Role of social capital in cancer screening adherence

Community-based interventions to increase breast and cervical cancer screening among the under-screened have been somewhat, but not entirely, successful. Concepts that move away from individual-level screening predictors and toward ecological-level predictors may be useful. Because social capital encompasses both direct relations between individuals and collective relations within communities, it may be appropriate in the investigation of current cancer screening disparities. The purpose of this research was two-fold. One was to evaluate the validity and reliability of a social capital index for an adult female sample. The second was to predict breast and cervical cancer screening behavior among average-risk, age-appropriate females using self-reports of social capital. This study uses data from the California Health Interview Survey (CHIS) for psychometric analysis and prediction of cancer screening behavior. Psychometric analysis included an expert Delphi panel, as well as validity and reliability analysis. Multivariate logistic regression models tested the ability of social capital to predict breast and cervical cancer screening behavior against other known cancer screening predictors. This study validated a six-item social capital scale (α=0.75) among 20,667 adult women. Mulitvariate modeling showed that social capital is a significant predictor of breast (OR=1.08, 95%CI=1.03-1.13) and cervical (OR=1.05, 95%CI=1.01-1.10) cancer screening behavior. However, commonly known predictors of cancer screening, such as insurance status and educational attainment, were stronger predictors of screening adherence than social capital. This study is the first step in exploring the link between social capital and cancer screening behavior, and may be a promising area of research in cancer prevention and control.