array:24 [
  "pii" => "S0213911107720253"
  "issn" => "02139111"
  "doi" => "10.1157/13108499"
  "estado" => "S300"
  "fechaPublicacion" => "2007-07-01"
  "aid" => "72025"
  "copyright" => "Sociedad Española de Salud Pública y Administración Sanitaria"
  "copyrightAnyo" => "2007"
  "documento" => "article"
  "crossmark" => 0
  "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
  "subdocumento" => "fla"
  "cita" => "Gac Sanit. 2007;21:282-9"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 3609
    "formatos" => array:3 [
      "EPUB" => 120
      "HTML" => 2951
      "PDF" => 538
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S0213911107720265"
    "issn" => "02139111"
    "doi" => "10.1157/13108501"
    "estado" => "S300"
    "fechaPublicacion" => "2007-07-01"
    "aid" => "72026"
    "copyright" => "Sociedad Española de Salud Pública y Administración Sanitaria"
    "documento" => "article"
    "crossmark" => 0
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "fla"
    "cita" => "Gac Sanit. 2007;21:290-7"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 4360
      "formatos" => array:3 [
        "EPUB" => 137
        "HTML" => 3701
        "PDF" => 522
      ]
    ]
    "es" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Originales</span>"
      "titulo" => "Impacto de una intervenci&#243;n de autoevaluaci&#243;n cl&#237;nica sobre la adecuaci&#243;n de la estancia hospitalaria"
      "tienePdf" => "es"
      "tieneTextoCompleto" => 0
      "tieneResumen" => array:2 [
        0 => "es"
        1 => "en"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "290"
          "paginaFinal" => "297"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "Impact of a clinical self-evaluation intervention on the appropriateness of hospital stays"
        ]
      ]
      "contieneResumen" => array:2 [
        "es" => true
        "en" => true
      ]
      "contienePdf" => array:1 [
        "es" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Jaume Monteis Catot, Montserrat Mart&#237;n-Baranera, Nikita Soler, Josep Vilar&#243;, Carlos Moya, Francesc Mart&#237;nez, Marta Riu, Carme Puig, Antoni Riba, Gemma Navarro, Assumpta Espinagosa, Gen&#237;s Carrasco G&#243;mez, Xavier Castells, Salvador Peir&#243;"
          "autores" => array:14 [
            0 => array:2 [
              "nombre" => "Jaume"
              "apellidos" => "Monteis Catot"
            ]
            1 => array:2 [
              "nombre" => "Montserrat"
              "apellidos" => "Mart&#237;n-Baranera"
            ]
            2 => array:2 [
              "nombre" => "Nikita"
              "apellidos" => "Soler"
            ]
            3 => array:2 [
              "nombre" => "Josep"
              "apellidos" => "Vilar&#243;"
            ]
            4 => array:2 [
              "nombre" => "Carlos"
              "apellidos" => "Moya"
            ]
            5 => array:2 [
              "nombre" => "Francesc"
              "apellidos" => "Mart&#237;nez"
            ]
            6 => array:2 [
              "nombre" => "Marta"
              "apellidos" => "Riu"
            ]
            7 => array:2 [
              "nombre" => "Carme"
              "apellidos" => "Puig"
            ]
            8 => array:2 [
              "nombre" => "Antoni"
              "apellidos" => "Riba"
            ]
            9 => array:2 [
              "nombre" => "Gemma"
              "apellidos" => "Navarro"
            ]
            10 => array:2 [
              "nombre" => "Assumpta"
              "apellidos" => "Espinagosa"
            ]
            11 => array:2 [
              "nombre" => "Gen&#237;s"
              "apellidos" => "Carrasco G&#243;mez"
            ]
            12 => array:2 [
              "nombre" => "Xavier"
              "apellidos" => "Castells"
            ]
            13 => array:2 [
              "nombre" => "Salvador"
              "apellidos" => "Peir&#243;"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "es"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0213911107720265?idApp=WGSE"
    "url" => "/02139111/0000002100000004/v2_201301241553/S0213911107720265/v2_201301241553/es/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S0213911107720241"
    "issn" => "02139111"
    "doi" => "10.1157/13108498"
    "estado" => "S300"
    "fechaPublicacion" => "2007-07-01"
    "aid" => "72024"
    "copyright" => "Sociedad Espa&#241;ola de Salud P&#250;blica y Administraci&#243;n Sanitaria"
    "documento" => "simple-article"
    "crossmark" => 0
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "edi"
    "cita" => "Gac Sanit. 2007;21:280-1"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 4318
      "formatos" => array:3 [
        "EPUB" => 104
        "HTML" => 3640
        "PDF" => 574
      ]
    ]
    "es" => array:9 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Notas editoriales</span>"
      "titulo" => "Pol&#237;ticas de salud y salud p&#250;blica"
      "tienePdf" => "es"
      "tieneTextoCompleto" => 0
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "280"
          "paginaFinal" => "281"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "Politics&#44; policy and public health"
        ]
      ]
      "contienePdf" => array:1 [
        "es" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Ildefonso Hern&#225;ndez-Aguado, Paloma Fern&#225;ndez-Cano"
          "autores" => array:2 [
            0 => array:2 [
              "nombre" => "Ildefonso"
              "apellidos" => "Hern&#225;ndez-Aguado"
            ]
            1 => array:2 [
              "nombre" => "Paloma"
              "apellidos" => "Fern&#225;ndez-Cano"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "es"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0213911107720241?idApp=WGSE"
    "url" => "/02139111/0000002100000004/v2_201301241553/S0213911107720241/v2_201301241553/es/main.assets"
  ]
  "es" => array:15 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Originales</span>"
    "titulo" => "Adaptaci&#243;n y validaci&#243;n del cuestionario de susceptibilidad&#44; beneficios y barreras ante el cribado con mamograf&#237;a"
    "tieneTextoCompleto" => 0
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "282"
        "paginaFinal" => "289"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "Magdalena Esteva, Joana Ripoll, Carmen S&#225;nchez-Contador, Francisca Collado, Cristian Teb&#233;, Eusebi Casta&#241;o, Mat&#237;as Torrent"
        "autores" => array:7 [
          0 => array:4 [
            "nombre" => "Magdalena"
            "apellidos" => "Esteva"
            "email" => array:1 [
              0 => "mesteva&#64;ibsalut&#46;caib&#46;es"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff1"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">¿</span>"
                "identificador" => "cor1"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "Joana"
            "apellidos" => "Ripoll"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff1"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "Carmen"
            "apellidos" => "S&#225;nchez-Contador"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff2"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "Francisca"
            "apellidos" => "Collado"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff2"
              ]
            ]
          ]
          4 => array:3 [
            "nombre" => "Cristian"
            "apellidos" => "Teb&#233;"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff3"
              ]
            ]
          ]
          5 => array:3 [
            "nombre" => "Eusebi"
            "apellidos" => "Casta&#241;o"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">d</span>"
                "identificador" => "aff4"
              ]
            ]
          ]
          6 => array:3 [
            "nombre" => "Mat&#237;as"
            "apellidos" => "Torrent"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">e</span>"
                "identificador" => "aff5"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:5 [
          0 => array:3 [
            "entidad" => "Gabinete T&#233;cnico&#44; Gerencia de Atenci&#243;n Primaria de Mallorca&#44; Ibsalut&#44; Palma de Mallorca&#44; Espa&#241;a"
            "etiqueta" => "<span class="elsevierStyleSup">a</span>"
            "identificador" => "aff1"
          ]
          1 => array:3 [
            "entidad" => "Programa de detecci&#243;n precoz del c&#225;ncer de mama&#44; Direcci&#243;n General de Salud P&#250;blica&#44; Conselleria de Salut i Consum de les Illes Balears&#59; Palma de Mallorca&#44; Espa&#241;a"
            "etiqueta" => "<span class="elsevierStyleSup">b</span>"
            "identificador" => "aff2"
          ]
          2 => array:3 [
            "entidad" => "Ag&#232;ncia d&#8217;Avaluaci&#243; de Tecnologia i Recerca M&#232;diques&#44; Conselleria de Salut i Consum&#44; Generalitat Catalunya&#44; Barcelona&#44; Espa&#241;a"
            "etiqueta" => "<span class="elsevierStyleSup">c</span>"
            "identificador" => "aff3"
          ]
          3 => array:3 [
            "entidad" => "Direcci&#243;n General de Planificaci&#243;n y Financiamiento&#46; Conselleria de Salut i Consum de les Illes Balears&#44; Palma de Mallorca&#44; Espa&#241;a"
            "etiqueta" => "<span class="elsevierStyleSup">d</span>"
            "identificador" => "aff4"
          ]
          4 => array:3 [
            "entidad" => "Direcci&#243;n M&#233;dica&#44; Gerencia de &#193;rea de Menorca&#44; Ibsalut&#44; Palma de Mallorca&#44; Espa&#241;a"
            "etiqueta" => "<span class="elsevierStyleSup">e</span>"
            "identificador" => "aff5"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor1"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Correspondencia&#58; Magdalena Esteva&#46; Gabinete T&#233;cnico&#46; Gerencia Atenci&#243;n Primaria de Mallorca&#46; Ibsalut&#46; Reina Esclaramunda&#44; 9&#46; 07003 Palma de Mallorca&#46; Espa&#241;a&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "en" => array:1 [
        "titulo" => "Adaptation and validation of a questionnaire on susceptibility&#44; benefits and barriers in breast cancer screening with mammography"
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2006-03-28"
    "fechaAceptado" => "2006-09-12"
    "PalabrasClave" => array:2 [
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec13971"
          "palabras" => array:6 [
            0 => "Estudios de validaci&#243;n"
            1 => "Escalas"
            2 => "Comportamiento en salud"
            3 => "Neoplasias de mama"
            4 => "Cribado poblacional"
            5 => "Mamograf&#237;a"
          ]
        ]
      ]
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Key words"
          "identificador" => "xpalclavsec13972"
          "palabras" => array:6 [
            0 => "Validation studies"
            1 => "Scales"
            2 => "Health behavior"
            3 => "Breast neoplasms"
            4 => "Mass screening"
            5 => "Mammography"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "es" => array:2 [
        "titulo" => "Resumen"
        "resumen" => "<span class="elsevierStyleSectionTitle">Objetivos</span><p class="elsevierStyleSimplePara elsevierViewall">Adaptar una &#171;escala de creencias&#187; sobre el c&#225;ncer de mama al castellano&#44; evaluando su validez y reproducibilidad&#46;</p> <span class="elsevierStyleSectionTitle">M&#233;todos</span><p class="elsevierStyleSimplePara elsevierViewall">Validaci&#243;n de una escala de 3 dimensiones &#8211;susceptibilidad&#44; beneficios y barreras&#8211; con respuestas tipo Likert&#44; en un estudio de casos y controles&#44; donde los casos eran las mujeres no participantes en un programa de cribado de c&#225;ncer de mama y los controles las participantes&#46; Se realiz&#243; un proceso de traducci&#243;n-retrotraducci&#243;n y un comit&#233; t&#233;cnico analiz&#243; las discrepancias&#46; Se pilot&#243; la comprensi&#243;n en 17 mujeres&#46; Participaron en el estudio 274 mujeres y a 32 de ellas se les repiti&#243; el cuestionario en el intervalo de un mes para valorar la reproducibilidad&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">El coeficiente de correlaci&#243;n intraclase fue de 0&#44;89&#44; 0&#44;70 y 0&#44;90&#44; y el coeficiente alfa de Cronbach de 0&#44;71&#44; 0&#44;48 y 0&#44;57 para susceptibilidad&#44; beneficios y barreras&#44; respectivamente&#46; Respecto a la validez de constructo&#44; del an&#225;lisis factorial exploratorio se extrajeron 3 factores&#44; lo que explicaba un 34&#37; de la varianza&#46; El an&#225;lisis factorial confirmatorio se&#241;ala un ajuste al l&#237;mite de los datos al modelo te&#243;rico&#46; Las mujeres de m&#225;s edad perciben menos susceptibilidad al c&#225;ncer de mama y declaran m&#225;s barreras para hacerse una mamograf&#237;a&#46; Las de menor nivel de estudios perciben m&#225;s barreras&#46; La escala no ha mostrado su capacidad para predecir la participaci&#243;n en el programa&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">La escala presenta problemas de validez y homogeneidad&#46; Las dimensiones de beneficios y barreras necesitan un proceso de adaptaci&#243;n y validaci&#243;n profunda para su utilizaci&#243;n&#46;</p>"
      ]
      "en" => array:2 [
        "titulo" => "Abstract"
        "resumen" => "<span class="elsevierStyleSectionTitle">Objectives</span><p class="elsevierStyleSimplePara elsevierViewall">To adapt the &#171;health belief model&#187; on breast cancer screening to Spanish&#44; and to asses its validity and reliability&#46;</p> <span class="elsevierStyleSectionTitle">Methods</span><p class="elsevierStyleSimplePara elsevierViewall">We assessed validation of a scale with 3 dimensions &#40;susceptibility&#44; benefits and barriers&#41; with Likert responses in a case-control study&#46; Cases were women not participating in a breast cancer screening program and controls consisted of participating women&#46; A process of translation and back-translation was carried out and a technical committee analyzed discrepancies&#46; Comprehension was tested in 17 women&#46; Two hundred seventy-four women participated in the study&#46; In 32 of these women&#44; the questionnaire was administered twice after a 1-month interval to estimate its reliability&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">The intraclass correlation coefficients were 0&#46;89&#44; 0&#46;70 and 0&#46;90&#44; and Cronbach&#39;s alpha coefficient was 0&#46;71&#44; 0&#46;48 and 0&#46;57 for susceptibility&#44; benefits and barriers&#44; respectively&#46; Construct validity&#58; from the factorial analysis&#44; 3 factors were obtained explaining 34&#37; of the variance&#46; The confirmatory factorial analysis indicated acceptable goodness-of-fit of the data to the theoretical model&#46; Older women perceived less susceptibility to breast cancer as well as greater barriers to attending screening&#46; Women with a lower educational level perceived greater barriers&#46; The scale did not seem to predict adherence to the program&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">The adapted scale presents problems of validity and internal consistency&#46; The dimensions of benefits and barriers require thorough adaptation and validation before the scale is used in Spanish women&#46;</p>"
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "Bibliograf&#237;a"
      "seccion" => array:1 [
        0 => array:1 [
          "bibliografiaReferencia" => array:32 [
            0 => array:3 [
              "identificador" => "bib1"
              "etiqueta" => "1&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Efficacy of screening mammography&#58; a meta-analisis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "K&#46; Kerlikowske"
                            1 => "D&#46; Grady"
                            2 => "S&#46;M&#46; Rubin"
                            3 => "C&#46; Sandrock"
                            4 => "V&#46;L&#46; Ernster"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "JAMA"
                        "fecha" => "1995"
                        "volumen" => "273"
                        "paginaInicial" => "149"
                        "paginaFinal" => "154"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7799496"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib2"
              "etiqueta" => "2&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Is screening for breast cancer with mammography justifiable&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "P&#46;C&#46; Gotzsche"
                            1 => "O&#46; Olsen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S0140-6736(99)06065-1"
                      "Revista" => array:6 [
                        "tituloSerie" => "Lancet"
                        "fecha" => "2000"
                        "volumen" => "355"
                        "paginaInicial" => "129"
                        "paginaFinal" => "134"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10675181"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib3"
              "etiqueta" => "3&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Screening mammography re-evaluated&#46; Correspondence"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "A&#46;B&#46; Miller"
                            1 => "C&#46;J&#46; Baines"
                            2 => "T&#46; To"
                            3 => "C&#46; Wall"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S0140-6736(05)72152-8"
                      "Revista" => array:5 [
                        "tituloSerie" => "Lancet"
                        "fecha" => "2000"
                        "volumen" => "355"
                        "paginaInicial" => "747"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10703819"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib4"
              "etiqueta" => "4&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "La evidencia del cribado de c&#225;ncer de mama&#58; la historia contin&#250;a"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46;M&#46; Borr&#225;s"
                            1 => "J&#46;A&#46; Espin&#225;s"
                            2 => "X&#46; Castells"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Gac Sanit"
                        "fecha" => "2003"
                        "volumen" => "17"
                        "paginaInicial" => "249"
                        "paginaFinal" => "255"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12841988"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib5"
              "etiqueta" => "5&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "From clinical trials to clinical practice&#58; generalising from participant to patient"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "H&#46;B&#46; Rubins"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Control Clin Trials"
                        "fecha" => "1994"
                        "volumen" => "15"
                        "paginaInicial" => "7"
                        "paginaFinal" => "10"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8149772"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib6"
              "etiqueta" => "6&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The Health Belief Model and personal health behaviour"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "M&#46;H&#46; Becker"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "Health Education Monographs"
                        "fecha" => "1974"
                        "volumen" => "2"
                        "paginaInicial" => "4"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib7"
              "etiqueta" => "7&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Social learning theory and the Health Belief Model"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "I&#46;M&#46; Rosenstock"
                            1 => "V&#46;J&#46; Strecher"
                            2 => "M&#46;H&#46; Becker"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Health Educ Q"
                        "fecha" => "1988"
                        "volumen" => "15"
                        "paginaInicial" => "175"
                        "paginaFinal" => "183"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3378902"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib8"
              "etiqueta" => "8&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Effect of interventions on stage of mammography adoption"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "V&#46; Champion"
                            1 => "G&#46; Huster"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Behav Med"
                        "fecha" => "1995"
                        "volumen" => "18"
                        "paginaInicial" => "169"
                        "paginaFinal" => "187"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7563045"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib9"
              "etiqueta" => "9&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Knowledge&#44; perceptions and mammography stage of adoption among older urban women"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "C&#46;S&#46; Skinner"
                            1 => "Cl&#46; Arfken"
                            2 => "R&#46;K&#46; Sykes"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Prev Med"
                        "fecha" => "1998"
                        "volumen" => "14"
                        "paginaInicial" => "54"
                        "paginaFinal" => "63"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9476836"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib10"
              "etiqueta" => "10&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The effects of health beliefs on screening mammography utilization among a diverse sample of older women"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "L&#46;R&#46; Thomas"
                            1 => "S&#46;A&#46; Fox"
                            2 => "B&#46;G&#46; Leake"
                            3 => "R&#46;G&#46; Roetzheim"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1300/J013v24n01_05"
                      "Revista" => array:6 [
                        "tituloSerie" => "Women Health"
                        "fecha" => "1996"
                        "volumen" => "24"
                        "paginaInicial" => "77"
                        "paginaFinal" => "91"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9046554"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib11"
              "etiqueta" => "11&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Instrument development for Health Beliefs Model constructs"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "V&#46;L&#46; Champion"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "ANS Adv Nurs Sci"
                        "fecha" => "1984"
                        "volumen" => "6"
                        "paginaInicial" => "73"
                        "paginaFinal" => "85"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6426380"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib12"
              "etiqueta" => "12&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Instrument refinement for breast cancer screening behaviours"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "V&#46;L&#46; Champion"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Nurs Res"
                        "fecha" => "1993"
                        "volumen" => "42"
                        "paginaInicial" => "139"
                        "paginaFinal" => "143"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8506161"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib13"
              "etiqueta" => "13&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Development of a benefits and barriers scale for mammography utilization"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "V&#46; Champion"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Cancer Nurs"
                        "fecha" => "1995"
                        "volumen" => "18"
                        "paginaInicial" => "53"
                        "paginaFinal" => "59"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7866977"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib14"
              "etiqueta" => "14&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Revised susceptibility&#44; benefits and barriers scale for mammography screening"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "V&#46;L&#46; Champion"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Res Nurs Health"
                        "fecha" => "1999"
                        "volumen" => "22"
                        "paginaInicial" => "341"
                        "paginaFinal" => "348"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10435551"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib15"
              "etiqueta" => "15&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Understanding attitudes and prediction social behaviour"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "I&#46; Ajzen"
                            1 => "M&#46; Fishbein"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:3 [
                        "fecha" => "1980"
                        "editorial" => "Englewoods Cliffs&#44; Prentice Hall"
                        "editorialLocalizacion" => "New Jersey"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib16"
              "etiqueta" => "16&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Age as a factor in breast cancer knowledge&#44; attitudes and screening behaviour"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "Z&#46; Mah"
                            1 => "H&#46; Bryant"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Can Med Assoc J"
                        "fecha" => "1992"
                        "volumen" => "146"
                        "paginaInicial" => "2167"
                        "paginaFinal" => "2174"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib17"
              "etiqueta" => "17&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Breast self-examination compliance and the health belief model"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "D&#46;N&#46; Rutledge"
                            1 => "G&#46;T&#46; Davis"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Oncol Nurs Forum"
                        "fecha" => "1988"
                        "volumen" => "15"
                        "paginaInicial" => "175"
                        "paginaFinal" => "179"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3357830"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib18"
              "etiqueta" => "18&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Evaluating women attitudes and perceptions in developing mammography promotion messages"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "C&#46; Schechter"
                            1 => "C&#46;F&#46; Vanchieri"
                            2 => "C&#46; Crofton"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Public Health Rep"
                        "fecha" => "1990"
                        "volumen" => "105"
                        "paginaInicial" => "203"
                        "paginaFinal" => "207"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib19"
              "etiqueta" => "19&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Relationship of age to mammography compliance"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "V&#46; Champion"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Cancer"
                        "fecha" => "1994"
                        "volumen" => "74"
                        "paginaInicial" => "329"
                        "paginaFinal" => "335"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8004604"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib20"
              "etiqueta" => "20&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Attitudes&#44; beliefs and knowledge about mammography among women over forty years of age"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "S&#46;E&#46; Slenker"
                            1 => "M&#46;C&#46; Grant"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1080/08858198909527969"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Cancer Educ"
                        "fecha" => "1989"
                        "volumen" => "4"
                        "paginaInicial" => "61"
                        "paginaFinal" => "65"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2641510"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib21"
              "etiqueta" => "21&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Factor analysis&#58; statistical methods and practical issues"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "J&#46; Kim"
                            1 => "C&#46;W&#46; Mueller"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:3 [
                        "fecha" => "1978"
                        "editorial" => "Sage"
                        "editorialLocalizacion" => "Newbury Park&#44; Beverly Hills"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib22"
              "etiqueta" => "22&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Structural equation modelling with LISREL&#44; PRELIS&#44; and SIMPLIS&#58; basic concepts&#44; applications and programming"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "M&#46;B&#46; Byrne"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:3 [
                        "fecha" => "1998"
                        "editorial" => "Lawrence Erlbaum Associates"
                        "editorialLocalizacion" => "London"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib23"
              "etiqueta" => "23&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The measurement of observer agreement for categorical data"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "J&#46;R&#46; Landis"
                            1 => "G&#46;G&#46; Koch"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Biometrics"
                        "fecha" => "1977"
                        "volumen" => "33"
                        "paginaInicial" => "159"
                        "paginaFinal" => "174"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/843571"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib24"
              "etiqueta" => "24&#46;"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Joreskog KG&#44; Sorbom D&#46; Lisrel 7&#58; a guide to the program and applications&#46; 2nd ed&#46; Chicago&#58; 1989&#46;"
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib25"
              "etiqueta" => "25&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Measuring Health&#46; A guide to rating scales and questionnaires"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "I&#46; McDowell"
                            1 => "C&#46; Newell"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:3 [
                        "fecha" => "1996"
                        "editorial" => "Oxford University Press"
                        "editorialLocalizacion" => "New York"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib26"
              "etiqueta" => "26&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Predictive factors of enrollment and adherence in a breast cancer screening program in Barcelona &#40;Spain&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "C&#46; Rodr&#237;guez"
                            1 => "A&#46; Plasencia"
                            2 => "D&#46;G&#46; Schoeder"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Soc Sci Med"
                        "fecha" => "1995"
                        "volumen" => "40"
                        "paginaInicial" => "1155"
                        "paginaFinal" => "1160"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7597469"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            26 => array:3 [
              "identificador" => "bib27"
              "etiqueta" => "27&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Estudio de la no participaci&#243;n en el programa de prevenci&#243;n de c&#225;ncer de mama en la Ciudad de Valencia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "M&#46; Alcaraz"
                            1 => "A&#46; Lluch"
                            2 => "J&#46; Miranda"
                            3 => "I&#46; Pereiro"
                            4 => "M&#46;D&#46; Salas"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Gac Sanit"
                        "fecha" => "2002"
                        "volumen" => "16"
                        "paginaInicial" => "230"
                        "paginaFinal" => "235"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12057178"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            27 => array:3 [
              "identificador" => "bib28"
              "etiqueta" => "28&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Mammography and age&#58; are we targeting the wrong women&#63; A community survey of women and physicians"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "R&#46;P&#46; Harris"
                            1 => "S&#46;W&#46; Flechter"
                            2 => "J&#46;J&#46; Gonz&#225;lez"
                            3 => "D&#46;R&#46; Lannin"
                            4 => "D&#46; Degnan"
                            5 => "J&#46;A&#46; Earp"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Cancer"
                        "fecha" => "1991"
                        "volumen" => "67"
                        "paginaInicial" => "2010"
                        "paginaFinal" => "2014"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2004318"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            28 => array:3 [
              "identificador" => "bib29"
              "etiqueta" => "29&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Differences in perceptions of risk&#44; benefits and barriers by stage of mammography adoption"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "V&#46;L&#46; Champion"
                            1 => "C&#46;S&#46; Skinner"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Womens Health &#40;Larchmt&#41;"
                        "fecha" => "2003"
                        "volumen" => "12"
                        "paginaInicial" => "277"
                        "paginaFinal" => "286"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            29 => array:3 [
              "identificador" => "bib30"
              "etiqueta" => "30&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Transcultural adaptation of Champion&#39;s Health Belief Model scales"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "B&#46;I&#46; Mikhail"
                            1 => "W&#46;I&#46; Petro-Nustas"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Nurs Scholarsh"
                        "fecha" => "2001"
                        "volumen" => "33"
                        "paginaInicial" => "159"
                        "paginaFinal" => "165"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11419312"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            30 => array:3 [
              "identificador" => "bib31"
              "etiqueta" => "31&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Validation evidence for Turkish adaptation of Champion&#39;s Health Belief Model scales"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "S&#46; Gozum"
                            1 => "I&#46; Aydin"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Cancer Nurs"
                        "fecha" => "2004"
                        "volumen" => "27"
                        "paginaInicial" => "491"
                        "paginaFinal" => "498"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15632789"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            31 => array:3 [
              "identificador" => "bib32"
              "etiqueta" => "32&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Edad&#44; creencias de salud y asistencia a un programa de cribado mamogr&#225;fico en la comunidad valenciana"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "Y&#46; Andreu Vaillo"
                            1 => "M&#46;J&#46; Gald&#243;n Garrido"
                            2 => "E&#46; Dur&#224; Ferrandis"
                            3 => "S&#46; Carretero G&#243;mez"
                            4 => "J&#46; Tuells Hern&#225;ndez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Esp Salud Publica"
                        "fecha" => "2004"
                        "volumen" => "78"
                        "paginaInicial" => "65"
                        "paginaFinal" => "82"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15071983"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "es"
  "url" => "/02139111/0000002100000004/v2_201301241553/S0213911107720253/v2_201301241553/es/main.assets"
  "Apartado" => array:4 [
    "identificador" => "764"
    "tipo" => "SECCION"
    "es" => array:2 [
      "titulo" => "Originales"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "es"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/02139111/0000002100000004/v2_201301241553/S0213911107720253/v2_201301241553/es/main.pdf?idApp=WGSE&text.app=https://gacetasanitaria.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0213911107720253?idApp=WGSE"
]
Compartir
Publique en esta revista
Información de la revista
Vol. 21. Núm. 4.
Páginas 282-289 (julio - agosto 2007)
Respuestas rápidas
Compartir
Compartir
Descargar PDF
Más opciones de artículo
Vol. 21. Núm. 4.
Páginas 282-289 (julio - agosto 2007)
Originales
Open Access
Adaptación y validación del cuestionario de susceptibilidad, beneficios y barreras ante el cribado con mamografía
Adaptation and validation of a questionnaire on susceptibility, benefits and barriers in breast cancer screening with mammography
Visitas
1169
Magdalena Estevaa,
Autor para correspondencia
mesteva@ibsalut.caib.es

Correspondencia: Magdalena Esteva. Gabinete Técnico. Gerencia Atención Primaria de Mallorca. Ibsalut. Reina Esclaramunda, 9. 07003 Palma de Mallorca. España.
, Joana Ripolla, Carmen Sánchez-Contadorb, Francisca Colladob, Cristian Tebéc, Eusebi Castañod, Matías Torrente
a Gabinete Técnico, Gerencia de Atención Primaria de Mallorca, Ibsalut, Palma de Mallorca, España
b Programa de detección precoz del cáncer de mama, Dirección General de Salud Pública, Conselleria de Salut i Consum de les Illes Balears; Palma de Mallorca, España
c Agència d’Avaluació de Tecnologia i Recerca Mèdiques, Conselleria de Salut i Consum, Generalitat Catalunya, Barcelona, España
d Dirección General de Planificación y Financiamiento. Conselleria de Salut i Consum de les Illes Balears, Palma de Mallorca, España
e Dirección Médica, Gerencia de Área de Menorca, Ibsalut, Palma de Mallorca, España
Este artículo ha recibido

Under a Creative Commons license
Información del artículo
Resumen
Bibliografía
Descargar PDF
Estadísticas
Resumen
Objetivos

Adaptar una «escala de creencias» sobre el cáncer de mama al castellano, evaluando su validez y reproducibilidad.

Métodos

Validación de una escala de 3 dimensiones –susceptibilidad, beneficios y barreras– con respuestas tipo Likert, en un estudio de casos y controles, donde los casos eran las mujeres no participantes en un programa de cribado de cáncer de mama y los controles las participantes. Se realizó un proceso de traducción-retrotraducción y un comité técnico analizó las discrepancias. Se pilotó la comprensión en 17 mujeres. Participaron en el estudio 274 mujeres y a 32 de ellas se les repitió el cuestionario en el intervalo de un mes para valorar la reproducibilidad.

Resultados

El coeficiente de correlación intraclase fue de 0,89, 0,70 y 0,90, y el coeficiente alfa de Cronbach de 0,71, 0,48 y 0,57 para susceptibilidad, beneficios y barreras, respectivamente. Respecto a la validez de constructo, del análisis factorial exploratorio se extrajeron 3 factores, lo que explicaba un 34% de la varianza. El análisis factorial confirmatorio señala un ajuste al límite de los datos al modelo teórico. Las mujeres de más edad perciben menos susceptibilidad al cáncer de mama y declaran más barreras para hacerse una mamografía. Las de menor nivel de estudios perciben más barreras. La escala no ha mostrado su capacidad para predecir la participación en el programa.

Conclusiones

La escala presenta problemas de validez y homogeneidad. Las dimensiones de beneficios y barreras necesitan un proceso de adaptación y validación profunda para su utilización.

Palabras clave:
Estudios de validación
Escalas
Comportamiento en salud
Neoplasias de mama
Cribado poblacional
Mamografía
Abstract
Objectives

To adapt the «health belief model» on breast cancer screening to Spanish, and to asses its validity and reliability.

Methods

We assessed validation of a scale with 3 dimensions (susceptibility, benefits and barriers) with Likert responses in a case-control study. Cases were women not participating in a breast cancer screening program and controls consisted of participating women. A process of translation and back-translation was carried out and a technical committee analyzed discrepancies. Comprehension was tested in 17 women. Two hundred seventy-four women participated in the study. In 32 of these women, the questionnaire was administered twice after a 1-month interval to estimate its reliability.

Results

The intraclass correlation coefficients were 0.89, 0.70 and 0.90, and Cronbach's alpha coefficient was 0.71, 0.48 and 0.57 for susceptibility, benefits and barriers, respectively. Construct validity: from the factorial analysis, 3 factors were obtained explaining 34% of the variance. The confirmatory factorial analysis indicated acceptable goodness-of-fit of the data to the theoretical model. Older women perceived less susceptibility to breast cancer as well as greater barriers to attending screening. Women with a lower educational level perceived greater barriers. The scale did not seem to predict adherence to the program.

Conclusions

The adapted scale presents problems of validity and internal consistency. The dimensions of benefits and barriers require thorough adaptation and validation before the scale is used in Spanish women.

Key words:
Validation studies
Scales
Health behavior
Breast neoplasms
Mass screening
Mammography
El Texto completo está disponible en PDF
Bibliografía
[1.]
K. Kerlikowske, D. Grady, S.M. Rubin, C. Sandrock, V.L. Ernster.
Efficacy of screening mammography: a meta-analisis.
JAMA, 273 (1995), pp. 149-154
[2.]
P.C. Gotzsche, O. Olsen.
Is screening for breast cancer with mammography justifiable?.
[3.]
A.B. Miller, C.J. Baines, T. To, C. Wall.
Screening mammography re-evaluated. Correspondence.
[4.]
J.M. Borrás, J.A. Espinás, X. Castells.
La evidencia del cribado de cáncer de mama: la historia continúa.
Gac Sanit, 17 (2003), pp. 249-255
[5.]
H.B. Rubins.
From clinical trials to clinical practice: generalising from participant to patient.
Control Clin Trials, 15 (1994), pp. 7-10
[6.]
M.H. Becker.
The Health Belief Model and personal health behaviour.
Health Education Monographs, 2 (1974), pp. 4
[7.]
I.M. Rosenstock, V.J. Strecher, M.H. Becker.
Social learning theory and the Health Belief Model.
Health Educ Q, 15 (1988), pp. 175-183
[8.]
V. Champion, G. Huster.
Effect of interventions on stage of mammography adoption.
J Behav Med, 18 (1995), pp. 169-187
[9.]
C.S. Skinner, Cl. Arfken, R.K. Sykes.
Knowledge, perceptions and mammography stage of adoption among older urban women.
Am J Prev Med, 14 (1998), pp. 54-63
[10.]
L.R. Thomas, S.A. Fox, B.G. Leake, R.G. Roetzheim.
The effects of health beliefs on screening mammography utilization among a diverse sample of older women.
Women Health, 24 (1996), pp. 77-91
[11.]
V.L. Champion.
Instrument development for Health Beliefs Model constructs.
ANS Adv Nurs Sci, 6 (1984), pp. 73-85
[12.]
V.L. Champion.
Instrument refinement for breast cancer screening behaviours.
Nurs Res, 42 (1993), pp. 139-143
[13.]
V. Champion.
Development of a benefits and barriers scale for mammography utilization.
Cancer Nurs, 18 (1995), pp. 53-59
[14.]
V.L. Champion.
Revised susceptibility, benefits and barriers scale for mammography screening.
Res Nurs Health, 22 (1999), pp. 341-348
[15.]
I. Ajzen, M. Fishbein.
Understanding attitudes and prediction social behaviour.
Englewoods Cliffs, Prentice Hall, (1980),
[16.]
Z. Mah, H. Bryant.
Age as a factor in breast cancer knowledge, attitudes and screening behaviour.
Can Med Assoc J, 146 (1992), pp. 2167-2174
[17.]
D.N. Rutledge, G.T. Davis.
Breast self-examination compliance and the health belief model.
Oncol Nurs Forum, 15 (1988), pp. 175-179
[18.]
C. Schechter, C.F. Vanchieri, C. Crofton.
Evaluating women attitudes and perceptions in developing mammography promotion messages.
Public Health Rep, 105 (1990), pp. 203-207
[19.]
V. Champion.
Relationship of age to mammography compliance.
Cancer, 74 (1994), pp. 329-335
[20.]
S.E. Slenker, M.C. Grant.
Attitudes, beliefs and knowledge about mammography among women over forty years of age.
J Cancer Educ, 4 (1989), pp. 61-65
[21.]
J. Kim, C.W. Mueller.
Factor analysis: statistical methods and practical issues.
Sage, (1978),
[22.]
M.B. Byrne.
Structural equation modelling with LISREL, PRELIS, and SIMPLIS: basic concepts, applications and programming.
Lawrence Erlbaum Associates, (1998),
[23.]
J.R. Landis, G.G. Koch.
The measurement of observer agreement for categorical data.
Biometrics, 33 (1977), pp. 159-174
[24.]
Joreskog KG, Sorbom D. Lisrel 7: a guide to the program and applications. 2nd ed. Chicago: 1989.
[25.]
I. McDowell, C. Newell.
Measuring Health. A guide to rating scales and questionnaires.
Oxford University Press, (1996),
[26.]
C. Rodríguez, A. Plasencia, D.G. Schoeder.
Predictive factors of enrollment and adherence in a breast cancer screening program in Barcelona (Spain).
Soc Sci Med, 40 (1995), pp. 1155-1160
[27.]
M. Alcaraz, A. Lluch, J. Miranda, I. Pereiro, M.D. Salas.
Estudio de la no participación en el programa de prevención de cáncer de mama en la Ciudad de Valencia.
Gac Sanit, 16 (2002), pp. 230-235
[28.]
R.P. Harris, S.W. Flechter, J.J. González, D.R. Lannin, D. Degnan, J.A. Earp, et al.
Mammography and age: are we targeting the wrong women? A community survey of women and physicians.
Cancer, 67 (1991), pp. 2010-2014
[29.]
V.L. Champion, C.S. Skinner.
Differences in perceptions of risk, benefits and barriers by stage of mammography adoption.
J Womens Health (Larchmt), 12 (2003), pp. 277-286
[30.]
B.I. Mikhail, W.I. Petro-Nustas.
Transcultural adaptation of Champion's Health Belief Model scales.
J Nurs Scholarsh, 33 (2001), pp. 159-165
[31.]
S. Gozum, I. Aydin.
Validation evidence for Turkish adaptation of Champion's Health Belief Model scales.
Cancer Nurs, 27 (2004), pp. 491-498
[32.]
Y. Andreu Vaillo, M.J. Galdón Garrido, E. Durà Ferrandis, S. Carretero Gómez, J. Tuells Hernández.
Edad, creencias de salud y asistencia a un programa de cribado mamográfico en la comunidad valenciana.
Rev Esp Salud Publica, 78 (2004), pp. 65-82
Copyright © 2007. Sociedad Española de Salud Pública y Administración Sanitaria
Descargar PDF
Idiomas
Gaceta Sanitaria
Opciones de artículo
Herramientas
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?