Mahmoodabad Seyed Saeed Mazloomy, Asadian Ali, Fallahzadeh Hossein, Rajaei Minoo
Department of Health Education and Promotion, Social Determinants of Health Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
International Campus, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
J Educ Health Promot. 2020 Oct 30;9:278. doi: 10.4103/jehp.jehp_119_20. eCollection 2020.
Implementing a cervical cancer prevention program requires an exploration of certain behaviors concerning this disease. This study is aimed to evaluate the psychometrics of a questionnaire that enquired about the factors involved in Precaution Adoption Process Model (PAPM) for cervical cancer among suburban women in Bandar Abbas, south of Iran.
The primary draft of the questionnaire was developed with a review of the related literature on cervical cancer and the constructs affecting PAPM, with 68 items. The face validity, content validity ratio (CVR), and content validity index (CVI) of the questionnaire were approved by a panel of 10 experts. The internal consistency and test-retest reliability of the questionnaire were estimated too. Field testing sample included 300 women recruited from a women's healthcare center in suburban areas of Bandar Abbas in the south of Iran. Exploratory factor analysis was used to evaluate validity, and Cronbach's alpha coefficient was estimated for reliability.
After the face validation, 11 items were eliminated. Once CVR was estimated, two items were discarded. The remaining items had a CVR >0.79. All had a CVI >0.79. Six items were eliminated in the factor analysis. The final questionnaire included 49 items organized in 8 factors including awareness, perceived susceptibility, perceived severity, perceived benefits, perceived barriers, social norms, fear, and self-efficacy. Principal component analysis with varimax rotation indicated eight main components that explained 56.25% of the variance. Reliability assessment showed a good internal consistency for all subscales and the Cronbach's alpha score ranged between 0.82 and 0.90. The test-retest reliability showed that the correlation coefficients (between 0.81 and 0.89) were significant at the 0.01 level for all sub-scales.
The final questionnaire was a new instrument comprised the effective constructs of PAPM and had a high reliability and validity. Thus, this questionnaire is recommended to be used to explore and enhance preventive behaviors of cervical cancer.
实施宫颈癌预防项目需要探究与该疾病相关的特定行为。本研究旨在评估一份问卷的心理测量学特性，该问卷询问了伊朗南部阿巴斯港郊区女性中宫颈癌预防采纳过程模型（PAPM）所涉及的因素。
问卷初稿在回顾宫颈癌及影响PAPM的相关文献基础上编制而成，共68个条目。问卷的表面效度、内容效度比（CVR）和内容效度指数（CVI）经10位专家组成的小组认可。同时还对问卷的内部一致性和重测信度进行了评估。现场测试样本包括从伊朗南部阿巴斯港郊区一家妇女保健中心招募的300名女性。采用探索性因素分析评估效度，并计算克朗巴哈系数估计信度。
表面效度验证后，删除了11个条目。估计CVR后，又舍弃了2个条目。其余条目CVR>0.79，所有条目CVI>0.79。因素分析中又删除了6个条目。最终问卷包含49个条目，分为8个因子，包括意识、感知易感性、感知严重性、感知益处、感知障碍、社会规范、恐惧和自我效能感。采用方差最大化旋转的主成分分析表明有8个主要成分，解释了56.25%的方差。信度评估显示所有子量表内部一致性良好，克朗巴哈系数在0.82至0.90之间。重测信度表明所有子量表的相关系数（在0.81至0.89之间）在0.01水平上显著。
最终问卷是一种包含PAPM有效构成要素的新工具，具有较高的信度和效度。因此，建议使用该问卷来探究和增强宫颈癌的预防行为。
