Adaptation and Validation of the Health Belief Model Scale for Breast Self-Examination in Mexican Women

Abstract

Objectives: In Mexico, breast cancer is often not detected until it is already at an advanced stage. Many women know about breast self-examination (BSE), but few do it correctly. BSE can assist in the early detection of breast cancer, and a valid and reliable instrument to help determine the factors of the Health Belief Model that affect the practice of BSE in Mexican women would thus be advantageous. This study evaluates the psychometric properties of the Spanish version of the Health Belief Model Scale (HBMS) for BSE and identifies the factors that influence its practice.

Methods: A cross-sectional design was used; 738 Mexican women aged 20 years and older who attended a tertiary public hospital were evaluated. The HBMS of Champion was translated into Spanish. Focus groups of women were consulted, and experts' judgments were gathered to determine content validity.

Results: In the exploratory factor analysis, a structure of 6 factors was obtained, and Cronbach's alpha scales ranged between 0.65 and 0.84. BSE practice was associated with age (odds ratio [OR] 1.05; confidence interval [CI] 1.03-1.07), self-efficacy (OR 1.16; CI 1.12-1.20), barriers (OR 0.953; CI 0.912-0.996), and health motivation (OR 0.907; CI 0.837-0.983).

Conclusion: The Spanish version of the HBMS is an adequate, valid, and reliable instrument for the Mexican population that allows us to evaluate their beliefs about breast cancer and BSE, and it should also be applicable to other Spanish-speaking people. Perceived barriers, self-efficacy, and health motivation in particular should be considered in the development of health promotion programs for Mexican women.

Keywords: breast self-examination; health belief model; reliability; validity.