Department of Midwifery, School of Nursing & Midwifery, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, United States of America.
PLoS One. 2024 Apr 11;19(4):e0295905. doi: 10.1371/journal.pone.0295905. eCollection 2024.
PURPOSE: Evidence supports that the Health Belief Model (HBM) can explain and predicts certain health behaviors, including participation in cervical cancer (CC) screening. The purpose of this study was to evaluate the psychometric properties of a modified HBM for CC and visual inspection with acetic acid (VIA) in female healthcare professionals in Addis Ababa, Ethiopia, 2020. METHODS: Psychometric properties related to CC and VIA were tested using 42-item modified HBM self-administered questionnaire and a cross-sectional study design with simple random sampling. Kaiser-Meyer-Olkin and Bartlett's sphericity test indicated that data sampling adequacy for exploratory factor analysis was 0.792 (χ2 = 3189.95, df = 351, p < .001). Items with cross-loading and factor loadings ≥ 0.5 were retained. Confirmatory factor analysis (CFA) was conducted to determine model fit. RESULTS: The final analysis included 194 women, (mean age 30±4.34). Twelve items with ≤ 0.5 were removed and 30 retained items loaded into 6 factors; (benefits of VIA, perceived seriousness of CC, barrier (fear of negative outcome), self-efficacy, susceptibility to CC, and barriers (health system delivery)) explained 65% of the total variance. Cronbach's alpha for the total instrument was 0.8 and reliability for the 6 subscales was 0.76-0.92. Composite reliability and average variance extracted indicated good internal consistency and convergent validity. CFA identified 6 additional items to be removed with high residual covariance. The final 24 items of the modified HBM had an acceptable model fit (goodness-of-fit index (GFI) = 0.861, adjusted GFI = 0.823, comparative fit index = 0.937, root mean square error of approximation = 0.059). CONCLUSION: The modified HBM for CC and VIA with 24 items had adequate psychometric properties and may be used by Ethiopian healthcare professionals for research or clinical purposes. To support external validity the updated 24 items tool is suggested for application in further study in different populations in Ethiopia.
目的:有证据表明,健康信念模型(HBM)可以解释和预测某些健康行为,包括参与宫颈癌(CC)筛查。本研究的目的是评估 2020 年在埃塞俄比亚亚的斯亚贝巴的女性医疗保健专业人员中经过修改的用于 CC 和醋酸视觉检查(VIA)的 HBM 的心理测量特性。
方法:使用经过修改的 42 项 HBM 自我管理问卷和简单随机抽样的横断面研究设计来测试与 CC 和 VIA 相关的心理测量特性。Kaiser-Meyer-Olkin 和 Bartlett 的球形检验表明,探索性因素分析的数据采样充分性为 0.792(χ2=3189.95,df=351,p<.001)。保留具有交叉加载和因子负荷≥0.5 的项目。进行验证性因素分析(CFA)以确定模型拟合度。
结果:最终分析包括 194 名女性,(平均年龄 30±4.34)。删除了 12 项≤0.5 的项目,保留了 30 项,这些项目加载到 6 个因素中;(VIA 的益处、对 CC 的严重性的认识、障碍(对负面结果的恐惧)、自我效能、CC 的易感性和障碍(卫生系统的提供))解释了 65%的总方差。总仪器的克朗巴赫α为 0.8,6 个子量表的可靠性为 0.76-0.92。综合可靠性和平均方差提取表明具有良好的内部一致性和收敛有效性。CFA 确定了另外 6 个需要删除的项目,其残余协方差较高。修改后的 HBM 的最终 24 个项目具有可接受的模型拟合度(良好拟合指数(GFI)=0.861,调整后的 GFI=0.823,比较拟合指数=0.937,均方根误差近似值=0.059)。
结论:经过修改的用于 CC 和 VIA 的包含 24 个项目的 HBM 具有足够的心理测量特性,可被埃塞俄比亚医疗保健专业人员用于研究或临床目的。为了支持外部有效性,建议在埃塞俄比亚不同人群中进一步研究中应用更新后的 24 项工具。
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