The purpose of the proposed study, Behavioral Constructs and Culture in Cancer Screening, is the adaptation for cultural appropriateness of five behavioral constructs widely used to explain breast cancer screening and to inform interventions: perceived threat, perceived benefits, intention, self-efficacy, and subjective norms.
Two specific aims are addressed through three study phases: 1. For two non-Anglo ethnic groups (Filipino and Latino), to assess the cultural appropriateness of five behavioral constructs commonly used in cancer control research by: a.) evaluating the meaning of each construct and its relationship to breast cancer screening within each ethnic group (for unique group meaning), across the two groups, and as compared with the meaning of the existing constructs developed for Anglos (for common meaning); and b.) examining the relationship of key cultural dimensions (e.g., individualism/collectivism) to each construct in each ethnic group. 2. To develop culturally appropriate measures of 5 behavioral constructs for 2 ethnic groups by: a.) developing measures that are culturally meaningful to each ethnic group, testing for validity and reliability within that group; b. refining all measures, testing each for validity and reliability within all groups, and assessing comparability across groups; and c.) testing the relationship of culturally appropriate constructs to one another and to screening behavior. This multi-disciplinary study draws on the extensive multi- cultural survey and intervention research of the Northern California Cancer Center, and involves researchers from Brown University and the University of California, San Francisco. Phase I includes analyses of standard measures from a concurrent study and key informant interviews to identify cultural factors likely to influence selected behavioral constructs. In Phase II, focus groups and ethnographic interviews explore the meaning of these constructs in two ethnic groups and the cultural factors expected to improve measurement. The result will be new/adapted measures. Phase III is the quantitative phase in which new items are fielded in a multi-lingual telephone survey of 900 women (300 each Filipina, Latina and white). For test-retest reliability, 150 women will be re-interviewed after four weeks. Items will be further refined and tested in a survey with the remaining 750 women six months later, yielding culturally appropriate measures that better predict breast cancer screening among Filipinas and Latinas.
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