Development and validity assessment of a chronic obstructive pulmonary disease knowledge questionnaire in low- And middle-income countries

Nicole M. Robertson, Trishul Siddharthan, Suzanne L. Pollard, Patricia Alupo, Oscar Flores-Flores2, Natalie A. Rykiel, Elisa D. Romani, Ivonne Ascencio-Dias, Bruce Kirenga, William Checkley, John R. Hurst, Shumonta Quaderi

Research output: Contribution to journalArticlepeer-review

Abstract

Rationale: The majority of the morbidity and mortality related to chronic obstructive pulmonary disease (COPD) occurs in low- and middle-income countries (LMICs). Despite the increasing burden of COPD, disease-specific knowledge among healthcare workers and patients in LMICs remains limited. COPD knowledge questionnaires (COPD-KQ) are valid and reliable tools to assess COPD knowledge and can be employed in settings with limited health literacy. Objectives: To develop and assess the validity and reliability of a COPD-KQ among individuals with COPD in three LMIC settings. Methods: Twelve questions were generated by an expert team of 16 researchers, physicians, and public health professionals to create an LMIC-specific COPD-KQ. The content was based on previous instruments, clinical guidelines, focus-group discussions, and questionnaire piloting. Participants with COPD completed the questionnaire across three diverse LMIC settings before and 3 months after delivery of a standardized COPD-specific education package by a local community health worker trained to deliver the education to an appropriate standard. We used paired t tests to assess improvement in knowledge after intervention. Results: Questionnaire development initially yielded 52 items. On the basis of community feedback and expertise, items were eliminated and added, yielding a final 12-item questionnaire, with a maximum total score of 12. A total of 196 participants with COPD were included in this study in Nepal (n = 86), Peru (n = 35), and Uganda (n = 75). The mean6standard deviation baseline score was 8.062.5, and 3 months after education, the mean score was 10.261.7. The community health worker-led COPD educational intervention improved COPD knowledge among community members by 2.2 points (95% confidence interval, 1.8-2.6 points; t = 10.9; P,0.001). Internal consistency using Cronbach's a was 0.75. Conclusions: The LMIC COPD-KQ demonstrates face and content validity and acceptable internal consistency through development phases, suggesting a reliable and valid COPD education instrument that can be used to assess educational interventions across LMIC settings

Original languageEnglish (US)
Pages (from-to)1298-1305
Number of pages8
JournalAnnals of the American Thoracic Society
Volume18
Issue number8
DOIs
StatePublished - Aug 2021
Externally publishedYes

Keywords

  • Chronic obstructive pulmonary disease
  • Patient education
  • Questionnaires

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

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