RESUMO
Colorectal cancer is a leading cause of cancer death in Uruguay, yet less than half of the eligible population is up to date with screenings. Research is hampered because no measures exist to assess psychosocial factors that influence screening decisions in this population. To address this gap, we report on the development and psychometric validation of the Colorectal Cancer Literacy Scale-Uruguay Version, a scale based on the health literacy model. We developed an item pool based on the extant literature, obtained feedback from experts, and conducted focus groups with community participants and health care providers. After revision, we conducted a psychometric validation with a national community sample of 405 participants. Through an exploratory factor analysis, we identified four factors that were collapsed into two for theoretical and pragmatic reasons, representing (a) disposition toward cancer prevention and (b) attitudes, beliefs, and emotions about cancer. A third factor, knowledge about colorectal cancer, was examined separately given its distinct focus. Subsequently, we conducted a confirmatory factor analysis with the remaining sample participants using Rasch measurement theory for validation purposes and to further assess the scales' psychometric properties. The resulting 44-item scale presented a good model fit with adequate EAP reliabilities and good initial discriminant validity. Further criterion-related validity analyses should be performed when additional measures are available. The Colorectal Cancer Literacy Scale-Uruguay Version is a theoretically based measure that can bring to light barriers and facilitative factors in an underscreened population at risk. Implications for theory, research, and practice are discussed.
Assuntos
Neoplasias Colorretais , Letramento em Saúde , Humanos , Psicometria , Uruguai , Emoções , Neoplasias Colorretais/diagnósticoRESUMO
Cancer is a leading cause of death worldwide and is expected to remain a public health concern for years to come. Within Latin America, Uruguay has the highest colorectal cancer rates. Heeding past calls to action, in this article we provide a critical assessment of colorectal cancer needs and opportunities in Uruguay with a focus on developing a roadmap for future action. First, we provide an overview of risk factors, screening procedures and guidelines, and screening rates. Next, we provide an overview of psychosocial factors that influence colorectal cancer screening, with the goal of providing guidance for future behavioral health promotion initiatives in Uruguay. In this effort, we present four conceptual models that may be used for interventions: the ecological systems theory, informed decision-making, the health beliefs model, and the health literacy model. Subsequently, we propose using an integrated model based on the ecological systems theory and health literacy model to develop national, local, and community-based interventions to increase screening rates and lower the colorectal cancer burden in Uruguay. We close the paper with a summary and implications section, including recommendations for future research programs focused on the assessment of factors that influence screening.
RESUMO
Abstract Cancer is a leading cause of death worldwide and is expected to remain a public health concern for years to come. Within Latin America, Uruguay has the highest colorectal cancer rates. Heeding past calls to action, in this article we provide a critical assessment of colorectal cancer needs and opportunities in Uruguay with a focus on developing a roadmap for future action. First, we provide an overview of risk factors, screening procedures and guidelines, and screening rates. Next, we provide an overview of psychosocial factors that influence colorectal cancer screening, with the goal of providing guidance for future behavioral health promotion initiatives in Uruguay. In this effort, we present four conceptual models that may be used for interventions: the ecological systems theory, informed decision-making, the health beliefs model, and the health literacy model. Subsequently, we propose using an integrated model based on the ecological systems theory and health literacy model to develop national, local, and community-based interventions to increase screening rates and lower the colorectal cancer burden in Uruguay. We close the paper with a summary and implications section, including recommendations for future research programs focused on the assessment of factors that influence screening.
Assuntos
Neoplasias Colorretais/prevenção & controle , Neoplasias Colorretais/epidemiologia , Fatores de Risco , Uruguai , Neoplasias Colorretais/psicologia , Detecção Precoce de Câncer , Promoção da SaúdeRESUMO
Latinas have disproportionally high rates of cervical cancer in part due to their reliance on Latino partners to make sexual health decisions, their limited knowledge about human papillomavirus (HPV), and inconsistent Pap smear screening behaviors. In this qualitative study, we examined the sexual health beliefs of Latino college men regarding HPV. Participants included 6 Mexican American college students from a large Midwestern university. We conducted 18 in-depth individual interviews about men's beliefs, attitudes, and knowledge about HPV. Through theme analysis, we identified 4 themes suggesting that participants' limited knowledge of HPV places their female partners at risk. Implications for health promotion programming are discussed.