PMID- 29514645 OWN - NLM STAT- MEDLINE DCOM- 20180620 LR - 20181114 IS - 1471-2458 (Electronic) IS - 1471-2458 (Linking) VI - 18 IP - 1 DP - 2018 Mar 7 TI - Development and validation of a new knowledge, attitude, belief and practice questionnaire on leptospirosis in Malaysia. PG - 331 LID - 10.1186/s12889-018-5234-y [doi] LID - 331 AB - BACKGROUND: In 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. METHODS: The 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). RESULTS: The 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. CONCLUSIONS: Based 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. FAU - Zahiruddin, Wan Mohd AU - Zahiruddin WM AUID- ORCID: 0000-0002-5564-6111 AD - Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan, Malaysia. drzahir@usm.my. FAU - Arifin, Wan Nor AU - Arifin WN AD - Unit of Biostatistics and Research Methodology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia. FAU - Mohd-Nazri, Shafei AU - Mohd-Nazri S AD - Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan, Malaysia. FAU - Sukeri, Surianti AU - Sukeri S AD - Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan, Malaysia. FAU - Zawaha, Idris AU - Zawaha I AD - Ministry of Health Malaysia, Institute of Behavioural Health Research, Jalan Rumah Sakit Bangsar, Kuala Lumpur, Malaysia. FAU - Bakar, Rahman Abu AU - Bakar RA AD - Ministry of Health Malaysia, Institute of Behavioural Health Research, Jalan Rumah Sakit Bangsar, Kuala Lumpur, Malaysia. FAU - Hamat, Rukman Awang AU - Hamat RA AD - Department of Medical Microbiology and Parasitology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia. FAU - Malina, Osman AU - Malina O AD - Department of Medical Microbiology and Parasitology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia. FAU - Jamaludin, Tengku Zetty Maztura Tengku AU - Jamaludin TZMT AD - Department of Medical Microbiology and Parasitology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia. FAU - Pathman, Arumugam AU - Pathman A AD - Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan, Malaysia. FAU - Mas-Harithulfadhli-Agus, Ab Rahman AU - Mas-Harithulfadhli-Agus AR AD - Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan, Malaysia. FAU - Norazlin, Idris AU - Norazlin I AD - Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan, Malaysia. FAU - Suhailah, Binti Samsudin AU - Suhailah BS AD - Department of Medical Microbiology and Parasitology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia. FAU - Saudi, Siti Nor Sakinah AU - Saudi SNS AD - Department of Medical Microbiology and Parasitology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia. FAU - Abdullah, Nurul Munirah AU - Abdullah NM AD - Department of Medical Microbiology and Parasitology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia. FAU - Nozmi, Noramira AU - Nozmi N AD - Department of Medical Microbiology and Parasitology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia. FAU - Zainuddin, Abdul Wahab AU - Zainuddin AW AD - Disease Control Division, Complex E, Ministry of Health Malaysia, Putrajaya, Malaysia. FAU - Aziah, Daud AU - Aziah D AD - Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan, Malaysia. LA - eng GR - UPM/700-2/1/LRGS/5526400/Ministry of Higher Education, Malaysia/International PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20180307 PL - England TA - BMC Public Health JT - BMC public health JID - 100968562 SB - IM MH - Adult MH - Factor Analysis, Statistical MH - Female MH - *Health Knowledge, Attitudes, Practice MH - Humans MH - Leptospirosis/*psychology MH - Malaysia MH - Middle Aged MH - Psychometrics MH - Reproducibility of Results MH - *Surveys and Questionnaires PMC - PMC5842588 OTO - NOTNLM OT - Attitude OT - Belief OT - Development OT - Knowledge OT - Leptospirosis OT - Practice OT - Questionnaires OT - Validation COIS- ETHICS APPROVAL AND CONSENT TO PARTICIPATE: Ethical approvals were obtained from the Human Research Ethics Committee of Universiti Sains Malaysia (USM/JEPeM/15120552) and Ethics Committee for Research for Human Subjects of Universiti Putra Malaysia (UPM/TNCPI/RMC/1.4.18.1. [JKEUPM]/F2 and UPM/TNCPI/RMC/1.4.18.2 [JKEUPM]. The questionnaire was designed to be anonymous, and informed consent was obtained from every respondent. The data were kept confidential and the results would not identify the respondents personally. CONSENT FOR PUBLICATION: Not applicable COMPETING INTERESTS: The authors declare that they have no competing interests. PUBLISHER'S NOTE: Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. EDAT- 2018/03/09 06:00 MHDA- 2018/06/21 06:00 PMCR- 2018/03/07 CRDT- 2018/03/09 06:00 PHST- 2017/05/13 00:00 [received] PHST- 2018/02/28 00:00 [accepted] PHST- 2018/03/09 06:00 [entrez] PHST- 2018/03/09 06:00 [pubmed] PHST- 2018/06/21 06:00 [medline] PHST- 2018/03/07 00:00 [pmc-release] AID - 10.1186/s12889-018-5234-y [pii] AID - 5234 [pii] AID - 10.1186/s12889-018-5234-y [doi] PST - epublish SO - BMC Public Health. 2018 Mar 7;18(1):331. doi: 10.1186/s12889-018-5234-y.