Questionnaire Validation of Colorectal Cancer Literacy Scale among Thai People in Northeastern Thailand

BACKGROUND: Colorectal cancer is an important public health problem worldwide. Although progress in screening and treatment has considerably improved the prognosis in the developed world, in developing countries colorectal cancer mortality rate remains relatively high. Colorectal cancer screening literacy is an important initial step in overcoming this problem. Development of a validated assessment instrument is therefore important for implementation of appropriate health education programs to facilitate early detection. OBJECTIVES: This study focused on generation and validation of a colorectal cancer screening literacy scale for Thai people in northeastern Thailand. METHODS: This methodological study was carried out in two phases: (1) literature reviews and semi-structured interviews were used to select items, then the content and face validity were checked; and (2) a confirmatory factor analysis (CFA) was conducted to test construct validity and reliability. A self-administered questionnaire was used to collect data from Thai people aged 50-65 in June 2017. RESULTS: For the total of 400 participants who responded (response rate 100 %), the age ranged from 50 to 65 years old (mean = 57.3, SD = 4.616). The colorectal cancer screening literacy scale was designed to include 6 domains and it was shown to have good internal consistency, and CFA demonstrated the model to fit data adequately (Chi-squared/degree of freedom = 1.079, p = 0.061, CFI = 1.00, GFI = 0.93, AGFI = 0.91, RMSEA = 0.014 and SRMR = 0.036). The final version of its, consisting of 57 items across the 6 domains covering key aspects of colorectal cancer screening literacy, demonstrated good psychometric properties for this population. CONCLUSIONS: Use of the colorectal cancer screening literacy scale in Thai people could lead to improved educational programs for optimizing colorectal cancer screening.