The Faculty of Medicine, Universiti Malaya, proudly congratulates Melissa binti Johari Chan on the successful defence of her Doctor of Public Health (DrPH) thesis entitled “Developing and Validating a Breast Cancer Screening Health Literacy Questionnaire for Malaysian Adults Guided by Sørensen’s Integrated Model” on 6 August 2026.
A Short Summary of the Thesis
Health literacy plays a fundamental role in enabling individuals to make informed decisions about their health and access appropriate healthcare services. In Malaysia, breast cancer remains the most common cancer among women, yet participation in breast cancer screening continues to be below optimal levels, particularly among those from lower socioeconomic and educational backgrounds. One of the key barriers identified is limited health literacy, which affects individuals’ ability to understand health information, assess risks, and navigate available screening services.
Recognising the lack of a culturally appropriate instrument for measuring breast cancer screening health literacy in Malaysia, Melissa undertook the development and validation of a comprehensive questionnaire grounded in Sørensen’s Integrated Model of Health Literacy. Employing a rigorous three-phase, multi-method approach involving systematic review, expert validation, cognitive testing, and psychometric evaluation among 779 Malaysian adults, the study successfully produced a reliable 41-item questionnaire covering seven key domains: Access, Understand, Appraise, Apply Information, Knowledge, Competence, and Motivation.
The final instrument demonstrated excellent reliability and validity, providing Malaysia with a scientifically robust and culturally sensitive tool for assessing breast cancer screening health literacy among Malaysian adults.
Highlight of the Candidate’s Achievement
Melissa’s doctoral research represents a significant scholarly achievement in public health research. Her work successfully translated complex health literacy theory into a practical measurement tool specifically designed for Malaysia’s multicultural and multilingual population.
Among the notable achievements are:
- Development of the first validated Breast Cancer Screening Health Literacy Questionnaire specifically tailored for Malaysian adults.
- Integration of Sørensen’s Integrated Model of Health Literacy into a culturally relevant assessment framework.
- Successful validation of the questionnaire using rigorous psychometric methods, including Exploratory Factor Analysis and Confirmatory Factor Analysis.
- Recruitment and evaluation of a large sample of 779 adults across multiple health clinics, strengthening the robustness and generalisability of the findings.
- Production of a highly reliable instrument with excellent internal consistency and construct validity, making it suitable for future research, programme evaluation, and public health practice.
Her work provides an important methodological contribution that will support future health literacy research both nationally and internationally.
Contribution to Public Health
Melissa’s research has important implications for improving cancer prevention and early detection in Malaysia. By providing healthcare professionals, researchers, and policymakers with a validated instrument to measure breast cancer screening health literacy, this work enables more accurate identification of knowledge and literacy gaps within the community.
The questionnaire offers a valuable resource for designing targeted educational interventions, evaluating health promotion programmes, and informing policies aimed at increasing breast cancer screening uptake. Ultimately, the findings have the potential to contribute towards earlier detection of breast cancer, reduction of health inequalities, improved health outcomes for Malaysian women, and more effective utilisation of healthcare resources.
Beyond breast cancer, this research also advances the broader field of health literacy by demonstrating a robust framework for developing culturally appropriate assessment tools in diverse populations.
Acknowledgement
We wish to acknowledge the invaluable guidance and mentorship provided by Melissa binti Johari Chan’s supervisors, Associate Professor Dr Nik Daliana Nik Farid, Dr Nithiah a/p Thangiah, and Dr Muhd Zulfadli Hafiz Ismail, whose expertise and support were instrumental in the completion of her thesis.
We extend our sincere gratitude to Professor Dr Karuthan Chinna, Institute of Research, Development and Innovation, IMU University, as External Examiner, and Dr Bala Murali a/l Sundram, Internal Examiner.
We would also like to thank the Committee of Examiners for their thorough evaluation and insightful feedback, including Professor Dr Puteri Shafinaz Akmar Abdul Rahman, Chairperson of the viva voce session; Professor Dr Victor Hoe Chee Wai Abdullah, Head of the Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya; and all members who contributed to the successful conduct of the examination.
Congratulations and Future Expectations
Heartiest congratulations to Dr Melissa binti Johari Chan on this remarkable academic milestone. The successful completion of her Doctor of Public Health degree reflects her dedication, perseverance, scholarly excellence, and commitment to advancing public health research in Malaysia.
Her work has laid a strong foundation for improving breast cancer screening health literacy and promoting evidence-based interventions that will benefit Malaysian communities for years to come. We are confident that Dr Melissa will continue to make meaningful contributions to public health practice, research, and policy, inspiring future researchers while improving the health and wellbeing of the nation.
Once again, congratulations on this well-deserved achievement. We wish Dr Melissa every success in her future academic and professional endeavours.
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