Cancer Screening Belief Scale – Chinese Version (CSBS-C)

Validation on Scale Psychometric Properties Among a Chinese Worksite Population

Abstract

Objective: To develop and validate a culturally sensitive scale measuring cancer screening beliefs for Chinese; and to examine the validity and reliability of the scores of the new instrument (CSBS-C). Methods: A modified instrument measuring cancer screening beliefs in general was developed, adapting from the previous Cervical Smear Belief Inventory (CSBI) developed by Hou and Luh (2005) among Chinese women, and tested among a Chinese worksite population in Taiwan. Items consisted in the CSBS-C were carefully reworded from Hou’s previously validated CSBI to reflect statements that would apply to cancer screening beliefs in general. Participants were asked to complete the self-administered screening belief items at baseline and one month follow-up (follow-up rate = 81%). Structural equation modeling (SEM) was used to assess the stability of the scores of the three-factor scale measured over time. Confirmatory factor analysis (CFA) was then used to validate these hypothesized theoretical constructs (factors). Results: SEM analysis revealed that the standardized coefficients of the three factors measured over time ranged from .30 to .75, indicating reasonable stabilities, and all three models revealed acceptable model fits (RMSEA=.06 ~ .09; GFI=.90~.99; IFI=.92~.99; TLI=.89~.97; and CFI=.92~.99). The final version of the CSBS-C, validated by CFA, consisted of 17 items that were clustered into three subscales: pros (eight items), cons (six items), and perceived cancer risks (three items); with all items loaded consistently and significantly with their corresponding factors (p<.001). Internal consistency ranged from 0.72 to 0.90. Conclusion: Evidence showed that psychometric properties of the CSBS-C demonstrated satisfactory reliability and validity. The instrument with its side-by-side English-Chinese comparison provides researchers and practitioners a valuable tool to reach Chinese population in a culturally sensitive and linguistically appropriate way.