Abstract A22: New instrument to measure functional breast cancer literacy

Abstract

Abstract A critical undertaking in designing research interventions that study effective ways to reduce health disparities among racial/ethnic and underserved women is to have instruments that are linguistically and culturally appropriate. Traditionally, when instruments are developed, even those that are used in health disparities, they have been normed using Caucasians and then used with other populations. We were funded by the National Institutes of Health, National Institute of Nursing Research to use traditional rigors of psychometric methods in the context of a community-based participatory research intervention to validate cancer literacy assessment tools (CLAT) that measure a woman's functional understanding of breast and cervical cancer in English, Spanish, and Arabic. With a sample size of 543 women, the reliability, factor structure, validity of the Breast Cancer Literacy Assessment Tool (BCLAT) was determined by exploratory and confirmatory factor analysis. We examined differential item functioning (DIF) with nonparametric IRT Multiple regression was used to identify variables predictive of performance on the BCLAT. Results: A confirmatory factor analysis (CFA), using a 2-parameter IRT model, had a good fit (CFI = .81, RMSEA = .05) to the proposed three factor structure. Maximum likelihood exploratory factor analysis of tetrachoric correlations and examination of scree plots also indicated a 3-factor solution. No items were eliminated as a result of the DIF analysis. The three scales, Awareness, Screening, and Prevention/Control, were moderately difficult with 63%, 62%, and 68% correct, respectively, with internal consistency reliability of .53, .62, and .63, respectively. The scales were only weakly inter-correlated (r's < .40). The total scale reliability was .70. Income, education and self-rated health were positively associated with Awareness but not related to Screening or Prevention/Control. Age was positively associated with Prevention/Control. Seventy seven participants were in a family with a history of breast cancer. This was associated with higher scores on Screening and Prevention/Control. Having friends with a history of breast cancer was unrelated to any of the BCLAT scales. The BCLAT scales have demonstrated internal consistency reliability and validity in this multiethnic community based sample. Even when implementing the Kin KeeperSM Cancer Prevention Intervention to deliver cancer education to Black, Latina and Arab women as the context in which we validated our cancer literacy assessment tools, we were still able to adhere to the rigorous of psychometric testing. Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):A22.