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

Document Type : Research Articles


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

2 Department of Epidemiology and Biostatistics, Faculty of Public Health, Khon Kaen University, Thailand.

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

4 Department of Public Health Administration Health Promotion Nutrition, Faculty of Public Health, Khon Kaen University, Thailand.


Background: Colorectal cancer is an important public health problem worldwide. Although progress in screening
and treatment has considerably improved the prognosis in the developed world, in developing countries colorectal cancer
mortality rate remains relatively high. Colorectal cancer screening literacy is an important initial step in overcoming this
problem. Development of a validated assessment instrument is therefore important for implementation of appropriate
health education programs to facilitate early detection. Objectives: This study focused on generation and validation of
a colorectal cancer screening literacy scale for Thai people in northeastern Thailand. Methods: This methodological
study 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 test
construct 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 from
50 to 65 years old (mean = 57.3, SD = 4.616). The colorectal cancer screening literacy scale was designed to include
6 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 cancer
screening literacy, demonstrated good psychometric properties for this population. Conclusions: Use of the colorectal
cancer screening literacy scale in Thai people could lead to improved educational programs for optimizing colorectal
cancer screening.


Main Subjects

Volume 20, Issue 2
February 2019
Pages 645-651
  • Receive Date: 23 October 2018
  • Revise Date: 16 December 2018
  • Accept Date: 18 January 2019
  • First Publish Date: 01 February 2019