavi N, Aghajari P, Vahidi M, Alaviehe F, et al. Risk Factors for breast cancer in Iranian women: A hospital based case control study in Tabriz, Iran. J Breast Cancer 2014;17:236 43.

Taymoori P, Berry T. The validity and reliability of Champion’s Health Belief Model Scale for breast cancer screening behaviors among Iranian women. Cancer Nurs 2009;32:465 72.

Montazeri A, Ebrahimi M, Mehrdad N, Ansari M, Sajadin A. Delayed presentation in breast cancer: A study in Iranian women. BMC Womens Health 2003;7:4.

Knight JA, Bernstein L, Largent J, Capanu M, Begg CB, Mellemkjaer L, et al. Alcohol intake and cigarette smoking and risk of a contralateral breast cancer: The women’s environmental cancer and radiation epidemiology study. Am J Epidemiol 2009;169:962 8.

Beji NK, Reis N. Risk factors for breast cancer in Turkish women: A hospital based case control study. Eur J Cancer Care (Engl) 2007;16:178 84.

Mahouri K, Dehghani Zahedani M, Zare S. Breast cancer risk factors in south of Islamic Republic of Iran: A case control study. East Mediterr Health J 2007;13:1265 73.

Didarloo A, Nabilou B, Khalkhali HR. Psychosocial predictors of breast self examination behavior among female students: An application of the health belief model using logistic regression. BMC Public Health 2017;17:861.

Montazri A, Vahdaninia M, Harirchi I, Harirchi AM, Sajadian A, Khaleghi F, et al. Breast cancer in Iran: Need for greater women awareness of warning signs and effective screening methods. Asia Pac Fam Med 2008;7:6.

Didarloo A, Shojaeizadeh D, Gharaaghaji Asl R, Niknami S, Khorami A. Psychosocial correlates of dietary behavior in type 2 diabetic women, using a behavior change theory. J Health Popul Nutr 2014;32:335 41.

Menon U, Champion V, Monahan PO. Health belief model variables as predictors of progression in stage of mammography adoption. Am J Health Promot 2007;21:255 61.

Avci IA. Factors associated with breast self examination practices and beliefs in female workers at a Muslim community. Eur J Oncol Nurs 2008;12:127 33.

Hochbaum GM. Public Participation in Medical Screening Programs: A Socio Psychological Study (Public Health Services Publication No. 572). Washington, DC: Government Printing Office; 1958.

Champion VL. Instrument development for health belief model constructs. Adv Nurs Sci 1984;6:73 85.

Champion LA. Instrument refinement for breast cancer screening behaviors. Nurs Res 1993;42:139 43.

Champion LA, Scott CR. Reliability and validity of breast cancer screening belief scales in African American women. Nurs Res 1997;46:331 7.

Champion LA. Revised susceptibility, benefits and barriers scale for mammography screening. Res Nurs Health 1999;22:341 8.

Parsa P, Kandiah M, Mohd Nasi MT, Hejar AR, Nor Afiah MZ. Reliability and validity of Champion’s Health Belief Model Scale for breast cancer screening among Malaysian women. Singapore Med J 2008;49:897 903.

Juárez García DM, Valenciano Salas IA, de Jesús García Solís M, Téllez A. Development and validation of a mexican version of the Champion’s Health Belief Model Scale for breast cancer screening. J Cancer Educ 2019. p. 1 6. doi: 10.1007/ s13187 019 01603 5.

Huaman MA, Kamimura Nishimura KI, Kanamori M, Siu A, Lescano AG. Validation of a susceptibility, benefits, and barrier scale for mammography screening among Peruvian women: A cross sectional study. BMC Womens Health 2011;11:54.

Hashemian M, Amin Shokravi F, Lamyian M, Hassanpour K, Akaberi A. Reliability and validity of the Champion’s Health Belief Model Scale for mammography among Iranian women with family history of breast cancer. HEHP 2013;1:19 31.

Hair J, Anderson R, Wiliam C, Black Barry J. Multivariate data analysis. New Jersey: Prentice Hall Inc.; 1995a.

Comrey AL. A First Course in Factor Analysis. New York: Academic Press; 1973.

Brisling RW. The wording and translation of research instruments. In: Loner WJ, Berry JW, editors. Field Methods in Cross Cultural Research. Beverly Hills, CA: Sage; 1986. p. 134 64.

Mousazadeh S, Rakhshan M, Mohammadi F. Investigation of content and face validity and reliability of sociocultural attitude towards appearance questionnaire 3 (SATAQ 3) among female adolescents. Iran J Psychiatry 2017;12:15 20.

Lawshe CH. The quantitative approach to content validity. Pers Psychol 1975;28:563 75.

Habibzadeh H, Jafarizadeh H, Didarloo A. Determinants of failure to thrive (FTT) among infants aged 6 24 months: A case control study. J Prev Med Hyg 2015;56:E180 6.

Polit DF, Beck CT. The content validity index: Are you sure you know what’s being reported? Critique and recommendations. Res Nurs Health 2006;29:489 97.

Tabachnick BG, Fidell LS. Principal Components and Factor Analysis Using Multivariate Statistics. 5th ed. Boston MA: Allyn & Bacon; 2007.

Vodanovich JS, Wallance CJ, Kass SJ. A confirmatory approach to the factor structure of the boredom proneness scale: Evidence for a two factor short form. J Pers Assess 2005;85:295 303.

Kline BR. Principals of Structural Equation Modeling. 2nd ed. New York: Guilford; 2005.

Tabachnick GB, Fidell SL. Using Multivariate Statistics. 5th ed. Boston: Pearson; 2007.

Buyukozturk S. Data Analysis Handbook for Social Sciences, 16th ed. Ankara: Pegem Publishing, Cantekin Printing House; 2012.

Eymen UE. SPSS 15.0 Data analysis: Publication of statistics center. Available from: http://www.istatistikmerkezi. Com.

[Last accessed on 2012 May 25].

Qozum S, Aydin I. Validation evidence for Turkish adoption of Champion’s Health Belief Model Scales. Cancer Nurs 2004;27:491 8.

Lee EH, Kim JS, Song MS. Translation and validation of Champion’s Health Belief Model Scale with Korean women. Cancer Nurs 2002;25:391 5.

Vietri V, Poskitt S, Slaninka SC. Enhancing breast cancer screening in the university setting. Cancer Nurs 1997;20:323 9.

Mikhail BI, Petro Nustas WI. Transcultural adaptation of Champion’s Health Belief Model Scale. J Nurs Scholarsh 2001;33:159 65.

Meleis A, Meleis M. Egyptian Americans. In: Purnell LD, Paulanka BJ, editors. Transcultural Health Care. A Culturally Competent Approach. Philadelphia: FA Davis; 1998. p. 217 43.

Secginli S, Nahcivan NO. Reliability and validity of the breast cancer screening belief scale among Turkish women. Cancer Nurs 2004;27:1 9.

Champion V, Menon U. Predicting mammography and breast self examination in African American women. Cancer Nurs 1997;20:315 22.

Yilmaz M, Yazici Sayin Y. Turkish translation and adaptation of Champion’s Health Belief Model Scales for breast cancer mammography screening. J Clin Nurs 2013;23:1978 89.

Wu TY, Yu MY. Reliability and validity of the mammography screening beliefs questionnaire among Chinese American women. Cancer Nurs 2003;26:131 42.

Champion VL, Monahan PO, Springston JK, Russell K, Zollinger TW, Saywell RM, et al. Measuring mammography and breast cancer beliefs in African American women. J Health Psychol 2008;13:827 37.

Medina Shepherd R, Kleier JA. Spanish translation and adaptation of Victoria Champion’s Health Belief Model Scales for breast cancer screening mammography. Cancer Nurs 2010;33:3 101.


Refbacks

  • There are currently no refbacks.