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Transcultural adaptation and validation of the Persian version of the breast cancer awareness measure (BCAM) questionnaire

BACKGROUND/OBJECTIVE: Enhancing awareness level about breast cancer is a pivotal strategy for reducing breast cancer burden. There is no fully validated Persian instrument for evaluating breast cancer awareness. This study aimed at investigating the validity and reliability of the Persian version of...

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Autores principales: Heidari, Zahra, Feizi, Awat
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6198204/
https://www.ncbi.nlm.nih.gov/pubmed/30152046
http://dx.doi.org/10.1002/cam4.1740
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author Heidari, Zahra
Feizi, Awat
author_facet Heidari, Zahra
Feizi, Awat
author_sort Heidari, Zahra
collection PubMed
description BACKGROUND/OBJECTIVE: Enhancing awareness level about breast cancer is a pivotal strategy for reducing breast cancer burden. There is no fully validated Persian instrument for evaluating breast cancer awareness. This study aimed at investigating the validity and reliability of the Persian version of the Breast Cancer Awareness Measure (BCAM) questionnaire. METHODS: This methodological cross‐sectional study was conducted among 1078 Persian language women (including 965 general women and 113 medical/clinical experts), which selected from different parts of Isfahan city using multistage cluster random sampling method. Translation of BCAM questionnaire was performed using forward‐backward method. Internal consistency was evaluated through Cronbach's α and test‐retest reliability using unweighted kappa statistic and intraclass correlation (ICC) coefficient. Construct validity was investigated using both exploratory and confirmatory factor analyses as well as Latent class analysis (LCA), and discriminant validity using ROC curve. Convergent validity was assessed using phi and eta correlation coefficients. Ceiling and floor effects, SE of measurement (SEM), and smallest detectable change (SDC) were also determined. RESULTS: Persian version of BCAM showed excellent test‐retest reliability (ICC = 0.841) and internal consistency (Cronbach's alpha = 0.882). Most of the computed kappa coefficients were in the range moderate to very good (0.47‐0.81). Medical/clinical experts had higher levels of breast cancer awareness than general women, indicating good discriminant validity (Area under the curve [AUC]) of 0.822 (95% CI: 0.781, 0.864). Construct validity evaluation by exploratory factor analysis (EFA) led to extraction of two factors from 11 items (“breast shape changes” and “breast pain and lump”), and the confirmatory factor analysis (CFA) confirmed the adequacy of extracted construct from EFA. Latent class analysis for evaluating of construct validity led to extracting three classes from participants (high [12.83%], moderate [60.97%], and low [26.2%]) in terms of awareness levels about early warning signs of breast cancer. All item‐scale correlation coefficients exceeded the set value of 0.40, indicating satisfactory convergent validity. No ceiling and floor effects were detected. SEM and SDC were found to be 0.85 and 2.36, respectively. CONCLUSIONS: The Persian version of BCAM is a reliable and valid instrument for monitoring levels of breast cancer awareness in general women population, also it can be used for evaluating the impacts of interventions attempting to raise breast cancer awareness.
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spelling pubmed-61982042018-10-31 Transcultural adaptation and validation of the Persian version of the breast cancer awareness measure (BCAM) questionnaire Heidari, Zahra Feizi, Awat Cancer Med Cancer Prevention BACKGROUND/OBJECTIVE: Enhancing awareness level about breast cancer is a pivotal strategy for reducing breast cancer burden. There is no fully validated Persian instrument for evaluating breast cancer awareness. This study aimed at investigating the validity and reliability of the Persian version of the Breast Cancer Awareness Measure (BCAM) questionnaire. METHODS: This methodological cross‐sectional study was conducted among 1078 Persian language women (including 965 general women and 113 medical/clinical experts), which selected from different parts of Isfahan city using multistage cluster random sampling method. Translation of BCAM questionnaire was performed using forward‐backward method. Internal consistency was evaluated through Cronbach's α and test‐retest reliability using unweighted kappa statistic and intraclass correlation (ICC) coefficient. Construct validity was investigated using both exploratory and confirmatory factor analyses as well as Latent class analysis (LCA), and discriminant validity using ROC curve. Convergent validity was assessed using phi and eta correlation coefficients. Ceiling and floor effects, SE of measurement (SEM), and smallest detectable change (SDC) were also determined. RESULTS: Persian version of BCAM showed excellent test‐retest reliability (ICC = 0.841) and internal consistency (Cronbach's alpha = 0.882). Most of the computed kappa coefficients were in the range moderate to very good (0.47‐0.81). Medical/clinical experts had higher levels of breast cancer awareness than general women, indicating good discriminant validity (Area under the curve [AUC]) of 0.822 (95% CI: 0.781, 0.864). Construct validity evaluation by exploratory factor analysis (EFA) led to extraction of two factors from 11 items (“breast shape changes” and “breast pain and lump”), and the confirmatory factor analysis (CFA) confirmed the adequacy of extracted construct from EFA. Latent class analysis for evaluating of construct validity led to extracting three classes from participants (high [12.83%], moderate [60.97%], and low [26.2%]) in terms of awareness levels about early warning signs of breast cancer. All item‐scale correlation coefficients exceeded the set value of 0.40, indicating satisfactory convergent validity. No ceiling and floor effects were detected. SEM and SDC were found to be 0.85 and 2.36, respectively. CONCLUSIONS: The Persian version of BCAM is a reliable and valid instrument for monitoring levels of breast cancer awareness in general women population, also it can be used for evaluating the impacts of interventions attempting to raise breast cancer awareness. John Wiley and Sons Inc. 2018-08-27 /pmc/articles/PMC6198204/ /pubmed/30152046 http://dx.doi.org/10.1002/cam4.1740 Text en © 2018 The Authors. Cancer Medicine published by John Wiley & Sons Ltd. This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Cancer Prevention
Heidari, Zahra
Feizi, Awat
Transcultural adaptation and validation of the Persian version of the breast cancer awareness measure (BCAM) questionnaire
title Transcultural adaptation and validation of the Persian version of the breast cancer awareness measure (BCAM) questionnaire
title_full Transcultural adaptation and validation of the Persian version of the breast cancer awareness measure (BCAM) questionnaire
title_fullStr Transcultural adaptation and validation of the Persian version of the breast cancer awareness measure (BCAM) questionnaire
title_full_unstemmed Transcultural adaptation and validation of the Persian version of the breast cancer awareness measure (BCAM) questionnaire
title_short Transcultural adaptation and validation of the Persian version of the breast cancer awareness measure (BCAM) questionnaire
title_sort transcultural adaptation and validation of the persian version of the breast cancer awareness measure (bcam) questionnaire
topic Cancer Prevention
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6198204/
https://www.ncbi.nlm.nih.gov/pubmed/30152046
http://dx.doi.org/10.1002/cam4.1740
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