The goal of this pilot project is to create and validate a community designed survey instrument to obtain accurate perceptions of barriers to cancer detection health screenings among American Indians. The goal will be accomplished through collaboration with three American Indian Communities in the Choctaw Nation of Oklahoma and will be met through the following objectives: 1) collaboratively create and validate a community designed survey instrument to obtain American Indian community member perceptions of barriers to cancer-related screenings; 2) enhance the Project Leader's (PL)understanding of survey instrument design and validation and community-based participatory research (CBPR) practical application; 3) create a foundation for collaboration with focus communities to build a practical plan for the implementation of the larger CBPR project for Community Designed Cancer Detection Plans for American Indian Communities. The development and validation of a community designed survey for measuring barriers to cancer screening among American Indians will combine the principles of CBPR and best practices in modern measurement theory. The scope of the community designed survey will include both males and females, and will address barriers to screening for the four cancer sites that are screened: breast, cervix, colorectal, and prostate. The methodology and process will utilize extensive community input via focus groups, review of constructs and items by an expert panel, cognitive testing of the constructs and items, and field testing of the instrument, with subsequent analysis of survey response rates, consistently unanswered questions, reliability and validity of responses. The construct validity of the instrument will be evaluated using factor analysis and correlation analysis. An exploratory factor analysis will be conducted to determine if the items developed """"""""load"""""""" on their screening barriers construct as intended and to determine associations among subscale components of measurements or even complete measures. Internal consistency of all factors consisting of two or more items will be assessed using the Cronbach coefficient alpha. This project is significant in that the development and validation of this survey instrument will be the foundation for a larger CBPR project for determining and addressing the barriers to cancer-related health screenings throughout the Choctaw Nation of Oklahoma. ? ? ? ?
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