50. Development and Validation of the Reproductive Health Knowledge Index (RHKI)

Abstract

<h3>Background</h3> Reproductive knowledge is important for promoting fertility, preventing pregnancy, and adhering to contraceptive and medical treatment regimens. To date there are no studies that broadly assess reproductive knowledge in females largely due to the absence of a validated tool. Extrapolating from studies in female adults utilizing several limited tools, it is likely that reproductive knowledge is low in all females, including adolescents. Thus, the objective of this study is to develop and validate a tool that reliably measures reproductive knowledge among female adolescents. <h3>Methods</h3> Development and validation of the reproductive health knowledge index (RHKI) was achieved as follows. 1. Instrument Development: Multiple answer questions were written at a fifth-grade reading level to assess: female pelvic anatomy and function, menstrual physiology, conception, gestation, and contraception. The multiple answer format was selected to undermine the advantage of the process of elimination and allow detection of partial knowledge. 2. Content Validity: The RHKI was reviewed by an expert panel (pediatricians, general and pediatric OB/GYNs, and OB/GYN residents) for comprehensiveness, accuracy, and length. IRB approval was obtained. The tool was reviewed by 10 female adolescents to ensure readability. A 20-item tool was finalized according to all suggestions. 3. Internal validity: Two groups with perceived differences in knowledge level, namely adolescents and medical students, were queried to investigate internal validity. Forty female adolescents age 13 to 19 awaiting an appointment at a pediatric gynecology clinic as well as 20 female medical students rotating at the same site were recruited to participate in the study. The REALM-TEEN tool was used to exclude adolescents reading below a fifth-grade reading level to limit confounding from poor comprehension. A Pearson correlation coefficient with p value was then calculated between age and performance with a goal metric of r = 0.7 supporting internal validity. <h3>Results</h3> Thus far, 26 adolescents and all 20 medical students have been surveyed. Preliminary analysis of performance by age yields a correlation coefficient of 0.82 with a p value of 0.0001. Overall, the content validity and internal validity support the ability of the RHKI to measure reproductive knowledge in female adolescents. <h3>Conclusions</h3> As noted, reproductive knowledge is important for many reasons. Further study in this area requires a valid tool, like the RHKI, capable of measuring said knowledge. Such a tool will allow us to identify factors influencing reproductive knowledge, inform sexual education courses, and educate adolescents with eventual impact on their overall well-being and health.