Questionnaire Validation of Colorectal Cancer Literacy Scale among Thai People in Northeastern Thailand

Background: Colorectal cancer is an important public health problem worldwide. Although progress in screeningand treatment has considerably improved the prognosis in the developed world, in developing countries colorectal cancermortality rate remains relatively high. Colorectal cancer screening literacy is an important initial step in overcoming thisproblem. Development of a validated assessment instrument is therefore important for implementation of appropriatehealth education programs to facilitate early detection. Objectives: This study focused on generation and validation ofa colorectal cancer screening literacy scale for Thai people in northeastern Thailand. Methods: This methodologicalstudy was carried out in two phases: (1) literature reviews and semi-structured interviews were used to select items,then the content and face validity were checked; and (2) a confirmatory factor analysis (CFA) was conducted to testconstruct validity and reliability. A self-administered questionnaire was used to collect data from Thai people aged 50-65 in June 2017. Results: For the total of 400 participants who responded (response rate 100 %), the age ranged from50 to 65 years old (mean = 57.3, SD = 4.616). The colorectal cancer screening literacy scale was designed to include6 domains and it was shown to have good internal consistency, and CFA demonstrated the model to fit data adequately(Chi-squared/degree of freedom = 1.079, p = 0.061, CFI = 1.00, GFI = 0.93, AGFI = 0.91, RMSEA = 0.014 and SRMR= 0.036). The final version of its, consisting of 57 items across the 6 domains covering key aspects of colorectal cancerscreening literacy, demonstrated good psychometric properties for this population. Conclusions: Use of the colorectalcancer screening literacy scale in Thai people could lead to improved educational programs for optimizing colorectalcancer screening.