Abstract
In low tuberculosis (TB) incidence countries, foreign-born individuals represent a population at risk. Knowledge, Attitude and Practice (KAP) surveys use standardized and structured questionnaires to collect information by a specific population in relation to a particular topic. As primary objective, we developed and validated a questionnaire exploring TB knowledge among foreign-born individuals from high TB incidence countries living in Ferrara's province, a low TB incidence province of northern Italy. As secondary objective, we investigated respondents' demographic and social determinants of health data. Questionnaire items were developed based on World Health Organization (WHO) "A guide to develop KAP surveys" questionnaire sample and literature review. Questionnaire underwent Delphi technique evaluation, back and forward translation, health literacy review, and two pilot tests. Internal consitency and validity were computed through Cronbach's alpha, content validity index, and principal component analysis (PCA). Descriptive statistics were used to summarize demographic and social determinants of health data. We initially proposed a 38-item questionnaire. After Delphi technique, performed with seven experts, a 17-items questionnaire was obtained. Cronbach's alpha coefficient, used to assess internal consistency, was 0.65. Content validity index was > 0.80. One factor was extracted by PCA, with a cumulative contribution of 50%. The population investigated was similar to the immigrant population settled in Ferrara's province, according to age, gender and TB risk factors. The questionnaire we developed and validated can contribute to measure foreign-born individuals' TB knowledge.
Highlights
In low tuberculosis (TB) incidence countries, foreign-born individuals represent a population at risk
As primary objective, based on World Health Organization (WHO)’s sample [6], we developed and validated a questionnaire exploring TB knowledge among foreign-born individuals from high TB incidence countries living in Ferrara’s province, a low TB incidence province of northern Italy
Based on the WHO guide [6], and literature review, we realized a 38-item questionnaire divided into seven sections [Appendix 1]
Summary
In low tuberculosis (TB) incidence countries, foreign-born individuals represent a population at risk. Attitude and Practice (KAP) surveys use standardized and structured questionnaires to collect information by a specific population in relation to a particular topic. We developed and validated a questionnaire exploring TB knowledge among foreign-born individuals from high TB incidence countries living in Ferrara’s province, a low TB incidence province of northern Italy. In Ferrara’s province, a low TB incidence province of northern Italy, foreign-born individuals represented 10.7% of total population [4], and 60% of notified TB cases [5]. Attitude and Practice (KAP) surveys are cross-sectional studies that use standardized and structured questionnaires to collect information on what is known, believed, and done by a specific population in relation to a particular topic [6]. There are studies that link higher KAP level with efficient management of illness, response to medical treatment, and promotion of one’s own health, and lower KAP level with poor health, inefficient health care use, decrease of disease screening rate [7-9]
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