Development and validation of an information-motivation-behavioral skills questionnaire for colorectal cancer prevention in a high-risk population

Abstract Background Colorectal cancer (CRC) is one of the most prevalent cancers, and the risk of CRC is substantially greater in a high-risk population than in the general population. However, no existing assessment instruments have been specifically designed to evaluate CRC prevention behaviors in...

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Main Authors: Bo Xin, Qiuli Zhao, Dong Chen, Dexin Ma, Han Su, Wenhui Jiang
Format: Article
Language:English
Published: BMC 2025-04-01
Series:BMC Psychology
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Online Access:https://doi.org/10.1186/s40359-025-02700-5
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author Bo Xin
Qiuli Zhao
Dong Chen
Dexin Ma
Han Su
Wenhui Jiang
author_facet Bo Xin
Qiuli Zhao
Dong Chen
Dexin Ma
Han Su
Wenhui Jiang
author_sort Bo Xin
collection DOAJ
description Abstract Background Colorectal cancer (CRC) is one of the most prevalent cancers, and the risk of CRC is substantially greater in a high-risk population than in the general population. However, no existing assessment instruments have been specifically designed to evaluate CRC prevention behaviors in a high-risk population. The aim of this study was to develop and psychometrically validate an information-motivation-behavioral skills (IMB) questionnaire tailored for the population at high risk for CRC (IMB-CRC) to assess the factors influencing prevention behaviors. Methods This cross-sectional study was conducted in northeastern China. The initial questionnaire items were derived from a comprehensive literature review, semistructured interviews analyzed via content analysis, and expert focus group discussions. Content validity was assessed through expert consultation using the Delphi method, and face validity was evaluated in the high-risk population for CRC. Explanatory factor analysis (EFA) was performed on Sample 1 (N = 287) to identify underlying factors, and confirmatory factor analysis (CFA) was performed on Sample 2 (N = 224) to validate the model. Internal consistency and test-retest reliability were also examined to ensure the stability and consistency of the questionnaire. Results The final IMB-CRC comprises 21 items distributed across four dimensions: prevention information (7 items), objective skills (5 items), self-efficacy (5 items), and motivation (4 items), collectively accounting for 61.99% of the variance. CFA indicated that the proposed model fit the data well (χ2/df = 1.779, RMSEA = 0.059, AGFI = 0.852, GFI = 0.883, CFI = 0.950, IFI = 0.951, TLI = 0.943, and NFI = 0.894). The item content validity index (I-CVI) for individual items ranged from 0.905 to 1, and the scale content validity index (S-CVI) was 0.952, suggesting good content validity. The IMB-CRC demonstrated high reliability, with a Cronbach’s alpha of 0.937, McDonald’s omega of 0.939, and test-retest reliability of 0.919. Significant positive correlations were observed between the IMB-CRC and each of its four dimensions, indicating that higher IMB-CRC scores were associated with greater engagement in cancer prevention behaviors among the high-risk population. Conclusion The IMB-CRC exhibited appropriate validity and reliability, indicating that this questionnaire is a robust tool for assessing behavioral components essential for CRC prevention in the high-risk population. Health care professionals and policymakers can use the IMB-CRC to develop targeted CRC risk communication and behavioral education strategies, thereby improving the preventive abilities of a high-risk population.
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spelling doaj-art-2c202d55a9ea47aca10b7efffcdf1be22025-08-20T02:12:03ZengBMCBMC Psychology2050-72832025-04-0113111410.1186/s40359-025-02700-5Development and validation of an information-motivation-behavioral skills questionnaire for colorectal cancer prevention in a high-risk populationBo Xin0Qiuli Zhao1Dong Chen2Dexin Ma3Han Su4Wenhui Jiang5Health Science Center, Xi’an Jiaotong UniversityThe Second Affiliated Hospital of Harbin Medical UniversityDepartment of Nursing, Heilongjiang Nursing CollegeDepartment of Colorectal Surgery, the Second Affiliated Hospital of Harbin Medical UniversityThe Second Affiliated Hospital of Harbin Medical UniversityHealth Science Center, Xi’an Jiaotong UniversityAbstract Background Colorectal cancer (CRC) is one of the most prevalent cancers, and the risk of CRC is substantially greater in a high-risk population than in the general population. However, no existing assessment instruments have been specifically designed to evaluate CRC prevention behaviors in a high-risk population. The aim of this study was to develop and psychometrically validate an information-motivation-behavioral skills (IMB) questionnaire tailored for the population at high risk for CRC (IMB-CRC) to assess the factors influencing prevention behaviors. Methods This cross-sectional study was conducted in northeastern China. The initial questionnaire items were derived from a comprehensive literature review, semistructured interviews analyzed via content analysis, and expert focus group discussions. Content validity was assessed through expert consultation using the Delphi method, and face validity was evaluated in the high-risk population for CRC. Explanatory factor analysis (EFA) was performed on Sample 1 (N = 287) to identify underlying factors, and confirmatory factor analysis (CFA) was performed on Sample 2 (N = 224) to validate the model. Internal consistency and test-retest reliability were also examined to ensure the stability and consistency of the questionnaire. Results The final IMB-CRC comprises 21 items distributed across four dimensions: prevention information (7 items), objective skills (5 items), self-efficacy (5 items), and motivation (4 items), collectively accounting for 61.99% of the variance. CFA indicated that the proposed model fit the data well (χ2/df = 1.779, RMSEA = 0.059, AGFI = 0.852, GFI = 0.883, CFI = 0.950, IFI = 0.951, TLI = 0.943, and NFI = 0.894). The item content validity index (I-CVI) for individual items ranged from 0.905 to 1, and the scale content validity index (S-CVI) was 0.952, suggesting good content validity. The IMB-CRC demonstrated high reliability, with a Cronbach’s alpha of 0.937, McDonald’s omega of 0.939, and test-retest reliability of 0.919. Significant positive correlations were observed between the IMB-CRC and each of its four dimensions, indicating that higher IMB-CRC scores were associated with greater engagement in cancer prevention behaviors among the high-risk population. Conclusion The IMB-CRC exhibited appropriate validity and reliability, indicating that this questionnaire is a robust tool for assessing behavioral components essential for CRC prevention in the high-risk population. Health care professionals and policymakers can use the IMB-CRC to develop targeted CRC risk communication and behavioral education strategies, thereby improving the preventive abilities of a high-risk population.https://doi.org/10.1186/s40359-025-02700-5Colorectal cancerPreventionHigh-risk populationQuestionnaireReliabilityValidity
spellingShingle Bo Xin
Qiuli Zhao
Dong Chen
Dexin Ma
Han Su
Wenhui Jiang
Development and validation of an information-motivation-behavioral skills questionnaire for colorectal cancer prevention in a high-risk population
BMC Psychology
Colorectal cancer
Prevention
High-risk population
Questionnaire
Reliability
Validity
title Development and validation of an information-motivation-behavioral skills questionnaire for colorectal cancer prevention in a high-risk population
title_full Development and validation of an information-motivation-behavioral skills questionnaire for colorectal cancer prevention in a high-risk population
title_fullStr Development and validation of an information-motivation-behavioral skills questionnaire for colorectal cancer prevention in a high-risk population
title_full_unstemmed Development and validation of an information-motivation-behavioral skills questionnaire for colorectal cancer prevention in a high-risk population
title_short Development and validation of an information-motivation-behavioral skills questionnaire for colorectal cancer prevention in a high-risk population
title_sort development and validation of an information motivation behavioral skills questionnaire for colorectal cancer prevention in a high risk population
topic Colorectal cancer
Prevention
High-risk population
Questionnaire
Reliability
Validity
url https://doi.org/10.1186/s40359-025-02700-5
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