Validation of the Arabic and French Versions of a Knowledge, Attitudes and Practices (KAP) Questionnaire on Tranquilizer Misuse.

Narmeen Mallah,Bahi Takkouche,Adolfo Figueiras,Francisco Caamaño-Isorna,Rubén Rodríguez-Cano,Danielle A Badro

doi:10.3390/ijerph182111144

Abstract

Tranquilizer misuse is an emerging international public health concern. The psychosocial determinants of this misuse remain understudied. Instruments to measure the Knowledge, Attitudes and Practices (KAP) of tranquilizer misuse are unavailable, except for a recently published questionnaire validated in the Spanish language. We translated the KAP questionnaire into Arabic and French, adapted it and undertook a complete validation procedure in the general adult population in Lebanon. The content validity indicators were good: item content validity index ranged between 0.89 and 1.00, the content validity index scale average was ≥0.95 and the modified Kappa statistic for each of the KAP items was equal to I-CVI. The intra-class correlation coefficient values (n = 100) were ≥0.62 for all Knowledge and Attitudes items, demonstrating the item reliability. Confirmatory factorial analysis (n = 1450) showed that the selected model of Knowledge and Attitude constructs has adequate fit indicators and encompassed three factors that showed acceptable internal reliability: Knowledge (Cronbach’s alpha = 0.72), personal Attitudes towards tranquilizers (Cronbach’s alpha = 0.79) and Attitudes towards healthcare providers (Cronbach’s alpha = 0.65). The Arabic/French questionnaire was highly accepted, with a response rate of 95.72% and item non-response rate ≤3.6%. The availability of a cross-cultural adapted and multilingual validated questionnaire would stimulate research on tranquilizer misuse.

Highlights

Content validity: The content validity indexes of each of the Arabic and French versions of the questionnaire which were calculated based on the experts’ evaluation showed good values: item content validity index (I-CVI) ranged between 0.89 and 1.00, revealing the clarity, understandability and relatedness of the items to KAP about tranquilizer misuse; K* statistic was >0.89 and equal to I-CVI for all items, indicating that the agreement between the nine experts on item evaluation is improbably to have happened by chance; S-CVI/Ave was ≥0.95, establishing the content validity of the scale
Face validity: The researchers who reviewed the final version of the Arabic and French questionnaires found that the items measured what they were intended to measure, establishing the face validity of the questionnaire
Pilot testing: The questionnaire was completely answered by the 40 adults (20 in Arabic and 20 in French) who participated in the pilot testing

Summary

Introduction

The misuse of tranquilizers represents an emerging international public health concern with devastating impacts on the economy and society [1]. Tranquilizer misuse is associated with increased risk of road traffic accidents, poor management of comorbid diseases, deteriorated quality of life, elevated hospitalization and mortality rates and increased expenditures on health [2,3,4,5]. It is associated with a high risk of dependence and can lead to illicit substance use [6].

Methods

Results

Conclusion