Objective: To generate item content for development of a measure of modesty to study breast cancer screening adherence practices among Jewish women.
Design: Q methodology was selected because it produces subjective perspectives that can be objectively analyzed. Due to the private, sensitive nature of the concept, focus groups were not feasible.
Population: Adult Jewish women, without a history of breast cancer, ages 21-76 (M=45 years).
Sample/Setting: Purposive sampling (n=20) for diverse Jewish affiliation (Orthodox, Conservative, Reconstructionist, and Reform); data collection in home or office of subjects.
Concept or Variables Studied Together: Modesty and type of religious affiliation.
Method: Individual interviews were conducted to generate statements which were categorized into a concourse which was a 5x3 matrix with 5 categories: "appearance", "behavior", "belief", "culture" and "relationship"; and 3 perspectives: "self", "others", and "health care providers". A total of 164 statements were reviewed for clarity, relevance, and homogeneity. Sixty statements were retained. Subjects (n=20) sorted the statements using a forced choice grid approximating a normal distribution, with +6 ="most like me" to-6 = "least like me". Data were analyzed using PCQwin to identify subjects with shared perspectives who loaded on factors.
Findings: Using varimax rotation, a four factor solution was chosen: 1) physical; 2) religious; 3) behavioral; and 4) health-care. Summary descriptions were written. Statements with factor loadings >. 33 were retained to form a twenty-item measure of modesty.
Conclusions: Benefits of using Q methodology are: 1) Individual responses obtained in a private environment provide quality data; 2) Smaller sample sizes can be used; and 3) Opportunity for socially desirable responses in minimized. However, data collection is time-consuming and analysis is complex. Q methodology provided a feasible, yet rigorous, approach to generating item content for a new measure.
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