Broadening the examination of socio-cultural constructs relevant to African American colorectal cancer screening

摘要

The importance of socio-cultural constructs as influences on cancer attitudes and screening has been established in the literature. This paper reports on efforts to explore alternatives to constructs previously associated with African American cancer screening, but with low acceptance among community members or incomplete measurement (empowerment and collectivism) and develop a measure for a recently identified construct of interest (privacy). We report preliminary psychometric data on these socio-cultural scales and their associations with cancer attitudes. African Americans (N=1021), 50 to 75 years of age participated in this study. Participants were identified via a listed sample and completed a telephone survey administered via call center. Socio-cultural attitudes were assessed using items identified through computerized database searches, reviewed by advisory panels, edited and tested using cognitive response strategies. Cancer screening pros and cons, cancer worry, perceived cancer risk, colorectal cancer screening subjective norms, and perceived self-efficacy for colorectal cancer screening were also assessed. Confirmatory factor analyses and multivariate analyses were conducted to provide support for the validity of the constructs and to understand the associations among the selected socio-cultural constructs (empowerment, collectivism and empowerment) and cancer beliefs and attitudes (CRC perceived benefits and barriers, perceived risks, subjective norms, and perceived behavioral control/self-efficacy). Consistent with the literature, the factor analytic model (RMSEA for the model was 0.062; 90% CI: 0.060-0.065) provided support for the empowerment, collectivism and privacy constructs. The modified collectivism and privacy scales had acceptable reliability. The privacy scale demonstrated the strongest associations with measures of cancer beliefs and attitudes. The implication of the findings and need for further scale development activities is discussed.