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Cancer Prevention Literacy Questionnaire (CPL-Q): development and validation within the World Code Against Cancer Framework

2026-02-23Artigo científico Acesso aberto
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datacite.subject.fosCiências Médicas::Ciências da Saúde
datacite.subject.sdg03:Saúde de Qualidade
dc.contributor.authorFeliu, Ariadna
dc.contributor.authorIslam, Rubana
dc.contributor.authorRomeo-Cervera, Paula
dc.contributor.authorBouaoun, Liacine
dc.contributor.authorWhitelock, Victoria
dc.contributor.authorPirvan, Mirela
dc.contributor.authorRoxo, Luis
dc.contributor.authorCarvalho da Silva Santos, Ana João
dc.contributor.authorEspina, Carolina
dc.date.accessioned2026-10-02T11:14:31Z
dc.date.available2026-10-02T11:14:31Z
dc.date.issued2026-02-23
dc.description.abstractBackground: Health literacy is a key determinant of health, shaping individuals ability to understand and act on health information. Low cancer literacy is associated with fatalistic beliefs and reduced participation in prevention and screening programmes. Although around 40% of all cancers are preventable, public awareness of modifiable risk factors remains low. The European Code Against Cancer (ECAC), developed under the World Code Against Cancer Framework, aims to strengthen prevention knowledge; however, tools to measure cancer prevention literacy, and therefore evaluate its impact, are lacking. This study aimed to develop and validate a questionnaire to assess ‘cancer prevention literacy’ in adults from the general population. Methods: We conducted a methodological study to develop a questionnaire measuring ‘cancer prevention literacy’ in adults from the general population using the Integrative Model of Behavioural Prediction as theoretical framework. Questionnaire development followed a three-stage process: (1) a literature review and two-round Delphi process to select and refine items; (2) a third Delphi round, complemented by readability checks, face-validity assessment, and cognitive testing to evaluate item relevance, clarity, and representativeness; and (3) a pre-test and psychometric analysis to assess construct validity. Results: The final Cancer Prevention Literacy Questionnaire (CPL-Q) consists of a 10-question validated instrument comprising 58 items, with selected items incorporating the verbatim wording of the recommendations from the ECAC, 4th edition. Strong expert agreement was achieved through an iterative Delphi process, and content and face validity indicated that the items were comprehensible, relevant, and appropriate. Psychometric analyses, including exploratory and confirmatory factor analysis, provide preliminary support for the instrument’s construct validity, with initial evidence suggesting acceptable reliability. Conclusion: The CPL-Q provides a standardised instrument to measure ‘cancer prevention literacy’ and to assess the impact of Regional Codes Against Cancer through monitoring and benchmarking changes over time. It also offers a practical tool to identify gaps in ‘cancer prevention literacy’ within specific populations and to support international comparisons and longitudinal evaluations, thereby contributing to the evidence base for cancer prevention policies.eng
dc.description.sponsorshipFunding from the HORIZON-MISS-2022-CANCER-01-01 (Project ID 101104432) as part of the 4P-CAN project has been used to conduct the cognitive interviews, the pre-test and the psychometric analysis; funding from EU4Health programme under Grant Agreement No. 101075240 as part of the ECAC project has supported part of the research team.
dc.identifier.citationBMC Public Health. 2026 Feb 23;26(1):1052. doi: 10.1186/s12889-026-26641-9
dc.identifier.doi10.1186/s12889-026-26641-9
dc.identifier.eissn1471-2458
dc.identifier.pmid41731412
dc.identifier.urihttp://hdl.handle.net/10400.18/11373
dc.language.isoeng
dc.peerreviewedyes
dc.publisherBioMed Central
dc.relationPersonalized CANcer Primary Prevention research through Citizen Participation and digitally enabled social innovation
dc.relation101075240
dc.relation.hasversionhttps://link.springer.com/article/10.1186/s12889-026-26641-9
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/
dc.subjectCancer Prevention
dc.subjectLiteracy
dc.subjectQuestionnaire
dc.subjectRegional Codes Against Cancer
dc.subjectEurope
dc.subjectDeterminantes da Saúde e da Doença
dc.titleCancer Prevention Literacy Questionnaire (CPL-Q): development and validation within the World Code Against Cancer Frameworkeng
dc.typejournal article
dcterms.referenceshttps://static-content.springer.com/esm/art%3A10.1186%2Fs12889-026-26641-9/MediaObjects/12889_2026_26641_MOESM1_ESM.docx
dcterms.referenceshttps://static-content.springer.com/esm/art%3A10.1186%2Fs12889-026-26641-9/MediaObjects/12889_2026_26641_MOESM2_ESM.docx
dcterms.referenceshttps://static-content.springer.com/esm/art%3A10.1186%2Fs12889-026-26641-9/MediaObjects/12889_2026_26641_MOESM3_ESM.pdf
dspace.entity.typePublication
oaire.awardNumber101104432
oaire.awardTitlePersonalized CANcer Primary Prevention research through Citizen Participation and digitally enabled social innovation
oaire.awardURIhttp://hdl.handle.net/10400.18/11265
oaire.citation.issue1
oaire.citation.startPage1052
oaire.citation.titleBMC Public Health
oaire.citation.volume26
oaire.fundingStreamHORIZON Research and Innovation Actions
oaire.versionhttp://purl.org/coar/version/c_970fb48d4fbd8a85
person.familyNameCarvalho da Silva Santos
person.givenNameAna João
person.identifier.ciencia-id7E12-E842-1216
person.identifier.orcid0000-0003-0556-5513
relation.isAuthorOfPublication7b015568-111e-4298-94af-90f1d3a958e4
relation.isAuthorOfPublication.latestForDiscovery7b015568-111e-4298-94af-90f1d3a958e4
relation.isProjectOfPublication73ea9237-61a1-416f-9de6-4201bdaadf69
relation.isProjectOfPublication.latestForDiscovery73ea9237-61a1-416f-9de6-4201bdaadf69

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