Indicators to Measure Health Literacy for Cervical Cancer Screening and Behavioral Intention to Cervical Cancer Screening

Abstract

This research aimed to develop the indicators to measure health literacy and behavioral intention for cervical cancer screening by applying Don Nutbeam’s health literacy concept. The study also aimed to conduct analysis on confirmatory factors that influence the behavioral intention to cervical cancer screen-ing. Furthermore, the study also aimed to explore direct and indirect affect of causal factors that influence the behavioral intention to cervical cancer screening. The instruments in this study comprised of the general information inquiries questionnaire, the health literacy and the behavioral intention to cervical cancer screening measures. The research tools were tested for content validity by 5 experts. The samples were 422 women of 30-60 years old women from nationwide selected by multistage sampling. Data analysis included percentage, mean, standard deviation and multiple regression analysis. Structural equation model and Path analysis were used to test construct validity. The results reveal that the health literacy and behavioral intention for cervical cancer screening scales had excellent reliability (Cronbach alpha=0.9, KR-20=0.8). The index of item-objective congruence (IOC) was between 0.8 - 1.0. The confirmatory factor analysis showed the model was consistent with empirical data at good level. ( 2 =980.66, df=378, X 2 /df=2.59, p<0.05, CFI=0.98, TLI=0.97, SRMR=0.05, RMSEA=0.06). Variables that most directly influence behavioral intention for cervical cancer screening at the statistical significant level of 0.05 were the self-management and health decision for cervical cancer screening which their coefficients of influence were 0.5 and 0.2, respectively. Variables that most indirectly influence behavioral intention for cervical cancer screening were accessibility to health information for cervical cancer screening which influential path via the self-management for cervical cancer screening. Secondly, the health communication skill for cervical cancer screening which influential path via accessibility to health information for cervical cancer screening and pass through the self-management for cervical cancer screening, which their coefficients of influence were 0.3 and 0.2, respectively. The findings of this study suggested that the assessment tool is suitable for measuring health literacy and behavioral intention for cervical cancer screening. Moreover, other researchers are encouraged to use or adapt this tool to their specific context.