Using Rogers’ innovation attributes in ECAC-4 implementation: psychometric evaluation

Abstract Background The 4th European Code Against Cancer (ECAC-4) outlines recommendations to reduce individual cancer risk. This study evaluates the psychometric properties of an instrument designed to identify barriers and facilitators to ECAC implementation, using Rogers’ Diffusion of Innovations five innovation attributes: relative advantage (perceived need and usefulness), compatibility (alignment with adopters’ values and experiences), complexity (ease of understand and use), trialability (opportunity to test before adoption), and observability (visibility of results). Methods Based on previous literature, 23 items were generated to assess ECAC-4 five innovation attributes. A pre-test was conducted with a convenience online sample of English native speakers. Exploratory Factor Analysis (EFA) was used to identify the latent structure of each dimension. Internal consistency was assessed for each factor using Cronbach's alpha (α). Results A total of 240 adults (51.7% women, median age: 51) participated. EFA supported a one-factor structure for each innovation attribute, with acceptable internal consistency: Relative advantage (α = 0.831, factor loadings between 0.60-0.85, 50.6% variance explained), Compatibility (α = 0.823, loadings 0.65-0.73, 48.3%), Complexity (α = 0.770, loadings 0.53-0.68, 40.6%), Trialability (α = 0.714, loadings 0.58-0.66, 38.6%), Observability (α = 0.776, loadings 0.55-0.79, 47.9%). Correlations between dimensions ranged between 0.61 and 0.74. Conclusions This study highlights the applicability of innovation attributes for the implementation of ECAC-4. Such instruments may help to determine not only sociodemographic factors associated with each dimension, measurement invariance among cultural settings and how these dimensions relate to the adoption of cancer-reduction behaviors. Key messages • Dimensions of Rogers’ Diffusion of innovations framework provide a relevant basis for ECAC-4 implementation. • Items assessing Relative advantage, Compatibility, Complexity, Trialability and Observability have good psychometric properties and can be used in future research about cancer prevention.