Development and Psychometric Evaluation of the Brief HIV Knowledge Questionnaire

Abstract

This research evaluated the psychometric properties of a brief self-report measure of HIV-related knowledge, the HIV-KQ-18. Low-income men and women (N = 1019) responded to 27 items that represented the domain of interest. Item analyses indicated that 18 items, with item-total correlations ranging from .24 to .57, be retained. Additional analyses demonstrated the HIV-KQ-18's internal consistency across samples (alphas = .75 to .89), test-rest stability across several intervals (rs = .76 to .94), and strong associations with a much longer, previously validated measure (rs = .93 to .97). Data from three clinical trials indicated that the HIV-KQ-18 detected knowledge gains in treated participants when compared to untreated controls. We conclude that the HIV-KQ-18 is internally consistent, stable, sensitive to the change resulting from intervention, and suitable for use with lowliteracy populations. KeywordsHIV; AIDS; knowledge; assessment; questionnaire Most models of HIV-risk taking identify knowledge about disease transmission and selfprotective behaviors as one of the determinants of behavior change. For example, Fisher and Fisher (1992) developed the Information-Motivation-Behavioral Skills model, and identified information as one determinant of risk behavior and its reduction. Consistent with this and other behavioral science theories, programs designed to reduce risk behavior typically include education about HIV as one component of the intervention (Kalichman, 1998). Because knowledge is a key component of HIV risk reduction programs, interventionists often use knowledge assessments to guide educational curricula and to provide feedback to enhance risk awareness (Carey & Lewis, 1999); also, program evaluators and researchers often assess knowledge to determine the effectiveness of their interventions. Thus, practitioners and scientists need a reliable, valid, and feasible questionnaire to assess HIV-related knowledge.The HIV Knowledge Questionnaire (HIV-KQ; Carey, Morrison-Beedy, & Johnson, 1997) is a self-administered instrument that was developed using formative work, item and factor analyses to assess knowledge needed for HIV prevention. Respondents read 45 statements about HIV, and indicate whether they think the statement is true or false, or they indicate that they "don't know." Text analyses of the reading level, using Flesch and Spache formulae, indicate that most passages fall within the "fairly easy" to "very easy" range (i.e., at or below the 4 th grade level); however, several foreign words (e.g., vaccine, antibiotic) increase the overall level to the 7 th grade level. Although such words increase the reading level, they are likely to be widely understood even by low-literacy readers because of their common use in Correspondence regarding this manuscript should be addressed to: Michael P. Carey, Ph.D., Director, Center for Health and Behavior, Syracuse University, 430 Huntington Hall, Syracuse, NY 13244-2340, Phone: 315.443.2755 The purpose of the research described in this paper was to v...

Adaptation and Refinement of the HIV Knowledge Questionnaire for Use With Adolescent Girls

“…This 18-item version was evaluated and showed strong and stable item association (internal consistencies alphas .75-.89). It also showed a sound association with the original HIV-KQ, capturing an approximately equal amount of knowledge variance (Carey & Schroder, 2002). Nevertheless, these modifications mainly address the issue of participant burden by shortening questionnaire length and narrowing the transmission topic domain to sexual behavior transmission and prevention versus, for example, HIV/AIDS treatment.…”

“…Four items on the proposed HIV-KQ AG (21 items) had means above .90, which showed an inability to capture participant variance and knowledge change after intervention. The decision was made to remove three of these items (m = .94 each) because of the high means on this respondent pool being consistent with other studies using the HIV-KQ items (Carey et al, 1997;Carey & Schroder, 2002). All other items, including the three items added for gender and age specificity, were retained.…”

“…However, the instrument was developed using a sample of men and women from a broad age range and tests general HIV-related information. It may also be associated with higher participant burden because it consists of 45 items (Carey & Schroder, 2002).…”

“…To reduce participant burden and focus on sexual transmission of HIV, the original 45-item HIV-KQ was modified into a brief 18-item version (Carey & Schroder, 2002). This 18-item version was evaluated and showed strong and stable item association (internal consistencies alphas .75-.89).…”

“…Despite nurses' demands for clinical practice tools based on sound evidence, many HIV knowledge measures are not published in sufficient detail to assess psychometric soundness. In addition, current HIV knowledge measures lack gender or age specificity, both in design and testing, despite documented need (Carey & Schroder, 2002;Loue, Cooper, & Fielder, 2003;Seha, Klepp, & Ndeki, 1995;Xinying, Wenbin, & Chun, 2004). The importance of HIV knowledge assessment for prevention research and practice, the lack of adequate measurement tools, and the increasing incidence of HIV among adolescent girls underscore the need for an HIV knowledge measure that is psychometrically sound, specific to female adolescents, and accessible to clinicians and researchers.…”