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. 2025 May 22;25(1):1887.
doi: 10.1186/s12889-025-23127-y.

Validity and reliability of the Turkish version of the health belief model scale for colorectal cancer screening

Ferdane Koçoğlu  1 , Mesut Teleş  2 , Semra Kocaöz  3
Affiliations

Validity and reliability of the Turkish version of the health belief model scale for colorectal cancer screening

Ferdane Koçoğlu et al. BMC Public Health. .

Abstract

Background: Colorectal cancer ranks second among the most prevalent and deadly cancer types for both sexes. Despite having a high mortality rate, colorectal cancer is simultaneously identifiable and preventable through early diagnosis. This study was intended to assess the validity and reliability of the Turkish version of the Health Belief Model Scale for Colorectal Cancer Screening.

Methods: This methodological study evaluated the 45-item five-point Likert-type Health Belief Model Scale for Colorectal Cancer Screening. Data collection forms were administered via convenience sampling to 649 participants selected from individuals seeking health services at primary healthcare institutions. The scale's reliability and validity were evaluated via item analyses, content and construct validities, exploratory and confirmatory factor analyses, Cronbach's alpha, McDonald's omega, the Spearman-Brown formula, and test-retest reliability coefficients. The data set was randomly divided into two subsamples. EFA, reliability analyses (Cronbach's alpha, McDonald's omega, Spearman-Brown Coefficient) and item-total statistics were conducted in sample 1 (n = 324). CFA was conducted in sample 2 (n = 325). Item and scale means and, discriminant validity were calculated and tested using the total sample (N = 649).

Results: According to the resulting four-dimensional structure, the factor loads of the subscale items were 0.48-0.89, and subscales explained 49% of the total variance. The Cronbach's alpha coefficients of the subscales were 0.804-0.923. The confirmatory factor analysis revealed good fit indices (χ2/df = 2.05; RMSEA = 0.06; CFI = 0.95; IFI = 0.95; GFI = 0.80; RMR = 0.08; NFI = 0.91). The subscale means ranged from 2.23 ± 0.72 to 3.60 ± 0.70 while the item means ranged from 1.95 ± 0.81 to 3.80 ± 0.91.

Conclusion: The Turkish version of the Health Belief Model Scale for Colorectal Cancer Screening is a valid and reliable measuring tool for Turkish people. Except for barrier scale items, those with low means suggest opportunities for improvement. This scale can be applied in Turkey when measuring individuals' health belief perceptions regarding colorectal cancer screening.

Keywords: Colorectal cancer screening; Health belief model scale; Reliability; Turkish version; Validity.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: Approval was obtained from the Niğde Ömer Halisdemir University Ethics Committee (Date: December 27, 2022, No: 2022/15–17), and permission was received from the Provincial Health Directorate of Niğde, Turkey. In accordance with the Declaration of Helsinki, the purpose of the study was explained to the participants, their consent was obtained and their voluntary participation was ensured. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Factor analysis of the Turkish version of the HBMS for CRC screening —scree plot
Fig. 2
Fig. 2
Confirmatory factor analysis results for the Turkish version of the HBMS for CRC screening
See this image and copyright information in PMC

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