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Validation Evidence for Turkish Adaptation of Champion's Health Belief Model Scales

Instruments using Health Belief Model constructs in breast cancer screening in previous studies were developed and tested by Champion for American women, and since then, these have been revised twice. Champion's Health Belief Model Scale (CHBMS) has been translated and tested in various studies in other countries and cultures. Also, the current study examined the validity and reliability of the Turkish adaptation of the CHBMS among Turkish women. The instrument was translated using a back-translation technique, which includes the use of a panel of experts and interpreters to translate the items from the source language to the target language and then back-translate them to the source language. The study was conducted in Ordu, a city in north Turkey. A total of 266 Turkish women aged 20 and older working as primary schoolteachers were included in the sample. Analyses included internal consistency, reliability, factor analysis, and known group techniques. After the analysis, 3 items from the Barriers domain, 1 from the Seriousness domain, and 2 from the Motivation domain were deleted from the original scale. So, the final Turkish version of the CHBMS (CHBMS-T) consisted of 36 items that were clustered into 6 subscales: susceptibility (3 items), seriousness (6 items), motivation (5 items), benefits of breast self-examination (BSE) (4 items), barriers to BSE (8 items), and confidence/self-efficacy of BSE (10 items). Internal consistency ranged from 0.69 to 0.83. Construct validity was supported by exploring the factor structure of the instrument using factor analysis and testing known-group techniques. Psychometric testing demonstrated satisfactory internal consistency and validity of the instrument for this group of women. It can be used in planning and testing interventions to improve BSE beliefs and practice.