Questionnaire Validation of Colorectal Cancer Literacy Scale among Thai People in Northeastern Thailand

Abstract

Background: Colorectal cancer is an important public health problem worldwide. Although progress in screening<br />and treatment has considerably improved the prognosis in the developed world, in developing countries colorectal cancer<br />mortality rate remains relatively high. Colorectal cancer screening literacy is an important initial step in overcoming this<br />problem. Development of a validated assessment instrument is therefore important for implementation of appropriate<br />health education programs to facilitate early detection. Objectives: This study focused on generation and validation of<br />a colorectal cancer screening literacy scale for Thai people in northeastern Thailand. Methods: This methodological<br />study was carried out in two phases: (1) literature reviews and semi-structured interviews were used to select items,<br />then the content and face validity were checked; and (2) a confirmatory factor analysis (CFA) was conducted to test<br />construct validity and reliability. A self-administered questionnaire was used to collect data from Thai people aged 50-<br />65 in June 2017. Results: For the total of 400 participants who responded (response rate 100 %), the age ranged from<br />50 to 65 years old (mean = 57.3, SD = 4.616). The colorectal cancer screening literacy scale was designed to include<br />6 domains and it was shown to have good internal consistency, and CFA demonstrated the model to fit data adequately<br />(Chi-squared/degree of freedom = 1.079, p = 0.061, CFI = 1.00, GFI = 0.93, AGFI = 0.91, RMSEA = 0.014 and SRMR<br />= 0.036). The final version of its, consisting of 57 items across the 6 domains covering key aspects of colorectal cancer<br />screening literacy, demonstrated good psychometric properties for this population. Conclusions: Use of the colorectal<br />cancer screening literacy scale in Thai people could lead to improved educational programs for optimizing colorectal<br />cancer screening.