Validation of a BCAM (Breast Cancer Awareness Measure) tool for women and midwives in Niger

Abstract

BackgroundBreast cancer is the first cause of cancer mortality in Niger. The objective of this study was to assess the internal consistency, validity and acceptability of the Breast Cancer Awareness Measure (BCAM) among women and midwives. MethodsWe conducted the study in the Niamey and Zinder regions of Niger. Multistage random sampling was used to select the women. All midwives working in the selected health districts were interviewed. Item analysis was used to assess acceptability and needed adaptations, the ‘known group method’ was used to assess construct validity, and internal consistency was assessed using Cronbach’s alpha. ResultsIn total, 675 women, 93 midwives and 25 specialists (gynaecologists, surgeons, and oncologists) participated in the survey. The average age of the women respondents is 39.2 years, the average age of the midwives is 38.6 years, and that of the specialists is 44.1 years; 72 % (62.2–80.1 %) of midwives who participated in the survey are clinical midwives, while 8.6 % (4.4–16.1 %) are heads of service. The average number of working years is 13.6 (11.7–15.6). The women and midwives found the questionnaire to be acceptable. Cronbach’s alpha has shown an admissible level of internal consistency. It ranges from 0.67 (0.63–0.71) to 0.85 (0.83–0.86) for women but is lower for midwives 0.63 (0.51–0.73). We found a significant knowledge gap among the women, who know significantly less than the midwives, who know less than the specialists, supporting the construct validity of the BCAM. ConclusionThe BCAM was found to be an acceptable, reliable and valid tool when applied to women and midwives in Niger. Nevertheless, it requires some refining to better suit some social and contextual factors.