Jašić Vesna, Prosen Mirko, Ličen Sabina
Institute of Oncology Ljubljana, Zaloška cesta 2, 1000 Ljubljana, Slovenia.
Department of Nursing, Faculty of Health Sciences, University of Primorska, Polje 42, 6310 Izola, Slovenia.
Healthcare (Basel). 2025 Jun 15;13(12):1433. doi: 10.3390/healthcare13121433.
BACKGROUND/OBJECTIVES: Despite the proven effectiveness of colorectal cancer screening, men are less likely to participate than women, with emotional, behavioural and informational barriers contributing to this disparity. The aim of this study was to develop and validate the Men's Response to Colorectal Cancer Screening Scale (MR-CCSS), a gender-sensitive instrument for measuring key factors that influence the participation of men in colorectal cancer screening.
The scale was developed through a structured process that included qualitative data from focus groups ( = 20 men) and expert review ( = 11 professionals). Initial item pools were refined based on indices of content validity (I-CVI ≥ 0.78; S-CVI/Ave ≥ 0.90), resulting in a 23-item scale. The MR-CCSS was administered to 289 Slovenian men aged 50-74 years, and its psychometric properties were assessed using exploratory factor analysis, confirmatory factor analysis and reliability tests.
The EFA revealed a five-factor structure. Together, these factors explained 61.9% of the total variance. The CFA confirmed the robustness of the model (CFI = 0.928, TLI = 0.910 and RMSEA = 0.056). The internal consistency was acceptable to good, with Cronbach's alpha between 0.665 (factor 4) and 0.833 (factor 5) for the subscales and 0.863 for the total scale. The ROC analysis showed moderate predictive accuracy (AUC = 0.702), with an optimal cut-off value of 92.5 (sensitivity = 0.782 and specificity = 0.509) for participation in screening.
The MR-CCSS is a valid and reliable tool for identifying barriers to colorectal cancer screening in men. Its use can serve as a basis for gender-specific interventions, customised health education and strategies to improve screening equity.
背景/目的：尽管结直肠癌筛查已被证明有效，但男性参与筛查的可能性低于女性，情绪、行为和信息方面的障碍导致了这种差异。本研究的目的是开发并验证男性对结直肠癌筛查的反应量表（MR - CCSS），这是一种对性别敏感的工具，用于测量影响男性参与结直肠癌筛查的关键因素。
该量表通过结构化过程开发，包括来自焦点小组（20名男性）的定性数据和专家评审（11名专业人员）。根据内容效度指标（I - CVI≥0.78；S - CVI/Ave≥0.90）对初始项目池进行完善，形成一个包含23个条目的量表。对289名年龄在50 - 74岁的斯洛文尼亚男性施测MR - CCSS，并使用探索性因素分析、验证性因素分析和信度测试来评估其心理测量特性。
探索性因素分析揭示了一个五因素结构。这些因素共同解释了总方差的61.9%。验证性因素分析证实了模型的稳健性（CFI = 0.928，TLI = 0.910，RMSEA = 0.056）。内部一致性良好，分量表的Cronbach's alpha在0.665（因素4）至0.833（因素5）之间，总量表为0.863。受试者工作特征分析显示预测准确性中等（AUC = 0.702），参与筛查的最佳临界值为92.5（敏感性 = 0.782，特异性 = 0.509）。
MR - CCSS是识别男性结直肠癌筛查障碍的有效且可靠的工具。其应用可为针对性别的干预措施、定制化健康教育以及改善筛查公平性的策略提供依据。
