Instrument refinement for breast cancer screening behaviors

The purpose of this study was to refine an instrument to measure the Health Belief Model concepts of susceptibility, seriousness, benefits, barriers, health motivation, and confidence, using the context of breast cancer and breast self-examination. A Likert format was used for attitudinal scales. A random sample (N = 581) of women 35 years and over was included. Items were subjected to content analysis by national experts. Construct validity was established using exploratory factor analysis. Predictive validity was established by relating breast self-examination behavior to breast self-examination attitudes, using simultaneous multiple regression and bivariate correlations. Cronbach alpha reliability coefficients for the revised scales ranged from .80 to .93. Test-retest correlations ranged from .45 to .70.