Appendix 1.

Culturally Adapted Champion Scales, Based on Focus-Group Input

Susceptibility	1. You are likely to get breast cancer in the next few years.
	2. You are likely to get breast cancer.
	3. You will get breast cancer sometime during your life.
Benefits	1. If you have regular mammograms, you won't worry as much about dying from breast cancer.
	2. If you have breast cancer found through regular mammograms, your chances of being cured are good.
	3. Having regular mammograms will help you find breast cancer early when it starts.a
	4. Having regular mammograms will set your mind at ease.
Self-efficacy	1. You can ask your doctor for a mammogram even if the doctor does not mention it.a
	2. You can get to the clinic to have a mammogram.a
	3. You can make time in your life to have a mammogram.a
	4. You can talk to people at the mammogram center if you have a problem.
	5. You can go for a mammogram even if you are worried.
	6. You can go for a mammogram even if you don't know what to expect during the test.a
	7. You can get a mammogram even if you can't afford it.a
	8. You can make an appointment for a mammogram.
	9. You can get a mammogram if you really want to.
	10. You can find a place to get a mammogram
Barriers	1. The treatment for breast cancer is worse than breast cancer itself.
	2. You are too old to have a mammogram.
	3. You are afraid to get a mammogram because it may find a problem in your breast.a
	4. Having a mammogram is too difficult.a
	5. Having a mammogram would cause too much pain.
	6. Having a mammogram would be too embarrassing.
	7. Worry about being exposed to harmful radiation keeps you from having a mammogram.a
	8. You have difficulty remembering to make an appointment for a mammogram.
	9. You are worried about having a mammogram because you don't understand how the test is done.a
	10. It is difficult for you to get transportation to go for a mammogram.a
	11. It is difficult for you to get child care to go for a mammogram.a
	12. You don't have time to get a mammogram.
	13. You don't have a convenient place to get a mammogram.
	14. Compared with your other health problems, having a mammogram is not important.
	15. You don't want to get a mammogram because if you have breast cancer it is better not to know about it.
	16. You wouldn't get a mammogram because it costs too much.
	17. You are afraid to have a mammogram because it may show a problem.
	18. You don't want to get a mammogram because people you know don't think it is necessary.
	19. You don't think a mammogram is necessary if you have a breast exam by a doctor.
	20. You don't think a mammogram is necessary because a doctor didn't recommend one.
	21. You don't need a mammogram because your chances of getting breast cancer are low.
	22. You wouldn't want to go for a mammogram if it was done by a male provider.a
	23. You wouldn't want to go for a mammogram unless the clinic has private space for mammography patients.a
Emotional (fear and shame)	1. When you think about breast cancer, you get scared.
	2. When you think about breast cancer, you get worried.
	3. When you think about breast cancer, you get depressed.
	4. Thinking about breast cancer is shameful.a

^aItem reworded per input from focus group participants.

^aNew items:

Susceptibility: reworded items (0), new items (0), deleted items (2). Your chances of getting breast cancer are higher than most women your age. Your chances of getting breast cancer are lower than most women your age.

Benefits: reworded items (1), new items (0), deleted Items (0).

Self-efficacy: reworded items (5), new items (0), deleted items (0).

Barriers: reworded items (6), new items (2), deleted items (1). Getting a mammogram could cause breast cancer because the breasts are squeezed.

Emotional (fear and shame): reworded items (0), new items (1), deleted items (4): When you think about breast cancer, you feel nervous. When you think about breast cancer, you get upset. When you think about breast cancer, you get edgy. When you think about breast cancer, your heart beats faster.