Abstract
OBJECTIVE: The purpose of the study was to develop and validate the psychometric properties of the Colorectal Cancer and Colonoscopy Screening Health Beliefs Scale for First-Degree Relatives (CCHBS-FDR) instrument for the first-degree relatives (FDRs) of people with colorectal cancer (CRC) in China. METHODS: This study was conducted in two phases: scale development and psychometric testing. In the scale development phase, a preliminary item pool was established based on a systematic review, qualitative interviews (n = 42), and the Revised Colorectal Cancer Perception and Screening (RCRCPS) instrument. The scale was then refined through expert consultation and laymen review. Psychometric properties were tested by item analysis, validity assessment and reliability evaluation on a convenience sample of 258 Chinese FDRs of patients with CRC. RESULTS: A preliminary 37-item scale with six dimensions, perceived severity, perceived susceptibility, perceived benefits, barriers-priority, barriers-concerns and barriers-knowledge, was developed in the first phase. The content validity index of the CCHBS-FDR was satisfactory (I-CVI = 0.86-1, S-CVI/UA = 0.89, S-CVI/Ave = 0.98). Cronbach's α coefficient for overall scale was 0.863, and subscales ranged from 0.689 to 0.939. Confirmatory factor analysis results suggested that the CCHBS-FDR conformed to the six-factor model (χ (2)/df = 2.075, RMSEA = 0.065, CFI = 0.892, TLI = 0.880, and SRMR = 0.077). CONCLUSIONS: The CCHBS-FDR demonstrated acceptable reliability and validity as a culturally specific instrument for assessing health beliefs among FDRs with CRC. It can serve as a valuable tool for providing a more precise assessment of health beliefs and helping healthcare professionals develop and evaluate tailored communication interventions to promote colonoscopy screening among FDRs.