Development of the mammography beliefs and attitudes questionnaire for low-health-literacy Mexican-American women.

Abstract Low-income, low-health-literacy Mexican-American women exhibit poor mammography screening participation and are being diagnosed at later stages of breast cancer than are non-Hispanic white women. No instrument has been available to measure the impact of cultural and psycho-social factors on the intent to seek mammography screening participation in this population. In this article the author describes the development process of the English Mammography Beliefs and Attitudes Questionnaire (MBAQ) and the Spanish Mammography Beliefs and Attitudes Questionnaire (SMBAQ). The Theory of Planned Behavior is the theoretical framework underlying these instruments designed to measure intent to seek mammography screening in low-health-literacy Mexican-American women. The process of developing the MBAQ utilized input from low-healthliteracy Mexican-American women and an expert committee. The MBAQ was translated into Spanish and assessed for content validity and reading level. In the discussion, the author explains why the MBAQ and SMBAQ are appropriate tools for use with low-health-literacy Mexican-American women to measure their intentions to seek mammography screening. Limitations of the study and implications for practice and research are presented. Citation: Lopez-McKee, G., (November 24, 2010) "Development of the Mammography Beliefs and Attitudes Questionnaire for Low-Health-Literacy Mexican-American Women" OJIN: The Online Journal of Issues in Nursing Vol. 16 No. 1. DOI: 10.3912/OJIN.Voll6No01PPT04 Keywords: breast cancer, cancer fatalism, translation of instruments, instrument development for low-healthliteracy individuals, mammography screening among Hispanic women, breast cancer prevention, the Theory of Planned Behavior, health- 1 ite racy among Mexican-American women, Spanish language instruments, cultural adaptation of health instruments. Only 38% of low-income, low-health-literacy Mexican-American women over the age of 40 have regular screening mammograms despite the availability of federally subsidized mammograms for this population. Low-income, lowhealth-literacy Mexican-American women are more likely to be diagnosed at a later stage of breast cancer and have lower survival rates than non-Hispanic white women (American Cancer Society (ACS), 2007; Fernandez, Palmer. & Leona-Wu. 2005: Intercultural Cancer Council fICO, 2005: O'Brien et al.. 2003^. In this article I will describe the development process of the English Mammography Beliefs and Attitudes Questionnaires (MBAQ) and the Spanish Mammography Beliefs and Attitudes Questionnaire (SMBAQ), utilizing the Theory of Planned Behavior as the theoretical framework. I designed these questionnaires to measure the intent to seek mammography screening in low-health-literacy Mexican-American women. The method used to develop the MBAQ included the utilization of input from low-health-literacy Mexican-American women and an expert committee. The MBAQ was translated into Spanish and assessed for content validity and reading level. The instruments have subsequently been revised and are currently titled the MBAQ-R and the SMBAQ-R. In the discussion section I will explain why the MBAQ and SMBAQ are appropriate tools for use with low-health-literacy Mexican-American women to measure their intentions to seek mammography screening. Limitations of the study and implications for practice and research will be presented. It is my goal that this article will motivate and guide others to develop health-related instruments or materials to facilitate health literacy among the Hispanic population. One of the reasons I developed the MBAQ and SMBAQ specifically for use with low-health-literacy Mexican-American women was that health-related materials currently available in Spanish have been written to reach a generic Hispanic audience. However, Hispanics are composed of many different subgroups, each with different usage of Spanish language terms. …