Validation of an Indonesian Version of the Breast Cancer Awareness Scale (BCAS-I)

Document Type : Research Articles


1 Doctor of Public Health Program, Faculty of Public Health, Khon Kaen University, Khon Kaen 40002, Thailand

2 Faculty of Public Health, Universitas Ahmad Dahlan, Yogyakarta 55166, Indonesia.

3 Department of Epidemiology and Biostatistics, Faculty of Public Health, Khon Kaen University, Khon Kaen 40002, Thailand

4 ASEAN Cancer Epidemiology and Prevention Research Group, Khon Kaen University, Khon Kaen, Thailand.

5 Faculty of Public Health, Thammasat University, Thailand

6 Biostatistics center of excellence Faculty of Medicine Chulalongkorn University


Background: Raising breast cancer awareness is a key strategy to reduce associated mortality. While a paucity of adequately validated instruments for breast cancer awareness is applicable across cultures, even outside the health care setting such instruments have been developed. Objective: This study investigated the validity and psychometric properties of a breast cancer awareness scale in Indonesia (BCAS-I). Methods: This cross-sectional study was carried out among Indonesian women conveniently selected within three provinces (Yogyakarta, South of Sumatera and East Nusa Tenggara) located in rural-urban areas using stratified random sampling. First, we translated all questionnaires from English to the local language and then back-translated. The third step was to perform psychometric testing of the adapted instrument by establishing internal consistency (Cronbach’s alpha score 0.79) and construct validity by confirmatory factor analysis (CFA). Results: In the 856 participants who responded (responded rate = 98.28%), the age ranged from 18 to 80 years old (mean = 30, SD = 11). The BCAS-I was shown to have good internal consistency, and CFA demonstrated the model fit data adequately (χ2 = 922.267, df = 515, p <0.001, comparative fit index = 0.965, Tucker-Lewis Index = 0.96, goodness-of-fit index = 0.97, adjusted goodness-of-fit index = 0.97, root-mean-square error of approximation = 0.03 95% confidence interval: 0.027, 0.034). The final version of BCAS-I consists of 33 items across 5 domains that cover most key aspects of breast cancer awareness for this population. Conclusion: The BCAS-I demonstrated good psychometric properties and was found to be valid to provide a measurement of breast cancer awareness in Asian women in general and Indonesian women in particular.


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