Wachira J, Busakhala A, Chite F, Naanyu V, Kisuya J, Otieno G, Keter A, Mwangi A, Inui T
Academic Model Providing Access to Healthcare (AMPATH) Partnership, P.O Box 4604-30100, Eldoret, Kenya.
School of Medicine, Department of Medicine, Moi University, P.O Box 4604-30100, Eldoret, Kenya.
BMC Health Serv Res. 2017 Feb 3;17(1):110. doi: 10.1186/s12913-017-2058-x.
Our study objective was to determine the validity and reliability of the breast module of a cancer awareness measure (BCAM) among adult women in western Kenya.
The study was conducted between October and November 2012, following three breast cancer screening events. Purposive and systematic random sampling methods were used to identity 48 women for cognitive focus group discussions, and 1061 (594 who attended vs. 467 who did not attend screening events) for surveys, respectively. Face and psychometric validity of the BCAM survey was assessed using cognitive testing, factor analysis of survey data, and correlations. Internal reliability was assessed using Cronbach's alpha.
Among survey participants, the overall median age was 34 (IQR: 26-44) years. Compared to those women who did not attend the screening events, women attendees were older (median: 35 vs. 32 years, p = 0.001) more often married (79% vs. 72%, p = 0.006), more educated (52% vs. 46% with more than an elementary level of education, p = 0.001), more unemployed (59% vs. 11%, p = 0.001), more likely to report doing breast self-examination (56% vs. 40%, p = 0.001) and more likely to report having felt a breast lump (16% vs. 7%, p = 0.001). For domain 1 on knowledge of breast cancer symptoms, one factor (three items) with Eigen value of 1.76 emerged for the group that did not attend screening, and 1.50 for the group that attended screening. For both groups two factors (factor 1 "internal influences" and factor 2 "external influences") emerged among domain 4 on barriers to screening, with varied item loadings and Eigen values. There were no statistically significant differences in the factor scores between attendees and non-attendees. There were significant associations between factor scores and other attributes of the surveyed population, including associations with occupation, transportation type, and training for and practice of breast self-examination. Cronbach's alpha showed an acceptable internal consistency.
Certain subpopulations are less likely than others to attend breast screening in Kenya. A survey measure of breast cancer knowledge and perceived barriers to screening shows promise for use in Kenya for characterizing clinical and community population beliefs, but needs adaptation for setting, language and culture.
我们的研究目的是确定癌症认知测量工具（BCAM）的乳房模块在肯尼亚西部成年女性中的有效性和可靠性。
该研究在2012年10月至11月期间进行，此前举办了三次乳腺癌筛查活动。分别采用立意抽样和系统随机抽样方法，确定48名女性进行认知焦点小组讨论，1061名女性（594名参加筛查活动者与467名未参加筛查活动者）进行调查。通过认知测试、对调查数据进行因子分析以及相关性分析来评估BCAM调查的表面效度和心理测量效度。使用克朗巴哈系数评估内部可靠性。
在调查参与者中，总体年龄中位数为34岁（四分位距：26 - 44岁）。与未参加筛查活动的女性相比，参加者年龄更大（中位数：35岁对32岁，p = 0.001），结婚比例更高（79%对72%，p = 0.006），受教育程度更高（52%受过小学以上教育对46%，p = 0.001），失业比例更高（59%对11%，p = 0.001），更有可能报告进行过乳房自我检查（56%对40%，p = 0.001），也更有可能报告摸到过乳房肿块（16%对7%，p = 0.001）。对于乳腺癌症状知识的领域1，未参加筛查的组出现一个特征值为1.76的因子（三个项目），参加筛查的组特征值为1.50。在筛查障碍的领域4中，两组均出现两个因子（因子1“内部影响”和因子2“外部影响”），项目载荷和特征值各不相同。参加者和未参加者的因子得分在统计学上无显著差异。因子得分与被调查人群的其他属性之间存在显著关联，包括与职业、交通方式以及乳房自我检查的培训和实践的关联。克朗巴哈系数显示出可接受的内部一致性。
在肯尼亚，某些亚人群比其他亚人群参加乳房筛查的可能性更低。一项关于乳腺癌知识和感知筛查障碍的调查测量工具显示有望在肯尼亚用于描述临床和社区人群的信念，但需要根据环境、语言和文化进行调整。
