Development and validation of the MARA scale in Spanish to assess knowledge and perceived risks and barriers relating to breast cancer prevention

Cancer Causes Control. 2021 Nov;32(11):1237-1245. doi: 10.1007/s10552-021-01473-7. Epub 2021 Jul 8.

Abstract

Objective: The aim of this study was to develop a measurement instrument for assessing knowledge of breast cancer and perceived risk of developing the disease (MARA).

Methods: 641 women with a mean age of 36.19 years (SD = 7.49) participated in the study. Data collection took place during 2019 and included sociodemographic data, data on history of cancer and breast cancer, perceived risk, and feelings of concern about developing breast cancer. Internal consistency, test-retest reliability, convergent validity, and structural validity were tested.

Results: The questionnaire items comprise 4 subscales: risk factors (9 items), signs and symptoms (9 items), perceived risk (6 items), barriers (7 items). A factor analysis revealed that the first two subscales had two dimensions each, whereas the other two subscales had one dimension each. Each subscale was shown to have adequate reliability (α = 0.74-0.92) and temporal stability (r = 0.201-0.906), as well as strong evidence of validity in relation to a questionnaire on breast cancer knowledge (r = 0.131-0.434). In addition, the subscales were shown to have high discriminatory power in terms of the presence or absence of a history of cancer or breast cancer, perceived risk, and feelings of concern.

Conclusion: The MARA questionnaire represents a valid, reliable tool for assessing Spanish women's knowledge, risks, perceptions, and barriers regarding breast cancer.

Keywords: Breast neoplasm; Education; Female cancers; Health promotion; Patient education; Prevention.

MeSH terms

  • Adult
  • Breast Neoplasms* / diagnosis
  • Breast Neoplasms* / epidemiology
  • Breast Neoplasms* / prevention & control
  • Female
  • Humans
  • Reproducibility of Results
  • Surveys and Questionnaires