Translation, Cross-Cultural Adaptation, and Validation of the Malay Version of the Protection Motivation Theory Scale Questionnaire for Pap Smear Screening

Abstract

Pap smear screening can detect cervical cancer early, but is underutilized. Motivational factors play a role in ensuring that women undergo Pap smear screening. This study was conducted to validate the adapted instrument, which was based on the protection motivation theory (PMT), into the Malay language to evaluate the motivational factors for Pap smear screening among women. The original 26-item PMT scale was developed based on seven constructs of the PMT framework. The adaptation involved translation by bilingual experts (n = 4), followed by synthesis (n = 6). Subsequently, we performed content validation (content validation index, CVI) among the health experts (n = 5) and face validation (face validation index, FVI) among women (n = 11). Reliability testing for internal consistency was determined via the confirmatory factor analysis (CFA) of women aged between 21 and 65 years (n = 150). One item was deleted based on the expert consensus, leaving a total of 25 items after the adaptation. The validation yielded a good CVI and FVI. Prior to CFA reliability testing, one item was deleted due to very low factor loading. The CFA indicated a good fit for 24 items. The factor loading (range: 0.45–0.98), average variance extracted (range: 0.44–0.90), and composite reliability (range: 0.69–0.97) indicated that the convergent validity for each construct was acceptable, except for the perceived vulnerability. However, the perceived vulnerability construct was accepted based on expert verification. We confirmed that the translation, cross-cultural, adaptation, and validation of the Malay-version PMT scale were valid and reliable. The scale contains 24 items that represent the seven constructs of the PMT framework.

Indonesia Translation and Cross-Cultural Validation of Pediatric Anesthesia Parent Satisfaction (PAPS) Questionnaire

“…Good constructs achieve when factor loading >0.40. Before CFA was conducted, Keyser-Meyer-Olkin (KMO) and Bartlett's test were conducted to measure sampling adequacy [ 16 ]. The KMO value was divided into several ranges: KMO ≥ 0.6 means low adequacy, KMO ≥ 0.7 means moderate adequacy, KMO ≥ 0.8 means high adequacy, and KMO ≥ 0.9 means very high [ 17 ].…”

“…The questionnaire is valid if Pearson’s correlation shows p <0.05 and has good construct validity (CFA >0.4) [ 15 , 16 ]. It was said to be reliable if Cronbach’s Alpha had a value of >0.70 [ 18 ].…”

Understanding cervical cancer screening motivations from women and health practitioners’ perspectives: A qualitative exploration

“…When faced with a threat such as CC, a person will first appraise it based on how likely it can affect them (perceived vulnerability), how bad it is (perceived severity), and its potential consequences (fear appraisal). Subsequently, the person decides how the threat (CC) can be reduced by determining how likely they could perform the required behavior, i.e., CC screening (self-efficacy), evaluate the potential cost (response cost), and the resources in performing such behavior (response efficacy) ( Li et al, 2020 , Romli et al, 2022 , Hassani et al, 2014 ). Intervention studies that focused on motivations used these seven PMT constructs as important elements and reported that the effects were evident ( Malmir et al, 2018 , Li et al, 2020 ).…”