Evidence map›Paper›PMID 31386684›Full record

ArticlePloS one2019

Development and validation of the African Women Awareness of CANcer (AWACAN) tool for breast and cervical cancer.

J Moodley, S E Scott, A D Mwaka, D Constant, J N Githaiga, T S Stewart, A Payne, L Cairncross, N I M Somdyala, F M Walter

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers.

0numbers the graph read from it
0cells of the map it votes in
31citing papers in PubMed
1.4field-weighted citation impact, top 16% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

31 citing papers in PubMed, 46 citations in OpenAlex.

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  10. Anticipated First Contact and Time to Seek Healthcare for Possible Breast Cancer Symptoms: A Cross-Sectional Study in Rural Ghana.Health expectations : an international journal of public participation in health care and health policy · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 6 institutions in 3 countries.

J MoodleyWomen's Health Research Unit, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town; Observatory, Cape Town, South Africa.ORCID 0000-0002-9398-5202
S E ScottCentre for Oral, Clinical and Translational Sciences, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, United Kingdom.
A D MwakaDepartment of Medicine, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda.
D ConstantWomen's Health Research Unit, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town; Observatory, Cape Town, South Africa.ORCID 0000-0002-7176-9963
J N GithaigaWomen's Health Research Unit, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town; Observatory, Cape Town, South Africa.
T S StewartDepartment of Obstetrics & Gynaecology, Plymouth Hospitals NHS Trust, Derriford Hospital, Plymouth, Devon, United Kingdom.
A PayneCancer Research Initiative, Faculty of Health Sciences, University of Cape Town; Observatory, Cape Town, South Africa.
L CairncrossSurgical Endocrine Oncology Unit, Division of General Surgery, Department of Surgery, University of Cape Town; Observatory, Cape Town, South Africa.
N I M SomdyalaEastern Cape Cancer Registry, South African Medical Research Council, Burden of Disease Research Unit, Tygerberg, South Africa.ORCID 0000-0001-6564-8754
F M WalterThe Primary Care Unit, Department of Public Health & Primary Care, University of Cambridge, Cambridge, United Kingdom.
University of Cape Town · ZASouth African Medical Research Council · ZADerriford Hospital · GBKing's College London · GBMakerere University · UGUniversity of Cambridge · GB

Funding

Cancer Research UK C8640/A23385Medical Research Council MC_PC_16098
6 · The paper itself

Abstract

backgroundMeasuring factors influencing time to presentation is important in developing and evaluating interventions to promote timely cancer diagnosis, yet there is a lack of validated, culturally relevant measurement tools. This study aimed to develop and validate the African Women Awareness of CANcer (AWACAN) tool to measure awareness of breast and cervical cancer in Sub-Saharan Africa (SSA).

methodsDevelopment of the AWACAN tool followed 4 steps: 1) Item generation based on existing measures and relevant literature. 2) Refinement of items via assessment of content and face validity using cancer experts' ratings and think aloud interviews with community participants in Uganda and South Africa. 3) Administration of the tool to community participants, university staff and cancer experts for assessment of validity using test-retest reliability (using Intra-Class Correlation (ICC) and adjusted Kappa coefficients), construct validity (comparing expert and community participant responses using t-tests) and internal reliability (using the Kuder-Richarson (KR-20) coefficient). 4) Translation of the final AWACAN tool into isiXhosa and Acholi.

resultsICC scores indicated good test-retest reliability (≥ 0.7) for all breast cancer knowledge domains and cervical cancer risk factor and lay belief domains. Experts had higher knowledge of breast cancer risk factors (p < 0.001), and cervical cancer risk factors (p = 0.003) and symptoms (p = 0.001) than community participants, but similar knowledge of breast cancer symptoms (p = 0.066). Internal reliability for breast cancer risk factors, lay beliefs and symptom and cervical cancer symptom subscales was good with KR-20 values > 0.7, and lower (0.6) for the cervical cancer risk subscale.

conclusionThe final AWACAN tool includes items on socio-demographic details; breast and cervical cancer symptom awareness, risk factor awareness, lay beliefs, anticipated help-seeking behaviour; and barriers to seeking care. The tools showed evidence of content, face, construct and internal validity and test-retrest reliability and are available for use in SSA in three languages.

Indexed as

AdultAfrica South of the SaharaBreast NeoplasmsFemaleHealth Knowledge, Attitudes, PracticeHumansMiddle AgedReproducibility of ResultsRisk FactorsSpecializationSurveys and QuestionnairesTherapeutic CommunityUterine Cervical Neoplasms

Identifiers

PMID31386684
PMCPMC6684059
OpenAlexW2964912634

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.