Testing the Validity and Reliability of the Barriers to Home Bowel Cancer Screening Scale

Testing the Validity and Reliability of the Barriers to Home Bowel Cancer Screening Scale

The purpose of this research is part of a USQ larger teamwork effort lead by Belinda Goodwin and Michael Ireland to improve outcomes in Home Bowel Cancer screening within the National Bowel Cancer Screening Program (NBCSP) to eligible Australians.
Objective: This particular thesis focuses on assessing the validity and reliability of a psychometric tool called Barriers to Bowel Cancer screening Scale (hereon BB-CanS) for measuring common barriers to home bowel cancer screening in a larger novel sample, via mailed kits dispensed to eligible Australians through the NBCSP.
Methods: Forty-nine items measuring barriers to bowel cancer screening, identified through the literature, and qualitative and quantitative research in the derivation study were presented to a large sample (N = 1158) of Australian NBCSP recipients age (50-74 years old). Invitees’ previous screening information and demographic information was also gathered. Confirmatory factor analysis was used to assess whether the factor structure, construct validity and internal reliability of the scale remained stable in the current sample.
Results: The ‘good model fit’ of the BB-Cans confirmed in the current sample (RMSEA = .034, RMSEA 90% CI [.032, .036], CFI = .972, TLI = .970, SRMR = .058). Consistent with original scale results, four clear barrier types to screening (factors) were confirmed, namely disgust for the process of screening, avoidance of test outcomes, practical ii difficulties (or challenges), and the need for greater autonomy. The BB-CanS also includes three stand-alone items corresponding to the most commonly-cited barriers to screening (screening outside of the program, lack of planning, misplacing the kit) in addition to the four clear and highly-correlated barrier types cited above. The scale was further refined in an effort to improve fit, with the removal of seven items; therefore a 39-item scale was retained as a final version (RMSEA = .029, RMSEA 90% CI [.027, .032], CFI = .982, TLI = .981, SRMR = .050). The 39-item brief version of the scale confirmed the scale’s construct validity across age and gender groups.
Conclusions: The BB-CanS is a valid and reliable scale and the findings support the results of the 2021 derivation study by Goodwin and colleagues. Findings of the current study call to apply multi‐faceted intervention strategies that address the broad range of barrier types covered by the four factors, as opt-out NBCSP participants reported significantly higher ratings across all barriers. This thesis’ findings will inform the strategies design and planning of the ongoing/future initiatives that focus on promoting NBCSP participation.

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