TY - JOUR
T1 - Development and validity assessment of a chronic obstructive pulmonary disease knowledge questionnaire in low- And middle-income countries
AU - Robertson, Nicole M.
AU - Siddharthan, Trishul
AU - Pollard, Suzanne L.
AU - Alupo, Patricia
AU - Flores-Flores2, Oscar
AU - Rykiel, Natalie A.
AU - Romani, Elisa D.
AU - Ascencio-Dias, Ivonne
AU - Kirenga, Bruce
AU - Checkley, William
AU - Hurst, John R.
AU - Quaderi, Shumonta
N1 - Funding Information:
A complete list of GECo investigators may be found before the beginning of the REFERENCES. Supported by the Medical Research Council grant MR/P008984/1 under the Global Alliance for Chronic Disease, an Etscorn Summer International Research Award, and U.S. National Institutes of Health (NIH) research training grant D43 TW009340 (O.F.-F.) funded by the NIH Fogarty International Center, U.S. National Institute of Neurological Disorders and Stroke, U.S. National Institute of Mental Health, and U.S. National Heart, Lung, and Blood Institute.
Publisher Copyright:
Copyright 2021 by the American Thoracic Society.
PY - 2021/8
Y1 - 2021/8
N2 - Rationale: The majority of the morbidity and mortality related to chronic obstructive pulmonary disease (COPD) occurs in low- and middle-income countries (LMICs). Despite the increasing burden of COPD, disease-specific knowledge among healthcare workers and patients in LMICs remains limited. COPD knowledge questionnaires (COPD-KQ) are valid and reliable tools to assess COPD knowledge and can be employed in settings with limited health literacy. Objectives: To develop and assess the validity and reliability of a COPD-KQ among individuals with COPD in three LMIC settings. Methods: Twelve questions were generated by an expert team of 16 researchers, physicians, and public health professionals to create an LMIC-specific COPD-KQ. The content was based on previous instruments, clinical guidelines, focus-group discussions, and questionnaire piloting. Participants with COPD completed the questionnaire across three diverse LMIC settings before and 3 months after delivery of a standardized COPD-specific education package by a local community health worker trained to deliver the education to an appropriate standard. We used paired t tests to assess improvement in knowledge after intervention. Results: Questionnaire development initially yielded 52 items. On the basis of community feedback and expertise, items were eliminated and added, yielding a final 12-item questionnaire, with a maximum total score of 12. A total of 196 participants with COPD were included in this study in Nepal (n = 86), Peru (n = 35), and Uganda (n = 75). The mean6standard deviation baseline score was 8.062.5, and 3 months after education, the mean score was 10.261.7. The community health worker-led COPD educational intervention improved COPD knowledge among community members by 2.2 points (95% confidence interval, 1.8-2.6 points; t = 10.9; P,0.001). Internal consistency using Cronbach's a was 0.75. Conclusions: The LMIC COPD-KQ demonstrates face and content validity and acceptable internal consistency through development phases, suggesting a reliable and valid COPD education instrument that can be used to assess educational interventions across LMIC settings
AB - Rationale: The majority of the morbidity and mortality related to chronic obstructive pulmonary disease (COPD) occurs in low- and middle-income countries (LMICs). Despite the increasing burden of COPD, disease-specific knowledge among healthcare workers and patients in LMICs remains limited. COPD knowledge questionnaires (COPD-KQ) are valid and reliable tools to assess COPD knowledge and can be employed in settings with limited health literacy. Objectives: To develop and assess the validity and reliability of a COPD-KQ among individuals with COPD in three LMIC settings. Methods: Twelve questions were generated by an expert team of 16 researchers, physicians, and public health professionals to create an LMIC-specific COPD-KQ. The content was based on previous instruments, clinical guidelines, focus-group discussions, and questionnaire piloting. Participants with COPD completed the questionnaire across three diverse LMIC settings before and 3 months after delivery of a standardized COPD-specific education package by a local community health worker trained to deliver the education to an appropriate standard. We used paired t tests to assess improvement in knowledge after intervention. Results: Questionnaire development initially yielded 52 items. On the basis of community feedback and expertise, items were eliminated and added, yielding a final 12-item questionnaire, with a maximum total score of 12. A total of 196 participants with COPD were included in this study in Nepal (n = 86), Peru (n = 35), and Uganda (n = 75). The mean6standard deviation baseline score was 8.062.5, and 3 months after education, the mean score was 10.261.7. The community health worker-led COPD educational intervention improved COPD knowledge among community members by 2.2 points (95% confidence interval, 1.8-2.6 points; t = 10.9; P,0.001). Internal consistency using Cronbach's a was 0.75. Conclusions: The LMIC COPD-KQ demonstrates face and content validity and acceptable internal consistency through development phases, suggesting a reliable and valid COPD education instrument that can be used to assess educational interventions across LMIC settings
KW - Chronic obstructive pulmonary disease
KW - Patient education
KW - Questionnaires
UR - http://www.scopus.com/inward/record.url?scp=85111634100&partnerID=8YFLogxK
U2 - 10.1513/AnnalsATS.202007-884OC
DO - 10.1513/AnnalsATS.202007-884OC
M3 - Artículo
C2 - 33476252
AN - SCOPUS:85111634100
SN - 2329-6933
VL - 18
SP - 1298
EP - 1305
JO - Annals of the American Thoracic Society
JF - Annals of the American Thoracic Society
IS - 8
ER -
