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Cervical cancer remains an important public health issue affecting women's health. Cervical cancer screening plays a key role in reducing morbidity and mortality through early detection. Women's decisions to participate in screening are influenced not only by knowledge, but also by psychosocial factors such as social norms, perceived threat, perceived benefits and barriers, and self-efficacy. The Cervical Cancer Screening Uptake Questionnaire (CCSTQ) is a multidimensional instrument designed to assess psychological and social determinants that may influence women's participation in cervical cancer screening. The aim of this study is to translate and culturally adapt the CCSTQ into Turkish and to evaluate its psychometric properties among Turkish women.
Cervical cancer remains an important public health issue affecting women's health. Cervical cancer screening plays a key role in reducing morbidity and mortality through early detection. Women's decisions to participate in screening are influenced not only by knowledge, but also by psychosocial factors such as social norms, perceived threat, perceived benefits and barriers, and self-efficacy. The Cervical Cancer Screening Uptake Questionnaire (CCSTQ) is a multidimensional instrument designed to assess psychological and social determinants that may influence women's participation in cervical cancer screening. The aim of this study is to translate and culturally adapt the CCSTQ into Turkish and to evaluate its psychometric properties among Turkish women.
This is a methodological study designed to translate, culturally adapt, and evaluate the psychometric properties of the CCSTQ in Turkish women. The study will be conducted in two phases: (1) translation and cross-cultural adaptation following international guidelines and recommendations; and (2) psychometric evaluation including factor structure, convergent validity, internal consistency, test-retest reliability, item discrimination, ceiling and floor effects, and known-groups validity. Women aged 21-65 years who meet the eligibility criteria and complete the Turkish version of the CCSTQ for psychometric evaluation. The study will end when the target sample size is reached and final assessments are completed.
Statistical analyses will be conducted using International Business Machines Statistical Package for the Social Sciences (IBM SPSS) Statistics.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Adult Turkish Women | Women aged 21-65 years who meet the eligibility criteria and complete the Turkish version of the Cervical Cancer Screening Uptake Questionnaire (CCSTQ) for psychometric evaluation. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Validity and reliability study | Other | Participants will complete the Turkish version of the Cervical Cancer Screening Uptake Questionnaire (CCSTQ) and the Health Belief Model Scale for Cervical Cancer and the Pap Smear Test via an online survey for psychometric evaluation purposes. No clinical intervention will be applied. |
| Measure | Description | Time Frame |
|---|---|---|
| Cervical Cancer Screening Uptake Questionnaire (CCSTQ) | The Cervical Cancer Screening Uptake Questionnaire (CCSTQ) is a 43-item, six-dimensional self-report instrument developed to assess cognitive, psychosocial, and structural determinants influencing women's participation in cervical cancer screening. The scale covers social norms, knowledge and awareness, perceived threat, perceived benefits, perceived barriers, and self-efficacy. It is rated on a five-point Likert scale and was developed based on the DOST model grounded in health behavior theory. No clinically validated cut-off score has been established for the CCSTQ. In the original study, the sample median was used to classify participants into high and low screening tendency groups. The instrument is easy to administer and can be completed in a short time. | Baseline and 2 weeks after the initial administration (Test-retest reliability ) |
| The Health Belief Model Scale for Cervical Cancer and the Pap Smear Test | The Health Belief Model Scale for Cervical Cancer and the Pap Smear Test is a multidimensional instrument designed to evaluate health beliefs related to cervical cancer screening. Originally developed within the framework of health belief theory and later adapted for cervical cancer and Pap smear screening, the scale consists of 35 items across five subdimensions: perceived benefits and motivation for Pap smear, perceived barriers to Pap smear, perceived seriousness of cervical cancer, perceived susceptibility, and health motivation. The scale uses a five-point Likert response format, and each subscale is scored independently. Higher scores indicate stronger perceptions or motivation within the respective domain, whereas higher perceived barriers are inversely associated with screening behavior. Turkish version, validity and reliability study is available. The scale will be used in this study to assess the convergent validity of the CCSTQ. | At baseline |
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Inclusion Criteria:
Exclusion Criteria:
This study includes adult women aged 21-65 years, as cervical cancer screening is applicable to individuals with a cervix. Participants must meet the specified inclusion criteria.
Community-based sample of women residing in Türkiye who will be recruited through online platforms (e.g., social media and email) using convenience sampling.
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Not Applicable - Online Study | Ankara | Turkey (Türkiye) |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| Background | Kyriazos, T.A., Applied psychometrics: sample size and sample power considerations in factor analysis (EFA, CFA) and SEM in general. Psychology, 2018. 9(08): p. 2207. | ||
| 20946564 | Background | Guvenc G, Akyuz A, Acikel CH. Health Belief Model Scale for Cervical Cancer and Pap Smear Test: psychometric testing. J Adv Nurs. 2011 Feb;67(2):428-37. doi: 10.1111/j.1365-2648.2010.05450.x. Epub 2010 Oct 15. | |
| 40098055 |
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| Background |
| Dsouza JP, Broucke SVD. DOST: A consolidated health behavior model that maps factors influencing cancer screening uptake. Arch Public Health. 2025 Mar 17;83(1):70. doi: 10.1186/s13690-025-01517-3. |
| Background | Champion, V.L. and C.S. Skinner, The health belief model. Health behavior and health education: Theory, research, and practice, 2008. 4: p. 45-65. |
| 41299382 | Background | Cheng N, Li X, Jin Z, Liu Y, Wang A. Cervical cancer screening uptake questionnaire (CCSTQ) for women: instrument development and validation. BMC Womens Health. 2025 Nov 26;25(1):577. doi: 10.1186/s12905-025-04065-8. |
| Background | World Health Organization, Global strategy to accelerate the elimination of cervical cancer as a public health problem. 2020: World Health Organization. |
| 31812369 | Background | Arbyn M, Weiderpass E, Bruni L, de Sanjose S, Saraiya M, Ferlay J, Bray F. Estimates of incidence and mortality of cervical cancer in 2018: a worldwide analysis. Lancet Glob Health. 2020 Feb;8(2):e191-e203. doi: 10.1016/S2214-109X(19)30482-6. Epub 2019 Dec 4. |