METHODS: Participants aged ≥40 years (n = 730) from randomly selected households in Selangor State Malaysia, completed interview-based assessments. Campaign reach was assessed in terms of responses to an adapted questionnaire that was used in evaluations in other countries. The impact of the campaign was assessed in terms of awareness, confidence to detect symptoms and self-efficacy to discuss symptoms with a doctor as captured by the Cancer Awareness Measure (CAM). CAM was administered before-and-after campaign implementation and responses by BCAC recognisers (i.e. participants who recognised one or more of the BCAC television, radio or print advertisements when prompted) and non-recognisers (i.e. participants who did not recognise any of the BCAC advertisements) were compared analytically. Logistic regression analysed comparative differences in cancer awareness by socio-demographic characteristics and recognition of the BCAC materials.
RESULTS: Over 65% of participants (n = 484) recognised the BCAC-CRC. Campaign-recognisers were significantly more likely to be aware of each CRC symptom at follow-up and were more confident about noticing symptoms (46.9% vs 34.9%, p = 0.018) compared to non-recognisers. There was no difference between groups in terms of self-efficacy to see a doctor about symptoms. Improved symptoms awareness at follow-up was lower for Indians compared to Malays (adjusted odds ratio (OR) 0.53, 95% Confidence Interval (CI): 0.34, 0.83, p = 0.005). Health service use data did not indicate an increase in screening activity during or immediately after the campaign months.
CONCLUSION: Overall, the findings of the evaluation indicated that the culturally adapted, evidence-based mass media intervention improved CRC symptom awareness among the Malaysian population; and that impact is more likely when a campaign operates a differentiated approach that matches modes of communication to the ethnic and social diversity in a population.
METHODS: Two separate studies were conducted among adult community-dwelling Singapore residents of Chinese, Malay or Indian ethnicity where participants completed self-administered questionnaires. In the first study, secondary data analysis was conducted using confirmatory factor analysis (CFA) to shorten the PMH instrument. In the second study, the newly developed short PMH instrument and other scales were administered to 201 residents to establish its factor structure, validity and reliability.
RESULTS: A 20-item short PMH instrument fulfilling a higher-order six-factor structure was developed following secondary analysis. The mean age of the participants in the second study was 41 years and about 53% were women. One item with poor factor loading was further removed to generate a 19-item version of the PMH instrument. CFA demonstrated a first-order six-factor model of the short PMH instrument. The PMH-19 instrument and its subscales fulfilled criterion validity hypotheses. Internal consistency and test-retest reliability of the PMH-19 instrument were high (Cronbach's α coefficient = 0.87; intraclass correlation coefficient = 0.93, respectively).
CONCLUSIONS: The 19-item PMH instrument is multidimensional, valid and reliable, and most importantly, with its reduced administration time, the short PMH instrument can be used to measure and evaluate PMH in Asian communities.