Cross-cultural adaptation of the awareness and beliefs about cancer measure for Hispanics/Latinos living in the United States

Front Public Health. 2024 Sep 2:12:1351729. doi: 10.3389/fpubh.2024.1351729. eCollection 2024.

Abstract

Introduction: The purpose of this study is to culturally adapt the Awareness and Beliefs about Cancer (ABC) measure for use in the Hispanic/Latino population living in the United States (US).

Methods: In accordance with Patient Reported Outcomes (PRO) Consortium guidelines for cross-cultural adaptation of measures for content and linguistic validity, we conducted: two forward-translations, reconciliation, two back-translations, revision and harmonization, six cognitive interviews, revision, external expert review, and finalization of the version. We used a mixed methods approach, conducting cognitive interviews with Hispanic/Latino community members while also convening an expert panel of six clinicians, health professionals, and community representatives and including the in the entire process. After cross-culturally adapting the ABC measure, we assessed the psychometric properties of the instrument using item response theory analysis. Item parameters, discrimination and category thresholds, and standard errors were calculated. For each of the adapted subdomains, we used item information curves to report the graphical profile of item effectiveness.

Results: Twenty-two Hispanic/Latino community members were enrolled in cognitive interviews, and Hispanics/Latinos fluent in Spanish completed the measure to assess its psychometric properties. Cognitive interviews revealed opportunities to improve items. Key changes from the original measure include the inclusion of gender inclusive language and an inquiry into e-cigarette use on items related to smoking habits. Psychometric property analyses revealed that the anticipated delay in seeking medical help, general cancer beliefs, and cancer screening beliefs and behaviors subdomains had some slope parameters that were < 1; this implies that those items were not able to adequately discriminate the latent trait and had poor performance.

Discussion: The adapted ABC measure for US Hispanics/Latinos meets content and linguistic validity standards, with construct validity confirmed for cancer symptom recognition and barriers to symptomatic presentation subdomains, but revisions are necessary for others, highlighting the need for ongoing refinement to ensure the cultural appropriateness of instruments.

Keywords: beliefs; cancer knowledge; cross-cultural adaptation; instrument development; item response theory; mixed-methods; psychometrics.

MeSH terms

  • Adult
  • Aged
  • Cross-Cultural Comparison
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Hispanic or Latino* / psychology
  • Humans
  • Male
  • Middle Aged
  • Neoplasms*
  • Psychometrics*
  • Surveys and Questionnaires
  • United States

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This study was supported in part by a research grant from the Investigator-Initiated Studies Program of Merck Sharp and Dohme Corp (MSD). The funder was not involved in the study design, collection, analysis, interpretation of data, the writing of this article, or the decision to submit it for publication. The opinions expressed in this paper are those of the authors and do not necessarily represent those of Merck Sharp and Dohme Corp.