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Confirmatory Factor Analysis of the Chinese Breast Cancer Screening Beliefs Questionnaire

Kwok, Cannas PhD; Fethney, Judith BA; White, Kate PhD

doi: 10.1097/NCC.0b013e31823fcb6a

Background: Chinese women have been consistently reported as having low breast cancer screening practices. The Chinese Breast Cancer Screening Beliefs Questionnaire (CBCSB) was designed to assess Chinese Australian women’s beliefs, knowledge, and attitudes toward breast cancer and screening practices.

Objectives: The objectives of the study were to confirm the factor structure of the CBCSB with a new, larger sample of immigrant Chinese Australian women and to report its clinical validity.

Methods: A convenience sample of 785 Chinese Australian women was recruited from Chinese community organizations and shopping malls. Cronbach α was used to assess internal consistency reliability, and Amos v18 was used for confirmatory factor analysis. Clinical validity was assessed through linear regression using SPSS v18.

Results: The 3-factor structure of the CBCSB was confirmed, although the model required respecification to arrive at a suitable model fit as measured by the goodness-of-fit index (0.98), adjusted goodness-of-fit index (0.97), normed fit index (0.95), and root mean square error of approximation (0.031). Internal consistency reliability coefficients were satisfactory (>.6). Women who engaged in all 3 types of screening had more proactive attitudes to health checkups and perceived less barriers to mammographic screening.

Conclusion: The CBCSB is a valid and reliable tool for assessing Chinese women’s beliefs, knowledge, and attitudes about breast cancer and breast cancer screening practices.

Implication for Practice: The CBCSB can be used for providing practicing nurses with insights into the provision of culturally sensitive breast health education.

Author Affiliations: Sydney Nursing School, University of Sydney, Australia.

This study was supported by Early Career Development Fellowship from the Cancer Institute of New South Wales.

The authors have no conflicts of interest to disclose.

Correspondence: Cannas Kwok, PhD, Sydney Nursing School, MO2, University of Sydney, New South Wales 2006, Australia (

Accepted for publication October 28, 2011.

© 2012 Lippincott Williams & Wilkins, Inc.