Scottish People Research Articles

Learning a New Language, Taking up a New Culture: Language and Culture Differences between Scottish Highland and Lowland in the 18th Century Reflected in R. L. Stevenson’s Kidnapped

<p><em>R. L. Stevenson’s novel Kidnapped takes Scottish Jacobite rebellions as its background and reflects resistance of Scottish people under British rule in the first half of the 18th century. Though within the same Scottish nation, the two heroes, Lowland boy David and Highland rebel Alan, have shown sharp contrasts in languages, political stands, moral standards and cultural values. Their contrasts reveal the binary opposition of Lowland and Highland cultures in the 18th century and can be explained by Fanon’s theory about language and culture differences within the same nation. In Kidnapped, the Lowland characters despise their own native culture, and regard the Highlanders who still keep traditional Scottish culture and language as “savage”. Therefore, they reject their own native culture and language, and have to completely depend on the English language and culture. The main goal of this article is to illustrate that learning a language also means taking up a culture, and it is essential to cultivate cultural awareness for English language teaching and culture teaching for foreign languages learners.</em></p>

Associations among height, body mass index and intelligence from age 11 to age 78 years

BackgroundIntelligence is related to both height and body mass index (BMI) at various stages of life. Several studies have demonstrated longitudinal relationships between these measures, but none has established whether height and intelligence, or BMI and intelligence are linked from childhood through to older age.MethodsWe assessed the relations between these measures over an interval of up to 67 years using data from the 36-Day Sample, an initially-representative sample of Scottish people born in 1936, assessed at age 11 years (N = 6,291) and again at 77–78 years (N = 722). This paper focuses on the 423 participants (6.7 % of the original sample) who provided relevant data in late adulthood.ResultsHeight and intelligence were significantly positively associated in childhood (β = .23) and late adulthood (β = .21–.29). Longitudinal correlations also showed that childhood intelligence predicted late-adulthood height (β = .20), and childhood height predicted late-adulthood cognitive ability (β = .12–.14). We observed no significant relationship between BMI and intelligence either in childhood or in late adulthood, nor any longitudinal association between the two in this sample.ConclusionsOur results on height and intelligence are the first to demonstrate that their relationship spans almost seven decades, from childhood through to late adulthood, and they call for further investigation into the mechanisms underlying this lifelong association.Electronic supplementary materialThe online version of this article (doi:10.1186/s12877-016-0340-0) contains supplementary material, which is available to authorized users.

The SNP’s Conception of Scottish Society and Citizenship, 2007-2014

In a context where the Scottish National Party (SNP) has become the dominant party in Scotland, this article explores one aspect of the party’s ideology, namely its conception of Scottish society and citizenship, based on an analysis of the speeches made by Alex Salmond in the years 2007-2014, when he was both party leader and Scottish First Minister. The language of politics provides the focus for this article. Its purpose is threefold: first, to present the way in which the SNP named and labelled Scottish society in those pivotal years; second, to establish what these naming strategies revealed about the party’s conception of Scottish citizenship, nationalism and national identity; and third, to explain how this conception was made integral to its general political strategy and campaign for independence. The analysis shows that Scottish society and the Scottish people were portrayed in three, complementary ways: as the people who reside on the territory of Scotland, which is in keeping with the SNP’s “civic” nationalism and with its perception of Scottish citizenship as one that is based on residency rather than ancestry; as a “sovereign people” and as “the community of the realm of Scotland”, which bears testimony to the SNP’s exploitation of two powerful Scottish political myths; and as a social democratic society with a “shared sense of the common weal” which translates into support for universalist policies at odds with both Labour and the Conservatives’ policy choices. These visions of society and citizenship were all included in the SNP’s case for an independent social democratic Scottish State.

Negative stereotypes of the Scottish diet: A qualitative analysis of deep-fried Mars bar references in bestselling newspapers in Scotland, 2011–14

The Scottish diet is associated in the UK media and popular discourse with unhealthy deep-fried foods. In addition to the stereotype's negative effects on perceptions of Scottish food, culture and people, there is evidence that the stereotype of the Scottish diet has negative effects on food behaviour and public health in Scotland, having been shown to encourage consumption of deep-fried foods and discourage positive dietary change. The most notorious deep-fried food associated with Scotland is the deep-fried Mars bar (DFMB), arguably invented in Stonehaven (near Aberdeen), and first reported in the Scottish and UK press in 1995. This article reports findings from an analysis of newspaper references to the DFMB in the two highest selling newspapers in Scotland, the Scottish Sun and the Daily Record, between 2011 and 2014. A keyword search (“deep fried Mars bar”) using the online media database Lexis Library generated 97 unique records, and the resulting dataset was analysed thematically and discursively. Analysis showed that both newspapers clearly associated the DFMB with Scotland. Further, both newspapers portrayed the DFMB and the broader “deep-fried” Scottish diet stereotype ambivalently (mixed positive and negative associations). However, the Daily Record actively criticised the DFMB stereotype much more often than did the Scottish Sun. These findings suggest that the Scottish population encounters different messages in the press about food and nutrition from people elsewhere in the UK, and that these messages vary depending on choice of media in Scotland. Given the known negative effects of the stereotype, differences in Scottish media discourse should be considered a potential factor in persistent health inequalities affecting Scotland. Educational efforts, and opening discussion with journalists and amongst the Scottish public, may be helpful.

Unsettled Will : Cultural Engagement and Scottish Independence

The phrase ‘the settled will of the Scottish people’ was originally invoked by John Smith, leader of the Labour party from 1992 till his death in 1994, but it was used to counterbalance the ‘settled will’ of many Labour politicians in Scotland that devolution was a distraction from the main business of British politics, and likely to encourage rather than to nullify the appeal of the Scottish National Party. But what Cameron saw as a ‘settled will’ in Scotland in 2014 was to be radically challenged in the general election of May 2015, when the SNP won all but three seats in Scotland and Labour lost 40 of its 41 seats. Had the electorate decided to punish Labour for working with the Tories in the ‘Better Together’ campaign ? Or was an overwhelming majority for the SNP a signal that Scots had changed their minds, and now did want independence ? Or was it the psephological consequence of the 45 % who had voted ‘Yes’ committing to the SNP, while the 55 % who had voted ‘No’ were split across a variety of parties ? Was the overwhelming SNP majority a call for a second referendum, or was the ‘settled will’ of the majority still for the Union ?

It's All About People and Relationships: Scotland's person-centred health and care collaborative

Objectives: Raise the profile of person centred approaches to care Explain concept and approaches to person centred care in simplified terms and identify high impact interventions Focus on what we can do now Design reliable processes of care to ensure every person has the opportunity to personalise care Measurement framework to support and track improvment Promote the sharing of ideas and approaches Methods: Modified Breakthrough Series Improvement Collaborative. 90 day R&D process. Systematic national approach to improving care experience focusing on what really matters to the Scottish people as described by NHS Scotland's “7Cs”: 1. Caring and compassionate staff and services 2. Clear communication and explanation about conditions and treatments 3. Effective collaboration between clinicians patients and others 4. Clean and safe care environment 5. Continuity of care 6. Clinical excellence This Collaborative is unique in that, as far as we are aware, it is the first to take a national approach to using Improvement Science to develop person-centred approaches to care at scale. It will run initially until December 2015. Collaborative focus: 1. Comprehensive systematic approach to hearing the voice of the people who use services through a multi method, mutli trait methodology. 15th International Conference on Integrated Care, Edinburgh, UK, March 25-27, 2015 1 International Journal of Integrated Care – Volume 15, 27 May – URN:NBN:NL:UI:10-1-116982 – http://www.ijic.org/ 2. Specific focus on five core aspects of care experience called the5 Must do With Meelements (listed below). 1. What matters to you? Personal outcomes / goals focus 2. Who matters to you? Family/carer involvement 3. What information do you need? Clear and full information / health literacy interventions 4. Nothing about me without me. Relationship based care and support where involvement and collaboration is supported and encouraged 5. Service Flexibility. Method and timing of contact flexes according to need. Results: Prototyping and testing under way. Short-term indicators of engagement outputs/outcomes: Change package and measurement framework developed 100% of Scottish territorial health boards participating 4 Learning Sessions held reaching 2250 staff 50+ test teams identified across 14 boards Board re-alignment of governance to profile person-centredness Conclusion: Person centred approaches to care make the difference between good and great. This is the glue that holds everything together, the boosters that have the potential to take us to the next level of healthcare provision and performance. The patient experience is inextricably intertwined with safety and effectiveness4 This is a “must do” not a “nice to do” Take care to explicitly define scope of work This agenda aligns strongly with staff values of staff Disclosure of Interest: None Declared

“Every County had more or lesse the civill warre within it selfe”1: the realities of war in Lucy Hutchinson’s Midland shires

IntroductionAs a historian of her own times, Lucy Hutchinson was shrewd enough to acknowledge that the warfare which comprises a major part of the memoir of her husband Colonel John Hutchinson was not simply an English Civil War. When she dealt with the first reverberations of the conflict which was then about engulf her family, she wrote:about the yeare 1639 the thunder was heard afarre of ratling in the troubled ayre, and even the most obscured woods were penetrated with some flashes, the forerunners of the dreadfull storme which the next yeare was more apparent.In writing this Lucy dated the beginning of the fall of the Stuart monarchy to 1639 - the year of the first Bishop's War.2 No doubt she and John, who seem, according to her account of the period some two years later, to have read newsbooks and discussed contemporary affairs together, were well aware that the trouble had begun two tumultuous years preceding the almost farcical first war in the four nations. The warning signs had been there even earlier when Charles I stage-managed his belated Scottish coronation in a way which symbolically turned the clock back to before the early-fourteenth-century Declaration of Arbroath by openly giving precedence to officials of the Church of England over the men of the Kirk. Serious trouble had begun in 1637 when the attempt to introduce a new prayer book, based upon the English Book of Common Prayer, into Scotland had provoked violence. This policy had firstly caused riots, and then secondly inspired the drafting of, and even more importantly, the mass subscription to a National Covenant creating a bond between the Scottish people and God in defence of the Kirk against the king's aggression. The king's provocative reaction in not seeking a compromise and being openly aggressive had pushed the Scots further. By the summer of 1639 the storm Lucy had alluded to had actually been underway for some time: by then Scotland had formed a new political structure and an executive which had not only circumvented the king in church and state but was able to manage a war effort to challenge him militarily. Mutual aggression led to the first war in the British Isles since the Nine Years' War and was later named by the victors after the archbishop of Canterbury, William Laud and his fellow Episcopalians both sides of the border: as the Bishops' War.Lucy's broad vision was not limited to her understanding that the war which broke out in England in 1642 had origins which lay beyond England's border; like her contemporary fellow historian, the royalist politician Edward Hyde, Earl of Clarendon, she acknowledged that the war was an affair which absorbed the entirety of the British Isles. In her background narrative, Hutchinson spent some space in her text dealing with the three initial conflicts within the archipelagic-wide war which preceded the direct involvement of her husband and herself. The First Bishops' War of 1639 was brief and involved the English forces being chased ignominiously out of Scotland and a more serious fight between Scottish covenanters and anti-covenanters outside Aberdeen at the Bridge of Dee, which ironically occurred during the peace negotiations being held at Berwick upon Tweed. A second Bishops' War in 1640 was a more deadly and involved the Scottish Army of the Covenant invading England, defeating the king's forces and occupying northeast England for a year. The third war in the sequence sprang from the rebellion in Ireland which began on the night of 22 October 1641 and involved a rapidly developing crisis for the Dublin administration. An alternative national Irish government was established in Kilkenny which managed a structured war-effort that challenged armies sent from England, Wales and Scotland. It was this latter war which more than any other formed the backdrop to the Lucy and John's decision to throw themselves into the coming war against their king. The war in Ireland created an atmosphere of fear in Britain where the newly invigorated press and rapidly spreading rumours inspired a genuine fear that there was an imminent threat of an invasion by Roman Catholic forces from Ireland. …

Territorial Finance and the Future of Barnett

AbstractThis article traces the changing funding relationships between Scotland and the UK government. Beginning from the Barnett Formula, it examines how the changing support within Scotland for greater political autonomy from Westminster has influenced the mechanisms that have determined Scotland's fiscal structure. Increasing support for the SNP, and then for the Yes campaign in the September 2014 independence referendum, has led to a mixture of new powers being granted to the Scottish Parliament. The Scotland Act 2012 extends the Scottish government's control over income tax and some other small taxes. Although independence was rejected by the Scottish people in September 2014, the ‘Vow’ made by the Westminster parties immediately before the vote is leading to far‐reaching changes in the UK's fiscal structure. This will cause a very substantial change in intergovernmental relations within the UK, which the Barnett Formula may not survive.

Wayfaring Strangers: The Musical Voyage from Scotland and Ulster to Appalachia by Fiona Ritchie, Doug Orr (review)

Reviewed by: Wayfaring Strangers: The Musical Voyage from Scotland and Ulster to Appalachia by Fiona Ritchie, Doug Orr Kevin Kehrberg Wayfaring Strangers: The Musical Voyage from Scotland and Ulster to Appalachia. By Fiona Ritchie and Doug Orr. (Chapel Hill: University of North Carolina Press, 2014. Pp. ix, 361.) In Wayfaring Strangers, Fiona Ritchie and Doug Orr join forces to expand the account of Scottish people and music that migrated to the United States via the Ulster region of Ireland. Ritchie, a Scotland native, is host of NPR’s Celtic music program The Thistle & Shamrock. Orr is president emeritus of Warren Wilson College in Asheville, North Carolina, where he also founded the Swannanoa Gathering, a premier educational program of folk music and dance workshops held each summer. The book’s objective is a more complete story of Scots-Irish migration that grasps “the full scope of this exodus and the effects on its living soundtrack” (5). While a sizeable amount of literature—by both scholars and enthusiasts—exists concerning the Scots-Irish diaspora and its impact on America, the only recent author to place music as a focal point within this discourse is Michael Scoggins (2013). In Wayfaring Strangers, Ritchie and Orr divide their migration story into three discrete sections. “Beginnings” explores the vestiges of medieval troubadour and minstrel music as part of the distinct musical landscape that [End Page 94] existed in Scotland just before immigration to Ulster got underway in the seventeenth century. “Voyage” covers the experience of these immigrants, first to Ulster and then to America, and the ways in which their musicking alleviated hardship and separation, strengthened community, and memorialized place. Finally, “Singing a New Song” chronicles the contributions that the Scots-Irish made to American vernacular music as they settled in and around southern Appalachia and absorbed the traditional music of other groups in these areas. Aspects of presentation and structure also distinguish Wayfaring Strangers. Over thirty sidebars appear throughout, usually one to two pages, on everything from Robert Burns to Dolly Parton. In addition, there are fifty-five interview transcription excerpts sprinkled among the text. The interviewees, whom the authors call their “Voices of Tradition,” include Pete Seeger, Brian McNeill, Doc Watson, and many other decorated performers of Celtic or American traditional music. Some of these artists are also featured on a twenty-track CD included with the book. The book’s size (roughly 9 × 11 inches) resembles an art or photography book, and, indeed, it contains many rich and abundant images of maps, photographs, artwork, and illustrations. The back matter is supplemented with a glossary, contextual timeline, discography, profiles of the “Voices of Tradition,” a list of resource centers, and CD notes. In the prologue, Ritchie and Orr state that they “do not seek to offer a new angle on the historic backstory” of this topic (5). Rather, they aim to broaden the saga of Scots-Irish migration beyond the sixteenth to seventeenth centuries while telling it from a musical perspective. Thus, Wayfaring Strangers relies primarily on secondary sources to accomplish its goal, weaving them together into a new narrative fabric. Certain scholars may take issue with the book’s widespread use of the term “Appalachian music” as a label for the Scots-Irish musical legacy in America. In 2004, noted country music historian Bill C. Malone criticized the term’s ambiguity, declaring that “there is no such thing as ‘Appalachian music’” and arguing for a more polyvalent perspective that acknowledges a wide variety of instrumental and vocal styles performed by Appalachian musicians.* Ritchie and Orr do include healthy discussions on the contributions of African Americans and others to music in Appalachia, although some may still disagree with the book’s firm stance that the music of the Scots-Irish emigrants “undoubtedly formed the bedrock of Appalachian music” (213). Many of the sidebars and interview excerpts are compelling, offering direct input from legendary performers that carried American and Celtic traditional music through the twentieth century. They do disrupt the prose [End Page 95] at times, and certain sidebars repeat information that already appears in the text. Another drawback is the lack of a table of contents containing the section subheadings; readers must scan the...

Being Chinese or being Scottish: National identification and intergroup attitudes of British born Chinese children

This study explored the age differences in national identification, and intergroup attitudes among British born Chinese (BBC) living in Scotland. Participants comprised 70 children in three age groups (8, 11 and 14 years). The study included three tasks: task 1 investigated children's national self-categorization; task 2 examined children's national self-identification; task 3 explored children's perception of the positive and negative traits of Chinese and Scottish people across the age groups (using card-sorting tasks). The results indicated that BBC children identified their national identity as Scottish, however, it varied with age and national contexts. Most BBC children identified themselves as both Chinese and Scottish but they attributed significantly more positive traits to Chinese than to Scottish people and showed significantly more liking for Chinese people than Scottish. The study concludes that BBC children experience a dual identity in which different components are integrated.

Saving the Unity of Great Britain, Breaking the Unity of Greater Russia

The media compelled all of us to follow closely both the Scottish referendum of September 2014 and the conflict between Russia and Ukraine that took on increased momentum starting in spring 2014. We all heard two opposing stories: the unity of Great Britain must be protected in the interest of the English and Scottish people. Moreover, the Scots freely chose, through a democratic vote, to remain in the Union. In contrast, we were told that the independence of Ukraine, freely chosen by the Ukrainian people, is being threatened by the Great Russian expansionist aims of the dictator Putin. Let us look at these facts that were presented to us as incontrovertibly obvious for a good-faith observer.This article can also be found at the Monthly Review website, where most recent articles are published in full.Click here to purchase a PDF version of this article at the Monthly Review website.

Explaining ethnic inequalities in health in Scotland: a pilot study linking primary care to census data to account for ethnic variations in cardiovascular disease

BackgroundEthnic health inequality is striking. Quantifying this inequality is important. The Scottish Health and Ethnicity Linkage Study (SHELS) linked National Health Service hospital discharges and mortality to the 2001 Scottish Census. Our analyses adjusted for age, country of birth, and socioeconomic status. However, the understanding of the role of other risk factors is crucial. The aim of this project was to explore the feasibility and value of linking risk factors from primary care to census and health data in cardiovascular disease. MethodsTen of 17 general practices in Glasgow and Edinburgh provided data relating to cardiovascular disease that were linked to census records using encrypted identifiers (for ethnic group labels, we used Census Scotland terminology). This process created a retrospective cohort study comprising 52 975 people, of whom around 8500 belonged to non-White ethnic groups. This cohort was linked to our pre-existing data on hospital admissions for cardiovascular disease. Risk ratios (RR) for first hospital admission were calculated, by sex, using Poisson regression with robust variance, adjusting for age, and then for smoking or diabetes status, with 95% CIs. The White Scottish population was the reference group (RR=100). The main outcome assessed whether ethnic variations in cardiovascular disease were attenuated on adjustment for smoking and diabetes. Ethics approval (11/MRE00/4) was obtained from Scotland A Research Ethics Committee. FindingsData completeness was similar across ethnic groups. 48 325 (91%) of 52 975 records had a valid smoking status and 2900 (5·5%) people had diabetes. Compared with White Scottish people, Pakistani people had the highest prevalence of diabetes (RR for men 274, 95% CI 238–314; RR for women 364, 305–434). Pakistani men (n=1165) and women (n=1075) were at higher risk of any hospital admission for cardiovascular disease than were White Scottish men (n=9890) and women (n=11 550) (153, 137–170 for men; 193, 158–235 for women). In Pakistani women adjustment for smoking increased the age-adjusted risk (216, 170–274), whereas adjustment for diabetes reduced the risk (161, 134–194). InterpretationThe high rate of hospital admissions for cardiovascular disease among Pakistani people can be explained partly by higher rates of diabetes, but not smoking. Our dataset is a non-representative sample, so results should be treated with caution. However, we have shown potential value (for further research and for health-care planning) in linking primary care to census data to shed light on ethnic variations in cardiovascular disease. FundingChief Scientist Office of the Scottish Government (grant numbers CZH/4/432, CZH/4/648, and CZH4/878).

“In Everything Illegitimate”: Bastards and the National Family

“In Everything Illegitimate”: Bastards and the National Family

Reducing health inequalities through the prevention of violence: a process evaluation of a Scottish school-based programme for the primary prevention of violence conducted 2011-2013

Background Violence is a significant cause of death and disability in Scottish young people and disproportionately affects men from the most socio-economically deprived areas. Medics Against Violence (MAV) is a primary prevention programme delivered by Scottish healthcare professionals to high-school pupils. Through an educational approach, MAV aims to reduce pro-violent attitudes and prevent perpetration and victimisation of violence. The process evaluation aimed to examine the context, delivery and students’ perceptions of the programme. Methods School …

The Sovereignty of the (Scottish) People: 1689 and All That

The Sovereignty of the (Scottish) People: 1689 and All That

Homo Anglicus / Homo Scotus: The Naturalisation of England and Scotland in Scottish Political, Economic and Social Discourse in Recent Times

Over the years, the Scottish National Party has clearly emphasised the alienness of England’s ethos (epitomised by Margaret Thatcher), thereby building on the idea that the two nations are divided in ways that go beyond their mere historical, institutional and economic differences. Interestingly, this approach to the relationship between Scotland and England is not altogether different from that defended by some, for example within the ranks of (Scottish) Labour. Testing the notion that Scottish people have a different outlook on politics, the economy and so on, against facts and the like is certainly a most interesting exercise. But if the dichotomy does not quite hold, a close look at the theoretical dimension of the question is probably equally instructive.

‘Not our war, not our country’: Contents and contexts of Scottish political rhetoric and popular understandings during the invasion of Iraq

Recent research has questioned the traditional assumption that populations inevitably rally round their national leaders in times of war and suggested instead that whether this occurs depends upon political communication and mass media coverage. In this study, we provide systematic analysis of the debate in Scotland over the invasion of Iraq in 2003. We examine how the conflict was construed as either for or against the national interest, and how the way this is done is linked to different dimensions of context. First, we provide a mixed-methods analysis of debates in the Scottish Parliament. We show that anti-war speakers from Scottish separatist parties map opposition to the war onto a series of collectively consistent and temporarily flexible categorical oppositions, starting with a familiar antinomy between Scottish people and British rulers (before the invasion), and then shifting to broader oppositions between subjugated people and imperial powers (after the invasion). By contrast, speakers from other parties appear less consistent and less flexible in the nature of their arguments. Second, we examine the opinions of a population sample on the war, how these opinions relate to understandings of Scottish identity and how the media context is pivotal in the translation of anti-war opinions into votes for separatist/anti-war political parties.

Pilot ethnic analysis of routine hospital admissions data and comparison with census linked data: CHD rates remain high in Pakistanis

PurposeRoutine data are needed to monitor ethnic health inequalities. The proportion of hospital discharge records with ethnicity information has been improving in Scotland. The aim of this paper is to assess whether routine data can provide valid comparisons of admission rates by ethnic group.Design/methodology/approachRoutine hospital admissions data in four NHS Boards were analysed by ethnic group and sex to compare incidence rate ratios (IRRs) for acute myocardial infarction (AMI) and coronary heart disease (CHD). A previous study linking health and census ethnicity information for 2001‐2003 provided the comparison standard.FindingsThere was a similar risk of AMI for South Asian compared to non‐South Asian people in 2009‐2011 and 2001‐2003. South Asian people and Pakistani women had higher risk of CHD than White Scottish people. The Other White group had higher and the White Irish lower risk of AMI admission in comparison to 2001‐2003 data.Research limitations/implicationsThe comparison used a different age range, did not include community deaths, covered a part of Scotland rather than the whole, and may have been affected by changes to denominators, which were based on the UK census 2001.Originality/valueThe similar IRRs for AMI from census linkage in 2001‐2003 and NHS data from 2009‐2011 suggest routine ethnicity data are valid in some NHS Boards. Analyses can reveal previously unknown variations to justify health improvement action. To maximise the precision of analyses, data completeness needs to be increased and sustained.

SNP, identity and citizenship: Re-imagining state and nation

The Scottish National Party (SNP) has been strongly critical of attempts to resuscitate British national identity and has sought to present an alternative Scottish cultural and political identity that is projected as ‘wholly civic’. However, questions persist as to how the SNP understand concepts such as citizenship and nationality and the extent to which their civic nationalism is reflected empirically in speeches and policies, particularly since forming a minority Scottish government in 2007. This article seeks to explore how the SNP and other Scottish separatists construct an independent Scottish state, nation and people. In particular, it will assess how Scottish separatists address Scottish nationality, multi-nationality and also its transnational imperial legacy.

A questionnaire to measure melanoma risk, knowledge and protective behaviour: Assessing content validity in a convenience sample of Scots and Australians

BackgroundThe aim of this study was to assess the content validity of a questionnaire to measure melanoma risk, knowledge and protective behaviour in a convenience sample of Scots and Australians. Australia has the highest melanoma incidence worldwide but has developed a culture of skin cancer avoidance with a long history of skin cancer primary prevention campaigns of proven effectiveness. Scotland has lower incidence, but has shown a greater rate of increase between 1985 and 2007. There is an urgent need in Scotland, therefore, to identify those groups at greatest risk and provide them with effective preventative advice.MethodA self-administered postal survey was completed by four groups formed from convenience samples in two geographical locations (Northeast Scotland and Western Australia). In univariate analysis scores on personal risk, level of concern, protective behaviour, and knowledge were compared by nationality, previous skin cancer diagnosis and personally knowing someone with melanoma. Multivariate linear regression analysis modelled the influence of potential predictor variables upon each of the scores.Results540 people completed the questionnaire, 273 Scots (50.6%). 133 (24.6%) Scots and 83 (15.4%) Australians previously had melanoma or non-melanoma skin cancer, whilst 120 (22.2%) Scots and 190 (35.2%) Australians personally knew someone with melanoma. Australians had higher knowledge (p < 0.001), level of concern (p < 0.001) and protective behaviour (p < 0.001) scores than the Scottish. Australian nationality was the strongest independent predictor of a higher knowledge score (p < 0.001), followed by a previous skin cancer diagnosis (p = 0.003), personal knowledge of someone with melanoma (p = 0.011), female gender (p = 0.005) and higher education status (p < 0.001) (R2 = 0.163).ConclusionThe questionnaire detected higher levels of knowledge and skin cancer protective behaviours in Australians than in Scottish people. This was expected and supports the content validity of the questionnaire and its value as a future research tool in the Scottish population.