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Background <p>Breast cancer screening participation remains suboptimal in China, partly due to psychological and behavioral barriers. A validated instrument is needed to assess knowledge, attitudes, and practices (KAP) related to screening behaviors among Chinese women.</p> Methods <p>A cross-sectional study with a multistage sampling approach was conducted in Guizhou Province, China. A total of 611 women aged 18–70 participated, with samples allocated for exploratory factor analysis (EFA: <i>n</i> = 314) and confirmatory factor analysis (CFA: <i>n</i> = 297). The KAP questionnaire, adapted from existing instruments and culturally tailored, included 24 knowledge items, 12 attitude items, and 8 practice items. Psychometric evaluation involved EFA, CFA, reliability testing, and measurement invariance (MI) analysis across residential settings.</p> Results <p>EFA revealed a five-factor structure encompassing three domains: knowledge (symptoms and screening/treatment), attitude (screening self-efficacy), and practice (breast self-examination and mammography utilization). CFA confirmed good model fit (CFI = 0.978; TLI = 0.976; RMSEA = 0.045 [90% CI: 0.038–0.051]; SRMR = 0.082). Internal consistency, composite reliability, and convergent validity were acceptable across all subscales (ω = 0.703–0.919; CR ≥ 0.70; AVE ≥ 0.50). Measurement invariance was supported across residential groups.</p> Conclusions <p>The validated KAP scale demonstrates strong psychometric properties and is suitable for assessing breast cancer screening behaviors in Chinese women. It provides a reliable tool for both research and practice, facilitating the identification of women at risk of low screening participation and informing tailored intervention strategies.</p>

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Psychometric validation of a knowledge, attitudes, and practices (KAP) scale for breast cancer screening among Chinese women

  • 期刊论文

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  • 发表日期：

    2025年10月14日

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  • Yang Liao,
  • Suhaily Mohd Hairon,
  • Najib Majdi Yaacob,
  • Tengku Alina Tengku Ismail,
  • Li Luo

摘要

Background

Breast cancer screening participation remains suboptimal in China, partly due to psychological and behavioral barriers. A validated instrument is needed to assess knowledge, attitudes, and practices (KAP) related to screening behaviors among Chinese women.

Methods

A cross-sectional study with a multistage sampling approach was conducted in Guizhou Province, China. A total of 611 women aged 18–70 participated, with samples allocated for exploratory factor analysis (EFA: n = 314) and confirmatory factor analysis (CFA: n = 297). The KAP questionnaire, adapted from existing instruments and culturally tailored, included 24 knowledge items, 12 attitude items, and 8 practice items. Psychometric evaluation involved EFA, CFA, reliability testing, and measurement invariance (MI) analysis across residential settings.

Results

EFA revealed a five-factor structure encompassing three domains: knowledge (symptoms and screening/treatment), attitude (screening self-efficacy), and practice (breast self-examination and mammography utilization). CFA confirmed good model fit (CFI = 0.978; TLI = 0.976; RMSEA = 0.045 [90% CI: 0.038–0.051]; SRMR = 0.082). Internal consistency, composite reliability, and convergent validity were acceptable across all subscales (ω = 0.703–0.919; CR ≥ 0.70; AVE ≥ 0.50). Measurement invariance was supported across residential groups.

Conclusions

The validated KAP scale demonstrates strong psychometric properties and is suitable for assessing breast cancer screening behaviors in Chinese women. It provides a reliable tool for both research and practice, facilitating the identification of women at risk of low screening participation and informing tailored intervention strategies.