Essential Qualitative Inquiry in the Development of a Cancer Literacy Measure for Immigrant Women

In this article, we describe the development of a comprehensive measure of breast and cervical cancer literacy for immigrant populations. To our knowledge, this is the first attempt to use a health literacy framework in this endeavor. Using qualitative strategies, we (a) developed an understanding of the experiences of Mexican and Filipina immigrant women with low health literacy through individual interviews, (b) conducted focus groups to obtain feedback from experts and participants to determine the adequacy of items included in the measure, and (c) refined the set of items to create an empirically based measure. The final measure included 129 items that assess beliefs, attitudes, knowledge, emotions, and contextual factors related to breast and cervical cancer. Processes for adapting the measure for use with other immigrant groups are discussed.