Development and psychometric testing of a Gastric Cancer Behavioural Risk Assessment Inventory (GC-BRAI)

Background: Gastric cancer (GC) is one of the most common cancers worldwide. There is no disease-specific tool for GC risk assessment in research and practice settings within the Iranian sociocultural context. Aims: To develop and assess the psychometric properties of the Gastric Cancer Behavioral Risk Assessment Inventory (GC-BRAI) in GC patients in Northwest Islamic Republic of Iran. Methods: Face-to-face interviews were performed on a convenient sample of 175 GC patients and a purposive sample of 350 matched non-GC patients as a control group. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were performed to appraise the structure validity of GC-BRAI and examine its possible latent constructs. Results: The designed instrument with its 5 latent factors indicated acceptable internal consistency (0.72), reliability (0.99) and fit indices (chi(2)/degrees of freedom = 2.24, root mean square error of approximation = 0.049, adjusted goodness of fit index = 0.91 and root mean square residual = 0.085). The identified components were specific nutritional behaviours, typical daily diet, routine heartburn-causing behaviours or foods in diet, daily use of rice and smoked foods, and tobacco smoking/alcohol consumption, which all indicated a significant association (P = 0.0001) with high-risk of GC. Conclusions: GC-BRAI can be considered a feasible tool to measure individual GC risk and a reliable data collection instrument in tailor-made risk reduction interventional programmes.