Validation of Spanish version of the human papilloma virus impact profile (HIP)

Abstract

Objective

To examine the construct validity and reliability of the Spanish version of the HPV Impact Profile scale (HIP) among women in Medellin, Colombia.

Methods

We conducted a nested analysis of data from the pragmatic randomized controlled trial “Evaluation of Strategies for Optimal Clinical Management of Women with Atypical Squamous Cells of Undetermined Significance” (ASCUS-COL; NCT02067468). Women with Atypical Squamous Cells of Undetermined Significance (ASCUS) were randomly assigned to one of three triage strategies (Pap smear, colposcopy, HPV). Participants completed a questionnaire with sociodemographic information and the HIP scale translated into Spanish at baseline, two weeks after receiving triage test results, and one year after the second questionnaire. We conducted exploratory and confirmatory factorial analysis, and then assessed test reliability using Cronbach’s alpha. Subsequently, we conducted multigroup confirmatory factor analysis to assess differences according to women´s age, and configurational invariance of the factor structure over the three time measures.

Results

The sample consisted of 675 women, with a mean age of 40 years. The exploratory and confirmatory factor analysis for the HIP showed a seven-factor structure with appropriate adjustment indicators (${\mathrm{\chi }}_{df=317\mathrm{ }}^2$= 1466.783, p < .0001). Only two items (1 and 10) had low factor loads and were removed from the confirmatory analysis. Multigroup analysis according to women’s age showed acceptable goodness of fit (RMSEA = 0.037, CFI/TLI:0.998/0.998). The factor structure was similar among the tree measures and the model preserved acceptable goodness of fit (RMSEA = 0.079, CFI:0.86). The Cronbach’s alpha for the total score was 0.91, with the lowest score for sexual impact (0.49) and the highest score for worries and concerns (0.90).

Conclusions

The Spanish version of the HIP had adequate reliability and construct validity, and its use could be considered in clinic and research settings.

Keywords:

• Human papillomavirus
• validation
• psychosocial impact
• HIP

Transparency

Declaration of funding

This work was supported by the Committee for Research Development (CODI, for the term in Spanish) at the Universidad de Antioquia; Fondo de Investigación Docente of the Facultad Nacional de Salud Pública, Universidad de Antioquia; additionally, ASCUS-COL was supported by the Departamento Administrativo de Ciencia, Tecnología e Innovación Colombiano (COLCIENCIAS) (Grant 1115-459-21657). Alexandra Restrepo is supported by Colciencias scholarship 728/2015, and the program Enlaza mundos of Major office of Medellin, Colombia, and Pasaporte a la ciencia scholarship (Colombia científica, 2017).

Declaration of financial/other relationships

The authors and peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

ARH: analysis and interpretation of the data, drafting of the paper, and approval of the version to be published; NEMG: analysis and interpretation of the data, and approval of the version to be published; DGG: analysis and interpretation of the data, drafting of the paper, and approval of the version to be published; ICGP: conception and design of the study, interpretation of data, drafting of the paper, and approval of the version to be published.

Acknowledgements

Thank you to Sarah Hayton for English editing services. ASCUS-COL Trial Group: Gloria I. Sanchez, Armando Baena, Maria C. Agudelo, Carolina Lopez, Arianis Tatiana Ramìrez, Kelly Melisa Castañeda, Marcela Riveros, Guadalupe Posada, Mauricio Borrero, Carlos A. Buitrago, David Suescun, Luis J. Gomez, Juan C. Ochoa, Mark Stoler, Julia Gage, Philip E. Castle, Peter Sasieni, Maribel Almonte, Rolando Herrero. Members of the ASCUS-COL Trial Group responsible for the collection of data included in the trial: Alejandra Botero, Astrid Bedoya, Catalina Villa, Claudia Cristina Rivera, Claudia Patricia Monsalve, Liliana Gamboa, Maria Elena Londoño, Natalia Echeverry, Ruth Elena Arboleda, Sandra Herrera, and Victor Florez (Group Infection and Cancer, Universidad de Antioquia). Sara Ramos (Epidemiology group). Maria Eugenia Mejia and Marleny Valencia (School of Microbiology, Universidad de Antioquia). Lina Toro and Jhon Henry Osorio (Comfama EPS). Jaime Agudelo, Gustavo Trujillo, Cristina Jimenez and Lizeth Ruiz (Comfenalco EPS). Mary Luz Arteaga and Liliana Rendon (Savia Salud EPS). Lina Serna and Jose Miguel Abad (Sura EPS). Beatriz Eugenia Perez, Gloria Cristina Calderon and Jaime Alexander Castañeda (Dinamica IPS). Luz Helena Londoño (Metrosalud IPS). Lucy Sanchez (Biosigno IPS and CEMEV IPS). Azucena Osorio (Laboratory of Pathology and Cytology Suescun). We are grateful to women who participated in the study.