Despite the effectiveness of mammography for early breast cancer detection, its’ utilization among Malaysian women remains low. Health beliefs are closely related to health screening behavior. Hence, it is important that health beliefs are employed when exploring mammography screening behavior. Thus, the study utilized HBM constructs in predicting the variance in adoptive behavior of mammography. A multi-stage, stratified random sampling method was utilized to select the polyclinics in Kuantan, Pahang. Using sample size calculation at 5% type 1 error, p < 0.05 and absolute error at 2%, 520 Malaysian women aged 35 to 70 years were randomly selected. Sets of copyrighted, validated questionnaire were used to obtain the data. Structural equation modeling using Mplus was used to test the model. All health beliefs were found to significantly influence the behavioral adoption of mammography screening. Socio-demographic factors (married women) were found to moderate significantly the relationship between perceived susceptibility and behavioral adoption of mammography. Further, knowledge and married women were found to significantly affect self-efficacy. Additionally, perceived severity, motivator factors and perceived benefits were found to significantly influence self-efficacy and that self-efficacy significantly influences the behavioral adoption of mammography screening. However, a negative correlation was found between perceived severity and perceived barriers on the behavioral adoption of mammography. The model can be used as an interventional tool in designing promotional and educational programs to encourage women to adopt mammography screening.

Background: Heart disease knowledge is an important concept for health education, yet there is lack of evidence on proper validated instruments used to measure levels of heart disease knowledge in the Malaysian context. Methods: A cross-sectional, survey design was conducted to examine the psychometric properties of the adapted English version of the Heart Disease Knowledge Questionnaire (HDKQ). Using proportionate cluster sampling, 788 undergraduate students at Universiti Sains Malaysia, Malaysia, were recruited and completed the HDKQ. Item analysis and confirmatory factor analysis (CFA) were used for the psychometric evaluation. Construct validity of the measurement model was included. Results: Most of the students were Malay (48%), female (71%), and from the field of science (51%). An acceptable range was obtained with respect to both the difficulty and discrimination indices in the item analysis results. The difficulty index ranged from 0.12.0.91 and a discrimination index of . 0.20 were reported for the final retained 23 items. The final CFA model showed an adequate fit to the data, yielding a 23-item, one-factor model [weighted least squares mean and variance adjusted scaled chi-square difference = 1.22, degrees of freedom = 2, P-value = 0.544, the root mean square error of approximation = 0.03 (90% confidence interval = 0.03, 0.04); close-fit P-value = > 0.950]. Conclusion: Adequate psychometric values were obtained for Malaysian undergraduate university students using the 23-item, one-factor model of the adapted HDKQ.