Abstract
The Self-Efficacy Scale for Sun Protection consists of two correlated factors with three items each for Sunscreen Use and Avoidance. This study evaluated two crucial psychometric assumptions, factorial invariance and scale reliability, with a sample of adults (N = 1356) participating in a computer-tailored, population-based intervention study. A measure has factorial invariance when the model is the same across subgroups. Three levels of invariance were tested, from least to most restrictive: (1) Configural Invariance (nonzero factor loadings unconstrained); (2) Pattern Identity Invariance (equal factor loadings); and (3) Strong Factorial Invariance (equal factor loadings and measurement errors). Strong Factorial Invariance was a good fit for the model across seven grouping variables: age, education, ethnicity, gender, race, skin tone, and Stage of Change for Sun Protection. Internal consistency coefficient Alpha and factor rho scale reliability, respectively, were .84 and .86 for Sunscreen Use, .68 and .70 for Avoidance, and .78 and .78 for the global (total) scale. The psychometric evidence demonstrates strong empirical support that the scale is consistent, has internal validity, and can be used to assess population-based adult samples.
Highlights
Skin cancer is a widespread, growing, and costly public health problem
Assessments of factorial invariance and internal consistency suggest that the Self-Efficacy Scale for Sun Protection is a reliable and valid instrument and can be used across a full range of adult participants varying by age, educational level, skin tone, gender, ethnicity, race, and stage attributes
The highest level tested, Strong Factorial Invariance, required that factor loadings and error terms were equal across the subgroups
Summary
Nonmelanoma skin cancers, which include squamous cell carcinoma and basal cell carcinoma, are the most common malignancies in the United States, with approximately 3.5 million new cases diagnosed each year [1]. Less common, is the deadliest form of skin cancer. 60,000 people are diagnosed and about 8,600 people die from melanoma each year [2]. Skin cancer is the most common form of cancer in the United States, and incidence is increasing [1]. It results in significant potential years of life lost and billions of dollars in costs, including both medical costs and lost productivity costs [3, 4]
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