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Journal ArticleDOI

Validation evidence for Turkish adaptation of Champion's Health Belief Model Scales.

01 Nov 2004-Cancer Nursing (Cancer Nurs)-Vol. 27, Iss: 6, pp 491-498
TL;DR: Psychometric testing demonstrated satisfactory internal consistency and validity of the instrument for this group of women, and it can be used in planning and testing interventions to improve BSE beliefs and practice.
Abstract: Instruments using Health Belief Model constructs in breast cancer screening in previous studies were developed and tested by Champion for American women, and since then, these have been revised twice. Champion's Health Belief Model Scale (CHBMS) has been translated and tested in various studies in other countries and cultures. Also, the current study examined the validity and reliability of the Turkish adaptation of the CHBMS among Turkish women. The instrument was translated using a back-translation technique, which includes the use of a panel of experts and interpreters to translate the items from the source language to the target language and then back-translate them to the source language. The study was conducted in Ordu, a city in north Turkey. A total of 266 Turkish women aged 20 and older working as primary schoolteachers were included in the sample. Analyses included internal consistency, reliability, factor analysis, and known group techniques. After the analysis, 3 items from the Barriers domain, 1 from the Seriousness domain, and 2 from the Motivation domain were deleted from the original scale. So, the final Turkish version of the CHBMS (CHBMS-T) consisted of 36 items that were clustered into 6 subscales: susceptibility (3 items), seriousness (6 items), motivation (5 items), benefits of breast self-examination (BSE) (4 items), barriers to BSE (8 items), and confidence/self-efficacy of BSE (10 items). Internal consistency ranged from 0.69 to 0.83. Construct validity was supported by exploring the factor structure of the instrument using factor analysis and testing known-group techniques. Psychometric testing demonstrated satisfactory internal consistency and validity of the instrument for this group of women. It can be used in planning and testing interventions to improve BSE beliefs and practice.
Citations
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Journal ArticleDOI
TL;DR: The Health Belief Model Scale for Cervical Cancer and the Pap Smear Test was found to be a valid and reliable tool in assessing the women's health beliefs and help healthcare professionals to develop more effective cervical cancer screening programmes.
Abstract: guvenc g., akyuz a. & acikel c.h. (2011) Health Belief Model Scale for Cervical Cancer and Pap Smear Test: psychometric testing. Journal of Advanced Nursing 67(2), 428–437. Abstract Aim. This study is a report of the development and psychometric testing of the Health Belief Model Scale for Cervical Cancer and the Pap Smear Test. Background. While the Champion Health Belief Model scales have been tested extensively for breast cancer and screening for this, evaluation of these scales in explaining the beliefs of women with regard to cervical cancer and the Pap Smear Test has only received limited attention. Methods. This methodological research was carried out in Turkey in 2007. The data were collected with 237 randomly selected women who met the criteria for inclusion and agreed to participate in this study. The Champion Health Belief Model scales were translated into Turkish, adapted for cervical cancer, validated by professional experts, translated back into English and pilot-tested. Findings. Factor analysis yielded five factors: Pap smear benefits and health motivation, Pap smear barriers, seriousness, susceptibility and health motivation. Cronbach’s alpha reliability coefficients for the five subscales ranged from 0·62 to 0·86, and test–retest reliability coefficients ranged from 0·79 to 0·87 for the subscales. Conclusion. The Health Belief Model Scale for Cervical Cancer and the Pap Smear Test was found to be a valid and reliable tool in assessing the women’s health beliefs. Understanding the beliefs of women in respect of cervical cancer and the Pap Smear Test will help healthcare professionals to develop more effective cervical cancer screening programmes.

179 citations

Journal ArticleDOI
TL;DR: It is indicated that perceived barriers and perceived self-efficacy could be predictors of BSE behavior among the sample of women and BSE training programs that emphasize self-efficiency and address perceived barriers are recommended.
Abstract: Background Iranian women, many of whom live in small cities, have limited access to mammography and clinical breast examinations. Thus, breast self examination (BSE) becomes an important and necessary approach to detecting this disease in its early stages in order to limit its resultant morbidity and mortality. This study examined constructs arising from the Health Belief Model as predictors of breast self examination behavior in a sample of women living in Bandar Abbas, Iran.

144 citations


Cites background or methods or result from "Validation evidence for Turkish ada..."

  • ...This result is in contrast to what was reported in a study among Turkish women regarding perceived benefits; this study concluded that women who perceived more benefits in relation breast self examination, were more likely to engage in the behavior [15]....

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  • ...A woman who performs regular BSE may be more motivated to seek medical attention, including mammography and clinical breast exams if available [15,16]....

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  • ...This model has been widely used to examine beliefs related to breast cancer screening behaviors such as BSE [14-18]....

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  • ...Although there is controversy surrounding the efficacy of BSE in countries where mammography and clinical breast exams are readily available [15], elsewhere BSE remains a costeffective method to detect breast cancer....

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  • ...Understanding women's beliefs regarding BSE can be used to design appropriate educational interventions which promote this screening behavior [3,14-16,19,24]....

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Journal ArticleDOI
TL;DR: Higher health motivation, higher perceived self-efficacy of BSE, marital status, and familial breast cancer history were significantly associated with breast cancer screening behaviors in a sample of Turkish women.

133 citations


Cites background or methods from "Validation evidence for Turkish ada..."

  • ...Recent studies show that Turkish women did not adopt early diagnosis practices at desired level despite attempts made by the Ministry of Health to improve awareness of early detection of breast cancer (Gözüm and Aydın, 2004; Sec-ginli and Nahc- ıvan, 2006; Karayurt and Dramalı, 2007)....

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  • ...Studies in Turkey have reported levels of BSE practice that range from 27% to 39% (Aydın, 2004; Bahar and Özsoy, 1995; Bahar et al., 1997; Demirhan et al., 2002; Gözüm and Aydın, 2004; Öztürk et al., 2000)....

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  • ...…studying beliefs related to cancer screening practices utilize the Health Belief Model (HBM) as a theoretical framework to study breast cancer screening behavior such as BSE or mammography screening (Champion, 1993; Dündar et al., 2006; Gözüm and Aydın, 2004; Lee et al., 2002; Wu and Yu, 2003)....

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  • ...Despite the known efficacy of breast cancer screening behaviors in reducing mortality, research findings indicate that such screening behaviors remain low in Turkey as well as other global areas (Aydın, 2004; Bahar et al., 1997; C- avdar et al., 2003; Demirhan et al., 2002; Gözüm and Aydın, 2004; Karayurt and Dramalı, 2007; Öztürk et al., 2000; Petro-Nustus and Mikhail, 2002; Rashidi and Rajaram, 2000; Sec-ginli, 2002; Zincir, 1999)....

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  • ...Many investigators studying beliefs related to cancer screening practices utilize the Health Belief Model (HBM) as a theoretical framework to study breast cancer screening behavior such as BSE or mammography screening (Champion, 1993; Dündar et al., 2006; Gözüm and Aydın, 2004; Lee et al., 2002; Wu and Yu, 2003)....

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Journal ArticleDOI
TL;DR: HBM was shown as a valid tool to predict BSE practice among Saudi women, and working women and those with family history of BC, higher perceived confidence and lower perceived barriers on HBM, andThose with high level of knowledge on BC were more likely to perform BSE.
Abstract: In the Kingdom of Saudi Arabia, breast cancer (BC) usually presents at advanced stages and more frequently in young pre-menopausal women in comparison to western countries. There is controversy surrounding the efficacy of breast self examination (BSE) for early detection of BC in countries where other methods are available. This study aims to explore the perception towards breast cancer and towards BSE among Saudi women, using the Health Belief Model (HBM). A convenient sample of adult Saudi female employees, working at King Abdulaziz Medical City, Riyadh, Saudi Arabia (n = 225), and their non-working adult female family members (n = 208), were subjected to the Arabic version of revised Champion’s Health Belief Model Scale (CHBMS) and the Arabic version of Breast Cancer Awareness Measure (CAM), to assess their knowledge and attitude on BC respectively. Percentage mean score (PMS) for each HBM domain was calculated. Significant predictors of BSE practice were identified using logistic regression analysis and significance was considered at p < 0.05. The majority of women heard about BSE (91.2 %), only 41.6 % reported ever practicing BSE and 21 % performed it regularly. Reported reasons for not doing BSE were: not knowing how to examine their breast (54.9 %), or untrusting themselves able to do it (24.5 %). Women were less knowledgeable about BC in general, its risk factors, warning signs, nature and screening measures (PMS:54.2 %, 44.5 %, 61.4 %, 53.2 %, 57.6 % respectively). They reported low scores of; perceived susceptibility, seriousness, confidence and barriers (PMS: 44.8 %, 55.6 %, 56.5 % & 41.7 % respectively), and high scores of perceived benefits and motivation (PMS: 73 % & 73.2 % respectively) to perform BSE. Significant predictors of BSE performance were: levels of perceived barriers (p = 0.046) and perceived confidence (p = 0.001) to BSE, overall knowledge on BC (p < 0.001), work status (p = 0.032) and family history of BC (p = 0.011). Saudi women had poor knowledge on BC, reported negative attitude towards BSE and their practice was poor. Working women and those with family history of BC, higher perceived confidence and lower perceived barriers on HBM, and those with high level of knowledge on BC were more likely to perform BSE. Breast awareness as an alternative to BSE needs further investigations. HBM was shown as a valid tool to predict BSE practice among Saudi women.

121 citations


Cites background from "Validation evidence for Turkish ada..."

  • ...health motivation, BSE benefits, BSE self-efficacy and low perceptions of barrier and perceived susceptibility to breast cancer demonstrate increased levels of BSE status [18, 53, 54]....

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References
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Journal ArticleDOI

2,050 citations


"Validation evidence for Turkish ada..." refers background in this paper

  • ...30 between an item and subscale score and (b) no decrease in the coefficient if the item was deleted.(16,23,24) All items met these criterions except 6 items....

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Journal ArticleDOI
TL;DR: Research was conducted to develop valid and reliable scales to test the Health Belief Model, and the dependent variable chosen for scale development was frequency of breast self-examination.
Abstract: Research was conducted to develop valid and reliable scales to test the Health Belief Model (HBM). The dependent variable chosen for scale development was frequency of breast self-examination. Independent variables were constructs related to the HBM: susceptibility, seriousness, benefits, barriers, and health motivation. Analyses for construct validity and theory testing included factor analysis and multiple regression. Chronbach Alpha and Pearson r were used to compute reliabilities. Scales that were judged valid and reliable were susceptibility, seriousness, benefits, barriers, and health motivation.

656 citations


"Validation evidence for Turkish ada..." refers methods in this paper

  • ...On the basis of the HBM, Champion developed and revised the CHBMS associated with breast cancer, mammography, and BSE.(8,12,13,19) The purpose of this study was to translate and adapt Champion’s last revised HBM scales to the Turkish language, and test it to measure Turkish women’s beliefs about breast cancer and BSE....

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Journal ArticleDOI
TL;DR: The purpose of this research was to revise scales measuring perceived susceptibility to breast cancer and perceived benefits and barriers to mammography utilization and these scales represent an improvement in those previously reported.
Abstract: The purpose of this research was to revise scales measuring perceived susceptibility to breast cancer and perceived benefits and barriers to mammography utilization. A total of 618 women age 50 and over who were enrolled in a large intervention study participated in data collection. Scales were revised beginning with focus group input. Analyses included internal consistency reliability, test-retest reliability, factor analysis, confirmatory analysis, and known groups techniques to test construct validity. Internal consistency ranged from .75 to .88, and test reliabilities from .59 to .72. Construct validity was confirmed with exploratory and confirmatory factor analyses, as well as known group techniques. Overall these scales represent an improvement in those previously reported.

469 citations


"Validation evidence for Turkish ada..." refers background or methods or result in this paper

  • ...69) is lower than in the last revision of Champion’s scale.(13) Champion reported that the SUS subscale showed a slight decrease in internal consistency reliability with only 3 items....

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  • ...Similarly, all the items except some items in each of the barriers to BSE, seriousness, and MOT subscales clustered together as the originals.(8,12,13) Four items loaded different dimensions....

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  • ...So, the purpose of this study was to asses the reliability and validity of the last revised CHBMS to measure Turkish women’s beliefs about breast cancer screening.(8,12,13)...

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  • ...In this study, the investigators translated the last version of CHBMS into Turkish and adapted and tested it for measuring beliefs about breast cancer and BSE.(8,12,13) The reliability coefficients obtained in this study except for the benefits (BEN) subscale of BSE and the MOT subscale were lower than for Champion’s scales(8,12,13) but had accepted alpha coefficients....

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  • ...In the construct with 6 factors, all the items in each of the confidence/self-efficacy of BSE, BSE benefits, and SUS subscales clustered together as in Champion’s instruments.(8,12,13) Similarly, all the items except some items in each of the barriers to BSE, seriousness, and MOT subscales clustered together as the originals....

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Journal ArticleDOI
TL;DR: An instrument to measure the Health Belief Model concepts of susceptibility, seriousness, benefits, barriers, health motivation, and confidence, using the context of breast cancer and breast self-examination is refined.
Abstract: The purpose of this study was to refine an instrument to measure the Health Belief Model concepts of susceptibility, seriousness, benefits, barriers, health motivation, and confidence, using the context of breast cancer and breast self-examination. A Likert format was used for attitudinal scales. A random sample (N = 581) of women 35 years and over was included. Items were subjected to content analysis by national experts. Construct validity was established using exploratory factor analysis. Predictive validity was established by relating breast self-examination behavior to breast self-examination attitudes, using simultaneous multiple regression and bivariate correlations. Cronbach alpha reliability coefficients for the revised scales ranged from .80 to .93. Test-retest correlations ranged from .45 to .70.

411 citations


"Validation evidence for Turkish ada..." refers background or methods in this paper

  • ...The original scales were tested and found to be valid and reliable in measuring BSE practices and breast cancer beliefs.(8,12,13) On the basis of the HBM, Champion developed and revised the CHBMS associated with breast cancer, mammography, and BSE....

    [...]

  • ...Instruments using HBM constructs in breast cancer screening in previous studies were developed for and tested with American women, and these were revised twice, in 1997 and 1999.(8,12,13) The CHBMS has also been translated and tested in various studies in other countries and cultures, such as Jordanian women,(9) Korean women,(11) African American women,(12,14) and Chinese American women....

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  • ...On the basis of the HBM, Champion developed and revised the CHBMS associated with breast cancer, mammography, and BSE.(8,12,13,19) The purpose of this study was to translate and adapt Champion’s last revised HBM scales to the Turkish language, and test it to measure Turkish women’s beliefs about breast cancer and BSE....

    [...]

  • ...In this study, the investigators translated the last version of CHBMS into Turkish and adapted and tested it for measuring beliefs about breast cancer and BSE.(8,12,13) The reliability coefficients obtained in this study except for the benefits (BEN) subscale of BSE and the MOT subscale were lower than for Champion’s scales(8,12,13) but had accepted alpha coefficients....

    [...]

  • ...In the construct with 6 factors, all the items in each of the confidence/self-efficacy of BSE, BSE benefits, and SUS subscales clustered together as in Champion’s instruments.(8,12,13) Similarly, all the items except some items in each of the barriers to BSE, seriousness, and MOT subscales clustered together as the originals....

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Journal ArticleDOI
TL;DR: Important considerations in conducting translation for equivalences, types of equivalence, and strategies to translate instruments that promote equivalence and how to test the translated version for equivalence are described.
Abstract: Cross-cultural influences affect perceptions and health practices, which are 2 areas of nursing concern. Culturally sensitive assessment instruments are needed, but many challenges exist in obtaining valid and reliable measurement. Translating questionnaires for cross-cultural research is fraught with methodological pitfalls related to colloquial phrases, jargon, idiomatic expressions, word clarity, and word meanings. It cannot be assumed that a particular concept has the same relevance across cultures. Simply translating an English version word-for-word into another language is not adequate to account for linguistic and cultural differences. Ideally, the perspectives of people from the culture about the concept of interest should be studied first, but often a practical alternative is to find and translate a tool developed in another culture. The purpose of this article is to describe important considerations in conducting translation for equivalence, types of equivalence, and strategies to translate instruments that promote equivalence and how to test the translated version for equivalence. These concepts and strategies are illustrated by describing the translation process of Hilton's Uncertainty Stress Scale into French and the use and testing of the French version with a French Canadian sample in Skrutkowski's study of perceived uncertainty in adult survivors of cancer.

353 citations