JMIR Publications

ABSTRACT

Background:

Breast cancer is the most common cancer among Chinese women, with an age-standardized prevalence of 21.6 cases per 100 000 women. Limited cancer health literacy reduces females’ ability to engage in cancer prevention and detection. It is necessary to assess Chinese women’s breast cancer literacy to deliver targeted interventions and effective education. However, there is no breast cancer literacy assessment tool available in China currently.

Objective:

This study aimed to translate and linguistically and culturally adapt the Breast Cancer Literacy Assessment Tool (B-CLAT) into a simplified-Chinese version (B-C-CLAT), and then evaluate its psychometric properties by administering it to Chinese college students.

Methods:

We first translated the B-CLAT into a simplified-Chinese version and verified its validity and reliability using rigorous translation and validation guidelines proposed in previous studies. The prospective psychometric evaluation study included 50 female participants with a mean age of 19.62 (SD=1.31) years recruited from Nantong University, China.

Results:

Items 1, 6, 8, 9, 10, 16, 17, 20, 21, 22, 23, 24, 25, 26, 29, 30 were deleted to increase the relevant subscale internal consistency. Items 3, 12, 13, 14, 18, 20, 27, and 31 were deleted due to their Cronbach's Alpha being lower than 0.5 in the test-retest analysis. After deletion, the internal consistency of the entire scale was fair, alpha = 0.607. The prevention and control subscale had the highest internal consistency, alpha = 0.730, followed by the screening and knowledge subscale, alpha = 0.509, while the awareness subscale had the lowest internal consistency, alpha = 0.224. The intraclass correlation coefficient for the C-B-CLAT (Items 2, 4, 5, 7, 11, 15, 28, 32, 33, and 34) was fair to excellent, ranging from 0.503–0.808, 95% Confidence Interval. The values of Cronbach's Alpha for Items 2, 4, 5, 7, 11, 15, 28, 32, 33, and 34 ranged from 0.499–0.806, and the Alpha value for the C-B-CLAT was 0.607. This indicates a fair test-retest reliability. The mean difference in the C-B-CLAT scores between Stage 1 and Stage 2 was 0.47 (− 0.53, 1.47), which was not significantly different from zero (t = 0.945, P = .349). This result implies that the C-B-CLAT produced the same scores at Stage 1 and Stage 2 on average, thus showing good agreement in the C-B-CLAT scores between Stage 1 and Stage 2. The standard deviation of the difference was 3.48. The 95% limits of agreement were − 6.34 to 7.28.

Conclusions:

We developed a simplified-Chinese version of the B-CLAT through translation and adaptation. The new scale has proven valid and reliable for assessing cancer literacy among Chinese populations.