Bridging the gaps among research, policy and practice in ten low- and middle-income countries: development and testing of questionnaire for health-care providers.

G Emmanuel Guindon ,Boungnong Boupha,Botagoz Turdaliyeva,Mintou Sidibe,John N Lavis ,Guang Shi

doi:10.1186/1478-4505-8-3

Abstract

BackgroundThe reliability and validity of instruments used to survey health-care providers' views about and experiences with research evidence have seldom been examined.MethodsCountry teams from ten low- and middle-income countries (China, Ghana, India, Iran, Kazakhstan, Laos, Mexico, Pakistan, Senegal and Tanzania) participated in the development, translation, pilot-testing and administration of a questionnaire designed to measure health-care providers' views and activities related to improving their clinical practice and their awareness of, access to and use of research evidence, as well as changes in their clinical practice that they attribute to particular sources of research evidence that they have used. We use internal consistency as a measure of the questionnaire's reliability and, whenever possible, we use explanatory factor analyses to assess the degree to which questions that pertain to a single domain actually address common themes. We assess the questionnaire's face validity and content validity and, to a lesser extent, we also explore its criterion validity.ResultsThe questionnaire has high internal consistency, with Cronbach's alphas between 0.7 and 0.9 for 16 of 20 domains and sub-domains (identified by factor analyses). Cronbach's alphas are greater than 0.9 for two domains, suggesting some item redundancy. Pre- and post-field work assessments indicate the questionnaire has good face validity and content validity. Our limited assessment of criterion validity shows weak but statistically significant associations between the general influence of research evidence among providers and more specific measures of providers' change in approach to preventing or treating a clinical condition.ConclusionOur analysis points to a number of strengths of the questionnaire - high internal consistency (reliability) and good face and content validity - but also to areas where it can be shortened without losing important conceptual domains.

Highlights

As part of a larger project that sought to explore the factors that explain whether and how the producers and users of research support the use of and/or use research evidence as inputs to decision making, a survey was conducted of health-care providers practicing in one of four areas relevant to the Millennium DevelopmentGoals in each of China, Ghana, India, Iran, Laos, Kazakhstan, Mexico, Pakistan, Senegal and Tanzania
A particular emphasis was placed on an intervention that was supported by strong international and local research evidence: (1) insecticide-treated materials (ITMs) to prevent malaria; (2) intrauterine devices (IUDs) for family planning; (3) oral rehydration therapy (ORT) to prevent dehydration in children with diarrhoea; and (4) DOTS strategy to control tuberculosis
From 2003 it was taken forward using an organizing framework drawn from the framework for capacities to bridge the gap between research and action described by the Canadian Health Services Research Foundation (CHSRF)[7]

Summary

Introduction

As part of a larger project that sought to explore the factors that explain whether and how the producers and users of research support the use of and/or use research evidence as inputs to decision making, a survey was conducted of health-care providers practicing in one of four areas relevant to the Millennium DevelopmentGoals (prevention of malaria, care of women seeking contraception, care of children with diarrhoea and care of patients with tuberculosis) in each of China, Ghana, India, Iran, Laos, Kazakhstan, Mexico, Pakistan, Senegal and Tanzania. A questionnaire used to examine barriers to research utilization in nursing is a notable exception [1,2,3]. To our knowledge, this is the first attempt to document the development and testing of an instrument that seeks to examine comprehensively health-care providers’ views about and experiences with research evidence, health-care providers in low- and middle-income countries. The reliability and validity of instruments used to survey health-care providers’ views about and experiences with research evidence have seldom been examined

Methods

Results

Discussion

Conclusion