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http://dx.doi.org/10.4040/jkan.2015.45.1.129

Cross-cultural Validation of Instruments Measuring Health Beliefs about Colorectal Cancer Screening among Korean Americans  

Lee, Shin-Young (Department of Nursing, Chosun University)
Lee, Eunice E. (School of Nursing, University of California)
Publication Information
Journal of Korean Academy of Nursing / v.45, no.1, 2015 , pp. 129-138 More about this Journal
Abstract
Purpose: The purpose of this study was to report the instrument modification and validation processes to make existing health belief model scales culturally appropriate for Korean Americans (KAs) regarding colorectal cancer (CRC) screening utilization. Methods: Instrument translation, individual interviews using cognitive interviewing, and expert reviews were conducted during the instrument modification phase, and a pilot test and a cross-sectional survey were conducted during the instrument validation phase. Data analyses of the cross-sectional survey included internal consistency and construct validity using exploratory and confirmatory factor analysis. Results: The main issues identified during the instrument modification phase were (a) cultural and linguistic translation issues and (b) newly developed items reflecting Korean cultural barriers. Cross-sectional survey analyses during the instrument validation phase revealed that all scales demonstrate good internal consistency reliability (Cronbach's alpha=.72~.88). Exploratory factor analysis showed that susceptibility and severity loaded on the same factor, which may indicate a threat variable. Items with low factor loadings in the confirmatory factor analysis may relate to (a) lack of knowledge about fecal occult blood testing and (b) multiple dimensions of the subscales. Conclusion: Methodological, sequential processes of instrument modification and validation, including translation, individual interviews, expert reviews, pilot testing and a cross-sectional survey, were provided in this study. The findings indicate that existing instruments need to be examined for CRC screening research involving KAs.
Keywords
Colorectal cancer; Screening; Korean Americans; Beliefs; Instruments;
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1 van de Vijver FJR, Leung K. Methods and data analysis for cross-cultural research. Thousand Oaks, CA: SAGE Publications; 1997.
2 Willis GB. Cognitive interviewing: A tool for improving questionnaire design. Thousand Oaks, CA: SAGE Publications; 2005.
3 Maxwell AE, Bastani R, Warda US. Demographic predictors of cancer screening among Filipino and Korean immigrants in the United States. American Journal of Preventive Medicine. 2000;18(1):62-68. http://dx.doi.org/10.1016/S0749-3797(99)00110-5   DOI   ScienceOn
4 Ullman JB. Structural equation modeling. In: Tabachnick BG, Fidell LS, editors. Using multivariate statistics. 4th ed. Boston, MA: Allyn & Bacon; 2001. p. 653-771.
5 SPSS Inc. SPSS 18.0 for windows. Chicago, IL: Author; 2009.
6 United States Census Bureau. Place of birth by citizenship status. Universe: Total population 2006-2010 American Community Survey selected population tables Washington, DC: Author; 2010 [cited 2013 February 21]. Available from: http://factfinder.census.gov/faces/tableservices/ jsf/pages/productview.xhtml?pid=ACS_10_SF4_B05002&prodType=table.
7 Lee SY, Lee EE. Korean Americans' beliefs about colorectal cancer screening. Asian Nursing Research. 2013;7(2):45-52. http://dx.doi.org/10.1016/j.anr.2012.10.001   DOI   ScienceOn
8 Polit DF, Beck CT. The content validity index: Are you sure you know what's being reported? Critique and recommendations. Research in Nursing and Health. 2006;29(5):489-497. http://dx.doi.org/10.1002/nur.20147   DOI   ScienceOn
9 Arbuckle JL. AMOS 18: User's guide. Chicago, IL: SPSS Inc.; 2009.
10 Nunnally JC. Psychometric theory. 2nd ed. New York, NY: McGraw Hill; 1978.
11 DeVellis RF. Scale development: Theory and applications. Newbury Park, CA: SAGE Publications; 1991.
12 Chan YK. Privacy in the family: Its hierarchical and asymmetric nature. Journal of Comparative Family Studies. 2000;31(1):1-17.
13 Beaton DE, Bombardier C, Guillemin F, Ferraz MB. Guidelines for the process of cross-cultural adaptation of self-report measures. Spine. 2000;25(24):3186-3191.   DOI   ScienceOn
14 Champion VL. Revised susceptibility, benefits, and barriers scale for mammography screening. Research in Nursing and Health. 1999;22(4): 341-348.   DOI   ScienceOn
15 Kandula NR, Wen M, Jacobs EA, Lauderdale DS. Low rates of colorectal, cervical, and breast cancer screening in Asian Americans compared with non-Hispanic whites: Cultural influences or access to care? Cancer. 2006;107(1):184-192. http://dx.doi.org/10.1002/cncr.21968   DOI   ScienceOn
16 Lee SH, Ham EM. The relationship between the optimistic bias about cancer and cancer preventive behavior of the Korean, Chinese, American, and Japanese adult residing in Korea. Journal of Korean Academy of Nursing. 2010;40(1):52-59. http://dx.doi.org/10.4040/jkan.2010.40.1.52   DOI   ScienceOn
17 Champion VL. Development of a benefits and barriers scale for mammography utilization. Cancer Nursing. 1995;18(1):53-59.
18 Rawl S, Champion V, Menon U, Loehrer PJ, Vance GH, Skinner CS. Validation of scales to measure benefits of and barriers to colorectal cancer screening. Journal of Psychosocial Oncology. 2001;19(3-4): 47-63. http://dx.doi.org/10.1300/J077v19n03_05   DOI
19 American Cancer Society. Colorectal cancer facts & figures 2014-2016. Atlanta, GA: Author; 2014.
20 Gomez SL, Noone AM, Lichtensztajn DY, Scoppa S, Gibson JT, Liu L, et al. Cancer incidence trends among Asian American populations in the United States, 1990-2008. Journal of the National Cancer Institute. 2013;105(15):1096-1110. http://dx.doi.org/10.1093/jnci/djt157   DOI   ScienceOn
21 Lee HY, Lundquist M, Ju E, Luo X, Townsend A. Colorectal cancer screening disparities in Asian Americans and Pacific Islanders: Which groups are most vulnerable? Ethnicity and Health. 2011;16(6):501-518. http://dx.doi.org/10.1080/13557858.2011.575219   DOI
22 Maxwell AE, Crespi CM. Trends in colorectal cancer screening utilization among ethnic groups in California: Are we closing the gap? Cancer Epidemiology, Biomarkers and Prevention. 2009;18(3):752-759. http://dx.doi.org/10.1158/1055-9965.epi-08-0608   DOI   ScienceOn
23 Lee EE, Fogg L, Menon U. Knowledge and beliefs related to cervical cancer and screening among Korean American women. Western Journal of Nursing Research. 2008;30(8):960-974. http://dx.doi.org/10.1177/0193945908319250   DOI
24 Lee HY, Im H. Colorectal cancer screening among Korean American immigrants: Unraveling the influence of culture. Journal of Health Care for the Poor and Underserved. 2013;24(2):579-598. http://dx.doi.org/10.1353/hpu.2013.0087   DOI   ScienceOn
25 Jo AM, Maxwell AE, Wong WK, Bastani R. Colorectal cancer screening among underserved Korean Americans in Los Angeles County. Journal of Immigrant and Minority Health. 2008;10(2):119-126. http://dx.doi.org/10.1007/s10903-007-9066-6   DOI
26 Sanders Thompson VL. Cultural context and modification of behavior change theory. Health Education and Behavior. 2009;36(5 Suppl):156S-160S.   DOI   ScienceOn
27 Becker MH, editor. The health belief model and personal health behavior. Thorofare, NJ: C. B. Slack; 1974.
28 Kline RB. Principles and practice of structural equation modeling. 2nd ed. New York, NY: Guilford; 2005.
29 Menon U, Champion VL, Larkin GN, Zollinger TW, Gerde PM, Vernon SW. Beliefs associated with fecal occult blood test and colonoscopy use at a worksite colon cancer screening program. Journal of Occupational and Environmental Medicine. 2003;45(8):891-898. http://dx.doi.org/10.1097/01.jom.0000083038.56116.30   DOI   ScienceOn
30 Champion VL. Instrument refinement for breast cancer screening behaviors. Nursing Research. 1993;42(3):139-143.