Department of Practice, Sciences, and Health Outcomes Research, University of Maryland School of Pharmacy, Baltimore, MD, United States.
College of Education, University of Washington, Seattle, WA, United States.
Front Public Health. 2024 Sep 2;12:1351729. doi: 10.3389/fpubh.2024.1351729. eCollection 2024.
The purpose of this study is to culturally adapt the Awareness and Beliefs about Cancer (ABC) measure for use in the Hispanic/Latino population living in the United States (US).
In accordance with Patient Reported Outcomes (PRO) Consortium guidelines for cross-cultural adaptation of measures for content and linguistic validity, we conducted: two forward-translations, reconciliation, two back-translations, revision and harmonization, six cognitive interviews, revision, external expert review, and finalization of the version. We used a mixed methods approach, conducting cognitive interviews with Hispanic/Latino community members while also convening an expert panel of six clinicians, health professionals, and community representatives and including the in the entire process. After cross-culturally adapting the ABC measure, we assessed the psychometric properties of the instrument using item response theory analysis. Item parameters, discrimination and category thresholds, and standard errors were calculated. For each of the adapted subdomains, we used item information curves to report the graphical profile of item effectiveness.
Twenty-two Hispanic/Latino community members were enrolled in cognitive interviews, and Hispanics/Latinos fluent in Spanish completed the measure to assess its psychometric properties. Cognitive interviews revealed opportunities to improve items. Key changes from the original measure include the inclusion of gender inclusive language and an inquiry into e-cigarette use on items related to smoking habits. Psychometric property analyses revealed that the anticipated delay in seeking medical help, general cancer beliefs, and cancer screening beliefs and behaviors subdomains had some slope parameters that were < 1; this implies that those items were not able to adequately discriminate the latent trait and had poor performance.
The adapted ABC measure for US Hispanics/Latinos meets content and linguistic validity standards, with construct validity confirmed for cancer symptom recognition and barriers to symptomatic presentation subdomains, but revisions are necessary for others, highlighting the need for ongoing refinement to ensure the cultural appropriateness of instruments.
本研究旨在对美国居住的西班牙裔/拉丁裔人群使用的癌症意识和信念（ABC）量表进行文化调适。
根据患者报告结局（PRO）联盟跨文化调适量表的内容和语言有效性准则，我们进行了：两次正向翻译、调和、两次反向翻译、修订和协调、六次认知访谈、修订、外部专家审查以及最终版本。我们采用了混合方法，对西班牙裔/拉丁裔社区成员进行认知访谈，同时召集了一个由六名临床医生、健康专业人员和社区代表组成的专家小组，并将其纳入整个过程。在跨文化调适 ABC 量表后，我们使用项目反应理论分析评估了该工具的心理测量特性。计算了项目参数、区分和类别阈值以及标准误差。对于每个适应的子领域，我们使用项目信息曲线报告项目有效性的图形概况。
22 名西班牙裔/拉丁裔社区成员参加了认知访谈，西班牙语流利的西班牙裔/拉丁裔人完成了该量表，以评估其心理测量特性。认知访谈揭示了改进项目的机会。与原始量表相比，关键变化包括纳入性别包容性语言以及在与吸烟习惯相关的项目中调查电子烟使用情况。心理测量特性分析显示，预期寻求医疗帮助的延迟、一般癌症信念、癌症筛查信念和行为子领域的一些斜率参数<1；这意味着这些项目无法充分区分潜在特征，表现不佳。
适用于美国西班牙裔/拉丁裔的适应 ABC 量表符合内容和语言有效性标准，对癌症症状识别和症状表现障碍子领域的构建有效性得到了确认，但其他子领域需要修订，突出了需要不断完善以确保工具的文化适宜性。
