Design and Psychometric Evaluation of the Breast Cancer Screening Behavior Scale Based on the Health Action Model (HAM)

Background: Breast cancer is the most common cancer and the first-rank malignancy in women. Screening plays a crucial role in early diagnosis and timely treatment. The present study aimed to design and psychometrically evaluate a questionnaire based on the health action model to evaluate breast cancer screening behaviors and their relevant factors. Methods The present methodological study used a combination of quantitative and qualitative methods for the optimal design and development of research tools. To design the constructs of the health action model and the factors related to breast cancer screening behaviors, qualitative methods such as semi-structured interviews and opinions of experts in this field as well as literature review and quantitative methods were used to investigate the psychometric properties of the research tool. The research population consisted of 210 females aged 30–69 years in Kashan who were selected through simple random sampling. The relative validity index and content validity index were calculated to judge the content of the tool and confirmatory factor analysis was used to evaluate its construct validity. Additionally, intra-class correlation coefficient and Cornbrash’s alpha coefficient were calculated to evaluate the reliability of the instrument. The data were analyzed using the SPSS 22 and AMOS 22 software packages. Results The mean age of the participants was 43 ± 9.82 years. The final version of the questionnaire was prepared in four sections, namely demographic factors (15 items), knowledge (12 items), constructs of the health action model or the factors related to breast cancer screening behaviors (67 items), and behavior (6 items). Factor analysis confirmed the health action model fit in measuring breast cancer screening behaviors. Conclusion The tool designed for measuring breast cancer screening behaviors showed acceptable psychometric properties amongst females and could be used as a valid tool in conducting research in the field of health.