Developing and pilot-testing a measurement tool assessing colon cancer knowledge, screening barriers, and information seeking among low-income middle- and older-age adults in the rural south

Purpose: Colon cancer screening among low-income adults warrants continuous public health attention.  This study pilot-tested a measurement tool developed to assess colon cancer knowledge, screening barriers, and information seeking among low-income middle- and older-age adults in the south.  Methods: A total of 245 people aged 40 years and above from selected rural, suburban, and small towns in Georgia completed the survey.  Results: Over 76.3% of the participants aged over 50 years, and nearly 40% had household’s income of $35,000 or less.  About 72.1% were females and 76.2% have had a colonoscopy.  The study used a five-item knowledge test to assess participants’ colon cancer knowledge level.  The mean (SD) of colon cancer knowledge scale among the study participants was 2.99 (1.159).  A 16-item barriers scale was used to assess reasons of putting off having a colonoscopy, and a 13-item scale was used to assess colon cancer information seeking behaviors.  Both scales showed satisfactory reliabilities, with alphas of .914 (CITC ranged .504 ~ .728) for the barrier scale and .886 (CITC ranged .401 ~ .719) for the information seeking scale.  There were no differences by age, gender, income, or MSA on the overall knowledge, screening barriers, or information seeking scales.  Correlation analyses showed higher information seeking scores were correlated with lower cancer screening barrier scores (p<.001).  Conclusion: This study piloted three measurement scales and showed satisfactory reliabilities validities among a low-income population group in the rural south.  The validated instrument can be used for future research and program evaluation purposes.