Abstract
INTRODUCTION: Psychological distress is highly prevalent among individuals with breast cancer (BC). This study culturally adapted the theory of planned behavior (TPB) scale and translated it into the Malay language to validate its evaluation of mental health help-seeking intentions among individuals with BC. MATERIALS AND METHODS: The original 14-item TPB scale was developed based on four TPB framework constructs: intention, attitude, subjective norms (SN), and perceived behavioral control (PBC). The adaptation involved translation by bilingual experts (n = 4), followed by synthesis. Subsequently, content validation (content validation index, CVI) was performed among health experts (n = 5), and face validation (face validation index, FVI) was conducted among individuals with BC (n = 7). RESULTS: The validation yielded a good CVI (0.86) and FVI (1.0). Construct validity was assessed through confirmatory factor analysis (CFA) using data from individuals with BC aged between 37 and 65 years (n = 140). One item was deleted from the SN construct based on expert consensus, leaving 13 items. The CFA indicated a good fit for the 13 items (Chi-square to degrees of freedom ratio = 2.45, comparative fit index = 0.95, Tucker-Lewis index = 0.94). The factor loading (range: 0.37-0.98), average variance extracted (range: 0.51-0.94), and composite reliability (range: 0.63-0.98) indicated that each construct, except SN, had acceptable convergent validity. The Cronbach's alpha of the 13 items was 0.92, indicating strong internal consistency. CONCLUSION: The results confirmed that the Malay-version TPB scale translation, cross-cultural adaptation, and validation are valid and reliable.