Title : Development and validation of a questionnaire on context relevant malaria preventive knowledge
Abstract:
Over the years, Malaysia has made significant progress in reducing malaria cases, including achieving zero local transmission in 2018. However, imported cases pose ongoing risks, especially in states like Kelantan with suitable ecosystems and cross-border population movements. Assessing local knowledge is vital for targeted education to achieve and sustain elimination. Although questionnaires assessing malaria knowledge exist, most of them were developed in settings with active transmission, or lack of rigorous validation processes. This study aimed to develop and validate a questionnaire that evaluates the knowledge of malaria prevention among local communities in Kelantan. The initial draft of the questionnaire was established from a literature review and expert input via the Nominal Group Technique, a semi-quantitative/qualitative method. Further validation was done by experts and local communities through content and face validity. Further validation involved administering the questionnaire to 300 adults in Jeli district, Kelantan, and was analysed through two-parameter logistic Item Response Theory (2-PL IRT). The initial questionnaire drafted consists of 79 items in seven domains. After modifications, the questionnaire demonstrated excellent content validity indices of 0.99 for S-CVI/Ave and 0.92 for S-CVI/UA. Face validity indices were 1.0 for S-FVI/Ave and 0.99 for S-FVI/UA. After the removal of items using 2-PL IRT, most of the items had appropriate difficulty and discrimination estimates. All domains displayed good model fit. Information gained across ability levels ranged from 90.6% to 97.3% for the domains. The reliability was greater than 0.6. The final questionnaire consists of 53 items in seven domains. In conclusion, rigorous mixed-methods development and validation processes resulted in a robust, context-appropriate 53-item, 7-domain questionnaire with strong psychometric properties to assess malaria prevention knowledge, thus aiding Malaysia's elimination goal amidst ongoing reintroduction risks.
Keywords: malaria, knowledge, validation, item response theory, nominal group technique
Audience Take Away:
- This study provides a framework for developing and validating context-specific questionnaires, which can be applied to other research areas beyond malaria prevention. Researchers and public health practitioners can adapt and expand upon this methodology to create reliable and valid tools for assessing knowledge, attitudes, or practices related to other public health issues or diseases.
- The validated questionnaire offers a practical solution for assessing malaria prevention knowledge. This can simplify the process of identifying knowledge gaps and designing targeted interventions, making the work of public health practitioners more efficient and effective.
- By using this questionnaire, health authorities can obtain accurate and reliable data on the current state of malaria prevention knowledge in the population. This can improve the accuracy of situation analyses, needs assessments, and program planning, ultimately leading to more informed decision-making and resource allocation.
- The insights gained from using the questionnaire can provide policymakers with evidence-based information to guide decision-making processes related to resource allocation, strategy development, and priority setting in the context of malaria elimination efforts in Malaysia.
- The methodology and findings of this study can be used to advocate for greater investment in malaria elimination efforts, as well as in health education and community engagement initiatives, by demonstrating the importance of understanding and addressing knowledge gaps to achieve public health goals.
