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Cancer Epidemiology, Biomarkers & Prevention
Cancer Epidemiology, Biomarkers & Prevention
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Factorial Validity and Invariance of a Survey Measuring Psychosocial Correlates of Colorectal Cancer Screening among African Americans and Caucasians

Jasmin A. Tiro, Sally W. Vernon, Terry Hyslop and Ronald E. Myers
Jasmin A. Tiro
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Sally W. Vernon
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Terry Hyslop
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Ronald E. Myers
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DOI: 10.1158/1055-9965.EPI-05-0217 Published December 2005
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    Figure 1.

    Five-factor general colorectal cancer screening measurement model.

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  • Table 1.

    Demographic characteristics by race and sex from a colorectal cancer screening intervention trial of primary care patients (n = 1,413)

    Total (n = 1,411%*)Caucasian males (n = 274%)Caucasian females (n = 291%)African American males (n = 195%)African American females (n = 653%)Test of difference
    Age, mean59.259.359.458.159.4F(3) = 2.11, P = 0.086
    Marital status
        Married/partner42.762.845.762.627.0χ2(3) = 143.9, P < 0.001
    Educational attainment
        <High school13.12.96.221.517.9χ2(9) = 376.9, P < 0.001
        High school/GED36.417.523.744.647.6
        Some college18.211.316.521.021.0
        4-y college degree+32.368.253.612.813.5
    • * Some percentages may not add up to 100 due to “refused” and “don't know” responses.

  • Table 2.

    Internal consistency reliabilities for five psychosocial scales by race and sex from a colorectal cancer screening intervention trial of primary care patients (n= 1,413)

    ConstructsCronbach's α
    Total (N = 1,411)Caucasian males (n = 274)Caucasian females (n = 291)African American males (n = 195)African American females (n = 653)
    Salience and coherence0.5630.5760.5990.5520.548
    Cancer worries0.6000.6950.6920.5700.528
    Perceived susceptibility0.6470.6950.7630.5260.598
    Response efficacy0.6370.4710.6050.6830.662
    Social influence0.6120.5410.5510.6730.604
  • Table 3.

    Results of the single-group and multigroup confirmatory factor analysis of the 16 general colorectal cancer screening items for four race-sex subgroups (n= 1,413) from a colorectal cancer screening intervention trial of primary care patients

    Modelnχ2Scaling correction factorMean-adjusted χ2*dfPCFIRMSEA (90% CI)
    Five-factor
        White males274176.916171.053940.0000.8920.055 (0.041-0.068)
        White females291182.742154.442940.0000.9140.047 (0.033-0.060)
        Black males195119.91196.601940.4070.9940.012 (0.000-0.040)
        Black females653244.121213.081940.0000.9120.044 (0.036-0.052)
    Five-factor and two correlated errors
        White males274126.920123.250920.0160.9560.035 (0.016-0.050)
        White females291141.781121.686920.0210.9580.033 (0.014-0.048)
        Black males195110.25390.348920.5290.9990.000 (0.000-0.037)
        Black females653187.851164.390920.0000.9470.035 (0.026-0.043)
    1. Unconstrained1,413566.8091.14497.7153680.0000.9590.016 (0.012-0.019)
    2. Equal factor loadings1,413650.2011.19546.7684010.0000.9540.016 (0.012-0.019)
    3. Equal factor loadings with rcc_low constraint released1,413614.3801.19518.1203980.0000.9620.015 (0.011-0.018)
    Model comparisons
    χ2diff
    Difference df
    Difference test scaling correction factor
    Mean-adjusted χ2diff†
    P
    1 vs 283.392331.7547.6350.048
    1 vs 347.571301.7627.0000.623
    • Abbreviations: df, degrees of freedom; scf, scaling correction factor; dtscf, difference test scaling correction factor; RMSEA, root mean square error of approximation.

    • ↵* The mean-adjusted χ2 is used when the outcome variables has a non-normal distribution. Satorra and Bentler (61) showed that if the usual normal-theory χ2 test statistic is divided by a scaling correction factor, the scaled statistic better approximates a χ2 distribution.

    • ↵† The difference between two mean-adjusted χ2 for nested models does not follow a χ2 distribution. Satorra and Bentler (66) showed that the following equation for the mean-adjusted difference statistic, which incorporates a difference test scaling correction factor, does follow a χ2 distribution. Mean-adjusted χ2diff = (χ 2nested (χ 2nested − χ 2comparison) / dtscf. dtscf = (dfnested × scfnested − dfcomparison × scfcomparison) / (dfnested − dfcomparison).

  • Question no.Variable nameItem description
    Salience and coherence: the perception that performing a health behavior is consistent with beliefs about how to protect and maintain health
    C1Cc_senseColorectal cancer screening makes sense to me.
    C3Cc_importHaving colorectal cancer screening is an important thing for me to do.
    C4Cc_protectHaving colorectal cancer screening can help to protect my health.
    C6Rcc_healthyI will be just as healthy if I avoid having colorectal cancer screening
    Cancer worries: concerns about negative consequences of completing the behavior
    C5Cc_abnormalI am afraid of having an abnormal colorectal cancer screening test result.
    C8Cc_showI am worried that colorectal cancer screening will show that I have colorectal cancer or polyps.
    Perceived susceptibility: subjective personal risk for developing colorectal cancer or polyps
    C11Cc_chighThe chance that I might develop colorectal cancer is high.
    C12Rcc_lowCompared with other persons my age, I am at lower risk for colorectal cancer.
    C13Cc_likelyIt is very likely that I will develop colorectal cancer or polyps.
    C15Cc_phighThe chances that I will develop colorectal polyps are high.
    Response efficacy: the belief that adopting a behavior will be effective in reducing disease threat
    C14Cc_preventedWhen colorectal polyps are found and removed, colorectal cancer can be prevented
    C16Cc_earlyWhen colorectal cancer is found early, it can be cured.
    Social influence: perceived beliefs about and desire to comply with key references' attitudes toward the behavior
    C2Cc_famdoI want to do what members of my immediate family think I should do about colorectal cancer screening.
    C7Cc_famthkMembers of my immediate family think I should have colorectal cancer screening.
    C9Cc_drdoMy doctor or health professional thinks I should have colorectal cancer screening.
    C10Cc_drthkI want to do what my doctor or health professional thinks I should do about colorectal cancer screening.
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Cancer Epidemiology Biomarkers & Prevention: 14 (12)
December 2005
Volume 14, Issue 12
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Factorial Validity and Invariance of a Survey Measuring Psychosocial Correlates of Colorectal Cancer Screening among African Americans and Caucasians
Jasmin A. Tiro, Sally W. Vernon, Terry Hyslop and Ronald E. Myers
Cancer Epidemiol Biomarkers Prev December 1 2005 (14) (12) 2855-2861; DOI: 10.1158/1055-9965.EPI-05-0217

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Factorial Validity and Invariance of a Survey Measuring Psychosocial Correlates of Colorectal Cancer Screening among African Americans and Caucasians
Jasmin A. Tiro, Sally W. Vernon, Terry Hyslop and Ronald E. Myers
Cancer Epidemiol Biomarkers Prev December 1 2005 (14) (12) 2855-2861; DOI: 10.1158/1055-9965.EPI-05-0217
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