The Development and Initial Validation of a Health Belief Model Scale to Reduce Single Cigarette Use among Urban, African American Smokers

ABSTRACT

Background: Single cigarette use among urban African Americans can perpetuate smoking continuation. There are no measures on perceptions related to reducing single cigarette use. Purpose: We developed the Beliefs and Self-Efficacy for Singles (BASES) Scale to measure beliefs related to reducing this behavior. Methods: We used a multiphase approach including qualitative interviews with 25 users, consultation with 3 experts, and pilot testing with 24 users. The scale items were administered to 122 users to examine psychometric properties including reliability and validity. Exploratory factor analysis via principal axis factoring with oblique rotation was conducted. Results: BASES is a 20-item scale to predict perceived benefits, barriers, susceptibility, severity, and self-efficacy related to reducing single cigarette use. BASES’ internal consistency was α = 0.87 and subscale consistencies were αs = 0.71– 0.85. BASES demonstrated moderate convergent validity (r = 0.43, p <.001) and strong discriminant validity (r = 0.01, p >.05). Discussion: Each subscale measures a dimension of intrapersonal beliefs that may support reducing single cigarette use. Translation to Health Education Practice: BASES provides health educators and cessation practitioners with a measure of malleable beliefs including perceived benefits, susceptibility, and self-efficacy related to reducing single cigarette use to inform health education design.

Acknowledgments

We would like to thank Stephen Lepore, PhD, Ed.M., Bradley Collins, PhD, MA, and Uma S. Nair, PhD, M.S. for providing their feedback on the pool of potential scale items. Additionally, we graciously thank Mr. Ron Friday, a community navigator from the District of Columbia Housing Authority (DCHA), and DCHA Resident Council Presidents for assisting us with coordinating study visits. Thanks to Mrs. Sheila Butler for her assistance at a study visit. Lastly, we thank the participants for their time and participation.

Disclosure statement

All authors declare that they have no conflicts of interest to disclose.

Additional information

Funding

This work was in part supported by grant number P50CA180523 from the National Cancer Institute and Food and Drug Administration (FDA) Center for Tobacco Products. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or FDA.