Adaptation of Champion's Health Belief Model Scale for Turkish women and evaluation of the selected variables associated with breast self-examination

The purpose of this study was to adapt Champion's Revised Health Belief Model Scale for Turkish women and to examine selected sociodemographic variables associated with breast self-examination (BSE). Data were collected from a total of 430 females who were living in one of the Health Center areas located in Izmir, a city in the west of Turkey. Champion's revised Health Belief Model Scale was translated into Turkish, validated by professional judges, translated back into English, and then tested. Factor analysis yielded 7 factors: susceptibility, seriousness, barrier 1, barrier 2, confidence, benefits, and health motivation. Significant correlations were found between 2 barriers. Therefore, 2 barriers were considered one barrier subscale. All the items on each factor were from the same construct. Cronbach alpha coefficients ranged from .58 to .89, and test-retest reliability coefficients ranged from .89 to .99 for the subscales. Women who received low scores on barriers reported greater frequency of BSE practice. Likewise, women having high scores on confidence, benefits, health motivation, susceptibility, and seriousness reported a greater frequency of BSE in the last year. The frequency of BSE practice was higher in high school and university graduates, women with a family history of breast cancer, and women with breast cancer and BSE training. The Turkish version of Champion's Revised Health Belief Model Scale was found to be a valid and reliable tool for use with Turkish women. It could be used to evaluate health beliefs about breast cancer and BSE among Turkish women.     

Predictors of prostate cancer screening intention among older men in Jordan

Intention to prostate cancer screening (PCS) is one of the major factors affecting the long‐term success of population‐based PCS programmes. The aim of this study is to explore strong factors linked to intention to PCS among older Jordanian adults using the Health Belief Model (HBM). Data were obtained from Jordanian older adults, aged 40 years and over, who visited a comprehensive health care centre within a ministry of health. A pilot test was conducted to investigate the internal consistency of the Champion Health Belief Model Scale for PCS and the clarity of survey questions. Sample characteristics and rates of participation in PCS were examined using means and frequencies. Important factors associated with intention to PCS were examined using bivariate correlation and standard multiple linear regression analysis. About 13% of the respondents were adherent to PCS over the prior decade. Four out of the seven HBM‐driven factors (perceived susceptibility, benefits and barriers to prostate‐specific antigen (PSA) test, and health motivation) were statistically significant. Those with greater levels of susceptibility, benefits of PSA test and health motivation and lower levels of barriers to PSA testing were having more intention to participate in PCS. Family history, presence of urinary symptoms, age and knowledge about prostate cancer significantly predicted the intention to PCS. Intervention programmes, which lower perceived barriers to PSA testing and increase susceptibility, benefits of PSA testing and health motivation, should be developed and implemented.     

Use of the health belief model in determining frequency of breast self-examination

The purpose of this research was to identify the relationships of attitudes about breast self-examination and breast cancer to the frequency of breast self-examination. The health belief model was used as a theoretical base. Likert scales were developed for the independent variables of susceptibility, seriousness, benefit, barriers, and health motivation; the dependent variable was frequency of breast self-examination. A convenience sample of 301 women was drawn from a large metropolitan city. Self-administered questionnaires contained the developed scales, a measure of frequency of breast self-examination, and demographic variables. Results supported the health belief model's prediction of frequency of breast self-examination (R = .51; p less than or equal to .01). In addition, the variables of seriousness, benefits, barriers, and health motivation discriminated groupings according to frequency of breast self-examination. Results support the relationship of the health belief model variable to the behavior of breast self-examination Nursing implications are discussed.     

Reliability and validity of the breast cancer screening belief scale among Turkish women

Breast cancer is the second leading cause of cancer deaths in Turkish women, and the use of breast self-examination (BSE) and mammography remains low in Turkey. Therefore, we need to identify the beliefs, influencing BSE and mammography, and a valid and reliable tool to measure constructs. The Champion's health belief model scale (CHBMS) is a valid and reliable tool to measure beliefs about breast cancer, BSE, and mammography in an English culture. The purpose of this study was to assess the psychometric characteristics of a Turkish version of the CHBMS related to breast cancer, BSE, and mammography. A convenience sample of 656 women was recruited from 3 health centers and 2 maternal and child health centers in Istanbul. The CHBMS was translated to Turkish, validated by professional judges, back translated, and tested. Factor analysis yielded 7 factors for BSE: confidence, seriousness, barriers-BSE, health motivation 1 and 2, susceptibility, and benefits-BSE. For mammography scale, 6 factors were identified: seriousness, benefits-mammography, barriers-mammography, health motivation 1 and 2, and susceptibility. All items on each factor were from the same construct. Cronbach alpha reliability coefficients ranged from.75 to.87 for the subscales. The Turkish version of the CHBMS showed adequate reliability and validity for use in Turkish women. It could easily be used to evaluate the health beliefs about breast cancer, BSE, and mammography. Further refinement is required to study Turkish women's health beliefs and breast cancer screening behaviors in various settings.     

Translation and validation of champion's health belief model scale with Korean women

The Champion's Health Belief Model Scale (CHBMS) is a reliable and valid instrument developed for American women to measure beliefs about breast cancer and breast self-examination. The purpose of this study is to translate the CHBMS into Korean and to validate the scale among Korean women. The CHBMS was translated using a back-translation technique. A convenience sample of 264 women was recruited from a continuing education center, a community health center, and a university in 3 South Korean cities. The participants were asked to complete the translated Korean version of the CHBMS questionnaire. The data obtained were analyzed using a principal component analysis with varimax rotation for construct validity. Loading criterion was set at.45. Cronbach's alpha was computed for the reliability of the scale. From the analysis, two items from the Benefits domain and four items from the Motivation domain were deleted from the original scale. Thus, the final Korean version of the CHBMS (CHBMS-K) consisted of 36 items that were clustered to 6 subscales: susceptibility (5 items), seriousness (7 items), benefits (4 items), barriers (6 items), confidence (11 items), and motivation (3 items). Cronbach's alpha reliability coefficients for the 6 subscales ranged from.92 to.72. The CHBMS-K was found to be reliable and valid in scale for use with Korean women. It can be used in planning and testing interventions to improve breast self-examination beliefs and practice.     

Factors associated with adherence to fecal occult blood testing for colorectal cancer screening among adults in the Republic of Korea

PurposeRepeated participation in fecal occult blood testing (FOBT) is one of the major factors affecting the long-term success of population-based colorectal cancer screening programs. The aim of this study is to explore strong factors linked to repeated participation in FOBT in the prior decade (2002–2011) among adults using the Health Belief Model (HBM) after controlling for other covariates.MethodsData were obtained from South Korean adults, aged 50 years and over, who visited a national health screening center within a magnet hospital (N = 237). A pilot test was conducted to investigate the internal consistency of the HBM instruments and the clarity of survey questions. Sample characteristics and rates of adherence to FOBT screening were examined using means and frequencies. Important factors associated with adherence to FOBT were examined using multivariate logistic regression analysis.ResultsAbout 44% of the respondents were adherent to FOBT screening over the prior decade. Four out of the six HBM-driven factors (perceived susceptibility, severity, and barriers, and health motivation) were statistically significant. Those with greater levels of susceptibility and health motivation and lower levels of severity and barriers were more likely to adhere to FOBT.ConclusionsHealth professionals should focus more on the four modifiable HBM-related factors to encourage adults to adhere to FOBT. Intervention programs, which lower perceived severity and barriers and increase susceptibility and health motivation, should be developed and implemented.     

The relationship of breast self-examination to health belief model variables

The relationship between frequency of breast self-examination and Health Belief Model variables was assessed in a convenience sample of 588 women. Susceptibility, seriousness, benefits, barriers, health motivation, control, and knowledge of breast cancer and breast self-examination were measured by scales previously tested for validity and reliability. Individual items measured the frequency of breast self-examination and the method by which breast self-examination was taught. Multiple regression and discriminant analysis demonstrated that barriers, knowledge, and susceptibility were correlated with frequency of breast self-examination (R = .53, p = less than or equal to .001). In addition, persons taught by a doctor or nurse evidenced greater frequency of breast self-examination than those taught in other ways.     

Health beliefs, health locus of control, and women's mammography behavior

Research has shown that routine mammography screening can significantly reduce mortality from breast cancer. The use of mammography screening, however, remains well below national goals. In an effort to understand the factors that influence women's mammography behaviors, this study explored the relation between health beliefs, locus of control, and women's mammography practice. Survey instruments used were Champion's health belief scales and the Multidimensional Health Locus of Control (MHLC) scales. The study used a convenience sample of 25 African Americans and 72 white women ages 35 to 84. Findings showed that women who participated in mammography screening were significantly more likely to perceive greater benefits, greater health motivation, and fewer barriers to screening than those who did not participate. These same three variables were similarly associated with greater frequency of receiving mammograms. It also was found that perceived benefits and health motivation were significantly correlated with shorter duration of time since the last mammogram. No support was found for perceived susceptibility, perceived seriousness, and health locus of control as predictors of women's mammography behavior. Implications for nursing research in further examining the MHLC and the Health Belief Model construct of susceptibility as they relate to mammography behavior are identified. Practice implications for nurses are suggested.     

Factors related to practice of breast self-examination in rural women

The purpose of this study was to examine variables related to breast self-examination (BSE) in rural women. The sample of convenience consisted of 347 women who were members of selected county-extension homemaker clubs. Champion's Health Belief Model Scale was used to measure susceptibility, seriousness, benefits, barriers, health motivation, sociodemographics, and knowledge variables and frequency of BSE. Multiple regression analysis indicated that the Health Belief Model concepts accounted for 26% of the variance in BSE practice. Women who perceived more benefits of BSE in reducing the severity of breast cancer were more likely to report more frequent BSE. Women who perceived fewer barriers to performing BSE and those who scored high on health motivation were also more likely to report performing monthly BSE. Pearson product-moment correlation indicated a significant positive relationship between the variables of BSE knowledge and BSE practice (r = 0.1216; p = 0.023). The lambda statistics showed weak or no association between the demographic variables of age, race, marital status, religion, education, personal experience with breast disease, and friend's experience with breast disease and BSE practice. These findings suggest that perhaps educational programs emphasizing benefits of BSE may be implemented for women represented in this sample in an attempt to increase the number of women practicing BSE. Assessment of women's perceptions of potential barriers would allow nurses to plan appropriate strategies that could reduce the barriers. Finally, assessment of women's general health practices may identify women motivated toward good health. These women may be likely to complete monthly BSE if encouraged to do so.     

A nursing intervention to increase compliance in otitis media patients

This study was conducted to evaluate two forms of a clinical nursing intervention based on the Health Belief Model (HBM) and designed to increase compliance among 59 otitis media (OM) patients (14 adults and 45 children) visiting an emergency department (ED). Subjects (adult patients or caretakers of child patients) who received an HBM clinical intervention administered by a nurse in the ED, and HBM phone intervention 2 to 4 days after the ED visit, or both interventions were much more likely than control subjects to comply with a follow-up referral appointment. Both the clinical and phone interventions were designed to increase perceived susceptibility to complications of the OM, seriousness of the complications, and benefits and costs of action. Other factors predicting compliance included subjects' unmet needs for child care, perceived seriousness of the OM, and degree of knowledge of the etiology, pathophysiology, and management of OM.     

Attitudinal variables related to intention, frequency and proficiency of breast self-examination in women 35 and over

A correlational study was conducted to identify attitudinal variables specified by the Health Belief Model that were related to intent, frequency, and proficiency of breast self-examination. The probability sample consisted of 380 women age 35 and over who were contacted via random digit dialing. Data were collected during in-home interviews. Results supported the combined ability of susceptibility, seriousness, barriers, health motivation, and control to predict intent to practice breast self-examination (R = .61, p. less than or equal to .001). In addition, frequency and total proficiency for breast self-examination were predicted by health motivations, susceptibility, and barriers using discriminant analysis. Results lend support to use of the Health Belief Model variables in predicting women's intention and actual behavior of breast self-examination.     

Screening for cervical cancer among Israeli lesbian women

Background:  The proportion of lesbian women who contract the human papilloma virus may reach 13% or even 21%; however, lesbian women were found to receive Pap smear tests less often or less regularly.
Aim:  To explore factors influencing lesbian women to undergo Pap smear tests and to determine whether the Health Belief Model (HBM) is able to predict whether lesbian women would be willing to undergo the test.
Method:  This is a correlational quantitative study guided by the HBM. A convenience sample of 108 Israeli lesbian women was recruited from local events in the lesbian community in the city of Tel Aviv, Israel. Data were collected using a self-administered questionnaire.
Findings:  Findings indicate that only 22.2% of the women had undergone Pap smear tests in the past, but a slightly higher proportion, 30.8%, intended to be tested during the next year. Older women were found to be more compliant with the test. Model-based factors affecting actual testing were perceived benefits and barriers. Factors affecting women's intention to be tested were perceived susceptibility, perceived benefits and general health motivation.
Conclusions:  Effective strategies for nurses promoting cervical cancer screening among lesbians should address ways to improve familiarity with Pap smear tests, raise physicians' awareness of offering the test to lesbians and emphasize the importance of women-based medical teams.     

Reliability and validity of the mammography screening beliefs questionnaire among Chinese American women

Cancer is the leading cause of death for Asian American women, and the breast is a primary site of cancer in Chinese women. Although a number of studies have used constructs from the Health Belief Model (HBM) to examine their relation to mammogram screening, the validity and reliability of the instruments on HBM constructs among Chinese women have not been consistently examined. The purpose of this study was to describe the psychometric properties of a culturally sensitive questionnaire for measuring Chinese women's beliefs (susceptibility, seriousness, benefits, and barriers) related to breast cancer and mammogram screening. The items developed for the questionnaire were drawn from a comprehensive literature review and focus groups. The instrument was translated using back translation technique and evaluated by a panel of professional experts and lay experts. A total of 220 Chinese American women ages 40 to 85 years residing in a suburban Midwestern community were included in the sample. Psychometric testing demonstrated satisfactory internal consistency and validity of the instrument for this group of women. The Cronbach alpha for the subscales ranged from.77 to.90. Construct validity was supported by exploring the factor structure of the instrument using confirmatory factor analysis and testing correlations with mammography compliance.     

Factors related to women's practice of breast self-examination

Factors related to women's practice of breast self-examination (BSE) were studied in a sample of upper-middle-class women attending meetings of voluntary women's groups. Factors found to relate directly to frequency of BSE practice were high perceived benefits of BSE, low perceived barriers to BSE, and high self-concept. Correlations with perceived susceptibility/seriousness of breast cancer, age, perceived level of social support, and social network properties were not significant. A multiple regression analysis was done with BSE frequency as criterion variable: perceived threat (susceptibility/seriousness) and perceived benefits minus perceived barriers were entered hierarchically; age, self-concept, and total social support were entered as a group. Perceived benefits minus barriers was the only significant predictor variable, R2 = .27. These findings underline the importance of assessing detective behaviors such as BSE as potentially different from preventive behaviors.     

Health beliefs and self breast examination in black women

The relationship between health beliefs and practice of breast self examination (BSE) in a sample of 179 black women, 20 to 49 years of age, was investigated. Health beliefs were operationalized by employing Champion's revised Health Belief Model Scale (1993) to collect data. Data analyses included multiple regression analysis to examine BSE behavior in relation to selected demographic attributes and health beliefs. Results indicated that health beliefs were much stronger in determining BSE performance for a given individual than were demographic characteristics. The frequency of BSE was related to increased perceived seriousness of breast cancer, benefits of BSE, and health motivation. Frequency of BSE was inversely related to perceived barriers.     

Preventive skin care beliefs of people with spinal cord injury

Although health beliefs have been correlated with self-care adherence in other chronic conditions, little is known about skin care beliefs after spinal cord injury (SCI). The purpose of this qualitative study was to identify the skin care beliefs of individuals with SCI. The conceptual framework was the Health Belief Model (HBM), which proposes that adherence to a health regimen is motivated by beliefs about susceptibility, severity, barriers, benefits, and self-efficacy. Purposive sampling was used to recruit 22 people with SCI. Content analysis of data collected using semistructured questions was used to identify domains of skin care beliefs, including HBM components. Themes that emerged about skin care beliefs included taking vigilant care, taking charge, maintaining health, and passing up care. Although most participants believed they were susceptible to pressure ulcers and preventive care was important, paradoxical statements about beliefs and preventive behaviors were common. These incongruent responses may reflect ambivalence about competing priorities or the efficacy of preventive practices. Further research is needed to understand this phenomenon. Increased understanding of skin care beliefs will assist in developing tailored teaching programs for people with SCI.     

Osteoporosis knowledge, health beliefs, and DXA T-scores in men and women 50 years of age and older

PURPOSE: To compare the knowledge of osteoporosis, revised health belief model variables (RHBM), and DXA (dual energy x-ray absorptiometry) T-scores among men and women 50 years of age and older. DESIGN: This was a secondary analysis that used 218 healthy community-based women 50 to 65 years of age and 226 healthy community-based men >or=50 years of age. Data for women were collected for 18 months during 2001-2003, and data for men were collected for 18 months during 2004-2006. The variables were knowledge of osteoporosis, RHBM variables (susceptibility, seriousness, benefits and barriers of calcium intake and of exercise, health motivation, self-efficacy of calcium intake and exercise), and DXA T-scores. METHOD: The women and men completed an osteoporosis questionnaire prior to having a DXA screening test. A total of 190 women and 187 men had DXA scans. FINDINGS: More than half of the sample had abnormal bone density scans. Knowledge of osteoporosis was low for women and even lower for men. Seven of the nine health belief variables were associated with gender. Women perceived osteoporosis to be serious and that they were susceptible. Men did not perceive osteoporosis to be serious or that they were susceptible. Men were more health motivated and more confident of their ability to engage in exercise.