Development and validation of a new knowledge, attitude, belief and practice questionnaire on leptospirosis in Malaysia

Abstract

BackgroundIn Malaysia, leptospirosis is considered an endemic disease, with sporadic outbreaks following rainy or flood seasons. The objective of this study was to develop and validate a new knowledge, attitude, belief and practice (KABP) questionnaire on leptospirosis for use in urban and rural populations in Malaysia.MethodsThe questionnaire comprised development and validation stages. The development phase encompassed a literature review, expert panel review, focus-group testing, and evaluation. The validation phase consisted of exploratory and confirmatory parts to verify the psychometric properties of the questionnaire. A total of 214 and 759 participants were recruited from two Malaysian states, Kelantan and Selangor respectively, for the validation phase. The participants comprised urban and rural communities with a high reported incidence of leptospirosis. The knowledge section of the validation phase utilized item response theory (IRT) analysis. The attitude and belief sections utilized exploratory factor analysis (EFA) and confirmatory factor analysis (CFA).ResultsThe development phase resulted in a questionnaire that included four main sections: knowledge, attitude, belief, and practice. In the exploratory phase, as shown by the IRT analysis of knowledge about leptospirosis, the difficulty and discrimination values of the items were acceptable, with the exception of two items. Based on the EFA, the psychometric properties of the attitude, belief, and practice sections were poor. Thus, these sections were revised, and no further factor analysis of the practice section was conducted. In the confirmatory stage, the difficulty and discrimination values of the items in the knowledge section remained within the acceptable range. The CFA of the attitude section resulted in a good-fitting two-factor model. The CFA of the belief section retained low number of items, although the analysis resulted in a good fit in the final three-factor model.ConclusionsBased on the IRT analysis and factor analytic evidence, the knowledge and attitude sections of the KABP questionnaire on leptospirosis were psychometrically valid. However, the psychometric properties of the belief section were unsatisfactory, despite being revised after the initial validation study. Further development of this section is warranted in future studies.

A Confirmatory Factor Analysis of the knowledge, attitude and practice questionnaire towards prevention of Respiratory tract infections during Hajj and Umrah

“…All the fit indices (RMSEA, CFI, TLI, SRMR) are within acceptable values and therefore supported the construct validity [25]. There are numerous studies done in Malaysia which support the accepted values of the fit indices which is similar to the present study results [26][27][28].…”

A Confirmatory Factor Analysis of the knowledge, attitude and practice questionnaire towards prevention of Respiratory tract infections during Hajj and Umrah

“…All the t indices (RMSEA, CFI, TLI, SRMR) are within acceptable values and therefore supported the construct validity [34]. There are numerous studies done in Malaysia which support the accepted values of the t indices which is similar to the present study results [35][36][37].…”

Low Levels of Knowledge, Attitudes and Preventive Practices on Leptospirosis among a Rural Community in Hulu Langat District, Selangor, Malaysia

“…The study used a validated KAP questionnaire on leptospirosis in Malaysia which has been adopted and modified accordingly [ 27 ]. The content validity of the study instrument was performed by cross-checking and authentication from experts in the field of study.…”