Development and psychometric testing of the Knowledge, Attitude, and Practice Questionnaire to assess knowledge, attitude, and practices regarding COVID-19 among patients attending COVID screening outpatient department in a tertiary care hospital in North India.

Background: COVID-19 pandemic has hit the world leading to major disruptions globally. Due to its highly contagious nature and associated mortality, a wide array of emotional and behavioral reactions were seen which indirectly reflected the knowledge, attitudes, and practices (KAP) of individuals. Understanding the KAP of individuals is fundamental when it comes to decreasing future COVID cases. Aim: The study aimed to develop a Knowledge, Attitude, and Practice Questionnaire regarding COVID-19 (COVID-KAPQ) among patients attending screening outpatient department (OPD) in a tertiary care hospital in North India and evaluate its psychometric properties. Materials and Methods: The study procedure consisted of step-wise procedure starting with item generation, expert evaluation for categorization of items into domains of KAP and testing for psychometric properties. The items were generated and evaluated by the Delphi method based on 8 experts. Reliability and validity were assessed using data from 200 patients attending COVID screening OPD. Content validity was evaluated using content validity index (CVI); construct validity was examined using exploratory factor analysis and Cronbach's alpha coefficient was computed for internal consistency. Results: The final COVID-KAPQ consisted of three domains and 29 items. Cronbach's alpha coefficient for the entire questionnaire was 0.734, 0.710 for knowledge domain, 0.614 for attitudes domain, and 0.759 for practice domain. CVI ranged from 0.86 to 1. Five factors each for knowledge and attitudes domain and two factors for practice domain were extracted by principal factor analysis and varimax rotation, with a cumulative contribution of 70.19%, 71.54%, and 66.77% variance in KAP domain. Conclusions: A questionnaire COVID-KAPQ (KAP regarding COVID-19) was developed. Psychometric testing indicated that it had adequate validity and reliability for use in COVID research in the general population. This questionnaire might help the public health researchers to map the level of KAP in the population and plan awareness and prevention strategies accordingly.

DEVELOPMENT AND VALIDATION OF KNOWLEDGE AND INTENTION TO BREASTFEED DURING PANDEMIC QUESTIONNAIRE USING EXPLORATORY FACTOR ANALYSIS AND RASCH MODEL

Breastfeeding during the COVID-19 pandemic is challenging. Strong intention and good knowledge on the risk and benefit of breastfeeding are important for a woman to breastfeed her child during this period. This study aims to develop and validate a Malay language questionnaire in order to measure Malaysian women's knowledge and intention about breastfeeding during the pandemic. The items were developed based on an extensive review of literature as well as breastfeeding guidelines and suggestions from experts, followed by an assessment of content and face validity that involved nine and 30 reviewers respectively. A pilot study was conducted on 90 respondents and the reliability assessment was performed using Rasch analysis. Exploratory factor analysis (EFA) was used to determine the number of latent factors within the intention dimension. Among 29 knowledge items and 36 intention items, 19 knowledge items remained with a person separation (person reliability) as well as item separation (item reliability) of 1.73(0.75) and 3.97(0.94). The final intention domain had 17 items with a person separation (person reliability) as well as item separation (item reliability) of 1.54(0.70) and 3.87(0.94). Three latent factors were identified within the intention questionnaire. The final 17 items explained 53.7% of the variance with an overall Kaiser-Meyer-Olkin measure of sampling adequacy of 0.70, χ2 = 623.40 (136), p<0.001. Using the framework of the theory of planned behaviour, the drafted questionnaire is reliable and valid based on the Rasch measurement model to measure the knowledge and intention about breastfeeding during an infection outbreak. © 2022, Malaysian Journal of Public Health Medicine. All Rights Reserved.

Development and Validation of a Questionnaire to Assess Social Participation of High Risk-Adults in Germany During the COVID-19 Pandemic.

Background: Restrictions to contain the COVID-19 pandemic affect the social participation of people worldwide. Especially those at high risk for a severe disease tend to abstain from social gatherings. While there are a few questionnaires to measure social participation in elderly or chronic patients, a valid survey instrument that includes pandemic-related social participation is needed. Methods: We developed a social participation questionnaire that aims to assess pandemic-related restrictions in social participation. Items were developed using a theory and literature-based approach and then compiled in a discursive process involving experts and lay people. This was followed by the validation of the questionnaire through a cross-sectional survey on 431 individuals. Items with low item-total correlations and low factor loadings using exploratory factor analysis [EFA] were excluded. Using EFA on the remaining items, the factor structure was retrieved and tested with a confirmatory factor analysis [CFA]. Internal consistency was assessed with Chronbachs α. Results: Initially, 27 items were developed which were used for validation. 13 items were excluded due to low item-total correlations and factors loadings. EFA of the remaining 14 items revealed three factors which were identified as domains "active social participation," "wellbeing," and "restrictions". CFA showed an acceptable model fit using the three-dimensional structure. Chronbachs α of 0.81 and McDonalds Ω of 0.87 indicate good internal consistency. Correlation analysis showed an association between the developed questionnaire and previously-established participation and mental health scales. Conclusion: This study suggests that our 14 item questionnaire is of high reliability and validity and can be used to measure social participation during a pandemic.

The Development of a Parental Questionnaire (QQ-MediaSEED) on Bilingual Children's Quantity and Quality of Digital Media Use at Home.

The quantity and quality of children's digital screen media exposure is an emerging area of early childhood studies because of its strong social relevance, and this has been particularly true since the COVID-19 pandemic. The few existing parental questionnaires on children's digital screen media exposure mainly focus on monolingual children's media habits and address either the quantity or quality of children's media exposure. Inspired by the existing instruments, the current study introduces a new parental questionnaire to comprehensively assess the duration, frequency, content, design, and use of bilingual children's digital screen media exposure at home, before and since the COVID-19 pandemic. Focus group discussions and the first wave of our data collection on 141 3-6 years old Singaporean bilingual children indicate good face validity and internal consistency of the parental questionnaire. Our results reveal substantial differences in children's quantity and quality of daily digital screen media exposure, as well as the discrepancies in their digital media habits between English and their mother tongue languages, before and since the COVID-19 pandemic.

Development and Content Validation of a Comprehensive Health Literacy Survey Instrument for Use in Individuals with Asthma during the COVID-19 Pandemic.

Individuals with chronic conditions have been faced with many additional challenges during the COVID-19 pandemic. Individual health literacy (HL) as the ability to access, understand, evaluate, and apply pandemic-related information has thus become ever more important in these populations. The purpose of this study was to develop and content-validate a comprehensive HL survey instrument for people with asthma based on an integrated framework, and on previous surveys and other instruments for use in the general population and vulnerable groups. Beside HL, assumed determinants, mediators, and health outcomes were embraced in the framework. A mixed-method design was used. A comprehensive examination of the available literature yielded an initial pool of 398 single items within 20 categories. Based on content validity indices (CVI) of expert ratings (n = 11) and the content analysis of cognitive interviews with participants (n = 9), the item pool was reduced, and individual items/scales refined or modified. The instrument showed appropriate comprehensibility (98.0%), was judged relevant, and had an acceptable CVI at scale level (S-CVI/Ave = 0.91). The final version comprises 14 categories measured by 38 questions consisting of 116 single items. In terms of content, the instrument appears a valid representation of behavioural and psychosocial constructs pertaining to a broad HL understanding and relevant to individuals with asthma during the COVID-19 pandemic. Regular monitoring of these behavioural and psychosocial constructs during the course of the pandemic can help identify needs as well as changes during the course of the pandemic, which is particularly important in chronic disease populations.

Development and validation of a new tool to identify factors that influence users' motivation toward the use of teleconsultation systems: A modified Delphi study.

BACKGROUND: Healthcare providers have improved consumer access to healthcare services by the adoption of information communication technology and the use of telemedicine. With the current COVID-19 pandemic, consumers are shifting to remote teleconsultation. There are several studies regarding consumers' acceptance and satisfaction with telemedicine among healthcare providers and a few among patients at healthcare facilities. However, studies about patients' motivation toward the use of teleconsultation systems are very few. AIM: The aim of this study was to validate an instrument of a newly developed framework to identify factors that motivate patients to use a teleconsultation system. METHOD: This study used a modified eDelphi method incorporating content validity index and content validity ratio procedures to validate the instrument among fifteen experts from different disciplines. The eDelphi consisted of three rounds to review each item's relevance, clarity, importance and the overall validity of the instrument. RESULT: The result showed a significant level of agreement among experts for individual items' relevance, clarity and importance. For relevance, all items had excellent I-CVI above 0.889, except one item with I-CVI = 0.78, which is still acceptable. For clarity, all items had an excellent I-CVI > 0.889, except one with I-CVI = 0.667. For importance, most items had CVR above the threshold value of 0.778, except 5 items. Also, the result showed moderate to high content validity of the overall instrument (S-CVI/UA = 0.694; S-CVI/Ave = 0.996). DISCUSSION: These findings support the validity and reliability of the developed instrument, which can be used to identify factors that motivated patients to use a teleconsultation system. Future testing of the instrument should be conducted with a larger population that uses a teleconsultation system. CONCLUSION: An instrument was developed to identify factors that motivated consumers to use teleconsultation, using a modified eDelphi method among experts. The eDelphi method consisted of three rounds and the results showed that the instrument is a valid and reliable tool.