Abstract
Background: Lung cancer screening is a recent recommendation for long-term smokers. Understanding individual health beliefs about screening is a critical component in future efforts to facilitate patient-provider conversations about screening participation.
Objective: The aim of this study was to describe the development and psychometric testing of 4 new scales to measure lung cancer screening health beliefs (perceived risk, perceived benefits, perceived barriers, self-efficacy).
Methods: In phase I, 4 scales were developed from extensive literature review, item modification from existing Breast and Colorectal Cancer Screening Health Belief Scales, focus groups with long-term smokers, and evaluation/feedback from a panel of 10 content experts. In phase II, we conducted a survey of 497 long-term smokers to assess the final scales' reliability and validity.
Results: Phase I: content validity was established with the content expert panel. Phase II: internal consistency reliability of the scales was supported with Cronbach's [alpha]'s ranging from .88 to .92. Construct validity was established with confirmatory factor analysis and testing for differences between screeners and nonscreeners in theoretically proposed directions.
Conclusions: Initial testing supports the scales are valid and reliable. These new scales can help investigators identify long-term smokers more likely to screen for lung cancer and are useful for the development and testing of behavioral interventions regarding lung cancer screening.
Implications for Practice: Development of effective interventions to enhance shared decision making about lung cancer screening between patients and providers must first identify factors influencing the individual's screening participation. Future efforts facilitating patient-provider conversations are better informed by understanding the perspective of the individual making the decision.