title: Development of a Breast Cancer Awareness Scale for Thai Women: Moving towards a Validated Measure.
abstract: BACKGROUND
  Breast cancer is a major health problem among women around the world. Recent developments in screening and treatment have greatly improved the prognosis of patients with breast cancer in developed countries. However, in developing countries breast cancer mortality remains high.Breast cancer awareness is a first and important step in reducing breast cancer mortality. The development of a validated instrument to measure breast cancer awareness is crucial for the understanding and implementation of suitable health education programs to facilitate early deletion and minimize mortality.
  
  
  OBJECTIVE
  The objective of this study was to develop an instrument for the assessment of breast cancer awareness in Thai women.
  
  
  METHODS
  This methodological study was conducted in two stages: (1) literature searches and semi-structured interviews were conducted to generate items of the breast cancer awareness scale (B-CAS) which were subsequently examined for content and face validity, and (2) an exploration of the factor structure of the resulting instrument and an examination of its reliability. Data were collected using a self-administered questionnaire in Thai women aged 20-64 in August, 2015.
  
  
  RESULTS
  A total of 219 women (response rate 97.4 %) participated in this validation study. The B-CAS contains five domains with 53 items on breast cancer awareness: 1) knowledge of risk factors, 2) knowledge of signs and symptoms, 3) attitude to breast cancer prevention, 4) barriers of breast screening, and 5) health behavior related to breast cancer awareness. Items with a content validity index <0.80 were excluded, and factor structure for the remaining items reflected the hypothesized five factor model. The scales based on all retained items was shown to have strongly internal consistency reliability (Cronbach's α=0.86).
  
  
  CONCLUSIONS
  The B-CAS provides good psychometric properties to assess breast cancer awareness in women. It can be used to examine breast cancer awareness in Thai women and it could lead to the development and evaluation of suitable educational interventions for raising breast cancer awareness. Future research should focus on further validating the B-CAS including an assessment of construct and criterion-based validity.
authors.affiliation: Doctor of Public Health Program, Khon Kaen University, Thailand E-mail : cphurst@gmail.com.
authors.forename: Nitchamon
authors.initials: N
authors.lastname: Rakkapao
authors.forename: Supannee
authors.initials: S
authors.lastname: Promthet
authors.forename: Malcolm A
authors.initials: MA
authors.lastname: Moore
authors.forename: Cameron P
authors.initials: CP
authors.lastname: Hurst
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology*; D055088:Early Detection of Cancer / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D013785:Thailand / Q000453:epidemiology; D054928:Validation Studies as Topic; D055815:Young Adult