Journal of Health Literacy

Journal of Health Literacy

Breast Cancer Literacy Assessment Tool (B-CLAT): Psychometric Properties of the Persian Version

Articles in Press

Document Type : Original Article

Authors
Sakineh Rakhshanderou 1
Nasim Abdipour 2
Narguess Abdipour 3
Mohtasham Ghaffari 4
1 Associate Professor of Health Education and Health Promotion, Department of Public Health, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
2 M.Sc. in Aging Health, Department of Public Health, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
3 PhD Student of Health Education and Health Promotion, Department of Public Health, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
4 Professor of Health Education and Health Promotion, Department of Public Health, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
10.22038/jhl.2026.92303.1885
Abstract
Background and Objective: Assessing women’s literacy about breast cancer is essential to identify existing knowledge gaps and design effective interventions. To translate, culturally adapt, and psychometrically evaluate the Breast Cancer Literacy Assessment Tool (B-CLAT) for use among Iranian women.

Materials and Methods: This methodological study was conducted in 2024–2025 among 400 women attending comprehensive health service centers in Tehran, Iran, selected through multistage sampling, to translate and validate the B-CLAT, originally developed in the U.S. The translation process followed the standard forward–backward method by two independent translators in each phase. Face validity was assessed by 10 women, and content validity by 10 experts, according to standard methodological practice. content validity ratio and content validity index were calculated. Construct validity was examined using confirmatory factor analysis and the known-groups method, comparing literacy scores by age and education. Reliability was determined through internal consistency (Cronbach’s alpha) and stability (Intra-class Correlation Coefficient) in a sample of 30 participants. Data were analyzed using SPSS 16 and EQS 6.4 software.

Results: Most participants were aged 30–39 years (46%), married (82.5%), and had a university degree (69.3%). The cultural adaptation of the Persian version showed satisfactory equivalence. The overall CVI was 0.942, indicating strong content validity. CFA confirmed acceptable model fit indices (RMSEA=0.063, IFI=0.913, CFI=0.903, GFI=0.919, CMIN/DF=2.956, MFI=0.933, AGFI=0.900). Known-groups comparison showed no significant relationship between literacy scores and age (P>0.05), but a significant association with education level (P<0.05), confirming construct validity. Reliability analysis indicated acceptable stability (ICC=0.868) and internal consistency (α=0.722).

Conclusion: The Persian version of the Breast Cancer Literacy Assessment Tool (IB-CLAT) demonstrated good validity and reliability. It can effectively assess breast cancer literacy among Iranian women, guide educational interventions, and promote screening and prevention behaviors.
Keywords
Breast Cancer
Health Literacy
Psychometrics

Acknowledgments: We would like to thank all the women who participated in the present study. We are also grateful to Shahid Beheshti University of Medical Sciences Vice-Chancellor of Health, for their help in sampling and accessing the target group.


Availability of data and materials: All data that support the findings of this study are not publicly available due to participants’ confidentiality.


Conflicts of interest: The authors declare no conflicts of interest.


Consent for publication: Not applicable.


Ethics approval and consent to participate: This study was performed in line with the principles of the Declaration of Helsinki and has been approved by the Research Ethics Committee of School of Public Health and Safety-Shahid Beheshti University of Medical Sciences (ethics code from IR.SBMU.PHNS.REC.1403.027). Informed consent Informed consent was obtained from all individual participants included in the study.Supplementary Files 1. Table of demographic characteristics of participants in face validity assessment, 2. IB-CLAT dimensions and items with related factor loadings.


Funding: This study was supported by the Vice Chancellor for Research and Technology of Shahid Beheshti University of Medical Sciences under Grant (03-43009980). The funder had no role in the study design, data collection, analysis, interpretation, or writing of the manuscript. 


Author’s contribution: All authors contributed to the writing and approving project proposal, and have read and approved the final manuscript. S.R. contributed to the methodology, data analysis, interpretation of the data, review, and editing. N (Narguess). A. contributed to data collection, data entry, and the writing of the initial draft. N (Nasim). A. contributed to project administration, data collection, data entry, and the writing of the initial draft. M.G. contributed to study’s conception design, supervision, methodology, data analysis, interpretation of the data, review, and editing.

 

Open Access Policy: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.To view a copy of this licence, visit https://creativecommons.org/licenses/by/4.0/

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Journal of Health Literacy

Articles in Press, Accepted Manuscript
Available Online from 25 January 2026