Psychometric Properties of Cultural Barriers to Prostate Cancer Screening Among African American Males

Background: Prostate cancer is the second leading cause of cancer death among men in the United States, and African American men especially represent a high risk population for prostate cancer (American Cancer Society, 2016). Although the overall prostate cancer incidence rates have been declining since 1992, the average annual prostate cancer incidence rates among African American men were still higher than any other racial groups, and the mortality rates were 2.4 times higher than that of Caucasian counterparts (American Cancer Society, 2016). One of the factors that may contribute to this disparity in the prostate cancer mortality is the low rate of prostate cancer screening among African American males (American Cancer Society, 2016). While numerous studies addressed various barriers to PSA among African American males, cultural barriers were frequently referred to as one of the main reason that that deterred them to participate in prostate cancer screening (Allen, Kennedy, Wilson-Glover, & Gilligan, 2007; Sellers & Ross, 2003). Unfortunately, however, relatively little is known about psychometric results of the scales about cultural barriers among African American males. The purpose of this study is to examine the psychometric properties and the factor structures of cultural barriers scale that was administered among African American males.

Methods: Data were collected from a cross-sectional survey using a convenience and purposive sampling. A total of 251 males participated in this study. The participants were mostly African Americans (93.6%) with a mean age of 58.3 years (SD=15.3). While 38.6% of participants were married, 33.9% of participants were separated, and 12% were divorced. Only 23.1% of participants were fulltime or part-time employees, and 66.5 % of participants had an annual household income below $29,900.

Results: Bartlett’s test of sphericity indicated that this data set is appropriate for factor analysis (χ²= 640.7,  p<.001), and Kaiser-Meyer-Olkin Measure of Sampling Adequacy indicated a value of .736, which showed that the degree of common variance is good. The factors loading for each item are all greater than the cutoff point ( <.4), and 10 items are retained in the final model. The three factors were generated when using a basic scree-test and eigenvalue at <1.0 criteria: Modesty, crisis orientation, and family support. These three factors which were rotated to position of maximum orthogonality in five iterations, explain 59.3 % of variances. The results for internal consistency for each factor showed mixed outcomes. While the alphas for modesty and crisis orientation was good (α= .868 for modesty and α=.634 for crisis orientation), the alpha for family support was not acceptable (α=.485).

Implications: To understand the influences of cultural barriers to cancer screening among African American males, empirical evaluation of the psychometric properties of the cultural barriers scale should precede further multivariate analyses. The findings showed that overall, the scale had good psychometric properties among African American men, but some items need to be revised or dropped because of low internal consistency.