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Developing and Validating a Measure of Chinese Cultural Views of Health and Cancer

Georgetown University Medical Center, Washington, DC, liangw1{at}georgetown.edu

Judy H. Wang, PhD

Georgetown University Medical Center, Washington, DC

Mei-Yuh Chen, MS

Georgetown University Medical Center, Washington, DC

Shibao Feng, PhD

Georgetown University Medical Center, Washington, DC

Marion Lee, PhD

University of California, San Francisco

Marc D. Schwartz, PhD

Georgetown University, Washington, DC

Rena J. Pasick, PhD

University of California, San Francisco

Jeanne S. Mandelblatt, MD, MPH

Georgetown University Medical Center, Washington, DC

To develop and validate quantitative scales that measure Chinese cultural views about health and cancer, cultural views were assessed by a 30-item scale through telephone interviews with 438 Chinese-American women aged 50 and older. Cultural subscales were identified using principal component analysis and validated by their associations with age at immigration and breast, cervical, and colorectal cancer (CRC) screening patterns. The overall scale had good reliability (Cronbach's alpha = .79). Factor analysis yielded seven cultural subscales—fatalism, hot-cold balance, use of herbs, self-care, medical examination, lifestyle, and Western medicine (alpha = .39 to .82). The majority of the cultural subscales were significantly associated with age at immigration (p < .001). Fatalism, Self-Care, and Medical Examination subscales consistently predicted nonadherence to breast, cervical, and CRC screening recommendations, even after considering other factors. Chinese cultural views consist of at least seven domains and may influence older women's breast, cervical, and CRC screening.

Key Words: culture • Asian Americans • women's health • mass screening • mammography • vaginal smears • occult blood • colonoscopy • sigmoidoscopy

This version was published on June 1, 2008

Health Education & Behavior, Vol. 35, No. 3, 361-375 (2008)
DOI: 10.1177/1090198106294893


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