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Development and assessment of a questionnaire for a descriptive cross-sectional study concerning parents' knowledge,
Sotiria G Panagakou1, Maria N Theodoridou, Vassiliki Papaevangelou
1Department of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, Thessaly, Greece. geopanagakos@yahoo.gr
Insights
This study developed a reliable questionnaire to assess parents' knowledge, attitude, and practices (KAP) regarding antibiotic use for children's upper respiratory infections (URIs). Findings support its use in understanding and improving antibiotic prescribing behaviors.
Area of Science:
- Pediatrics
- Public Health
- Medical Education
Background:
- Upper Respiratory Infections (URIs) are common in children, often viral.
- Parental attitudes can lead to inappropriate antibiotic prescribing, fueling antibiotic resistance.
- Assessing parental Knowledge, Attitude, and Practices (KAP) is crucial for targeted interventions.
Purpose of the Study:
- To develop and evaluate a questionnaire assessing parents' KAP regarding antibiotic use for pediatric URIs.
- To determine questionnaire response rates, completeness, and reliability (Cronbach's alpha).
- To identify study limitations for future research.
Main Methods:
- Literature review and pre-testing informed questionnaire development.
- A national postal survey was conducted with 8000 parents across 200 stratified schools.
- Factor analysis and Cronbach's index were used to assess questionnaire reliability and structure.
Main Results:
- A 69% response rate was achieved, with higher rates in Northern Greece.
- 68.9% of questionnaires were fully completed; 91.5% were at least 95% complete.
- Initial reliability (Cronbach's alpha) was 0.55, improved to 0.68 after item refinement.
Conclusions:
- The developed questionnaire demonstrates satisfactory reliability for measuring parental KAP regarding antibiotic use in pediatric URIs.
- Teacher involvement likely contributed to the higher-than-expected response and completion rates.
- The instrument is a valuable tool for research and interventions aimed at reducing antibiotic misuse.
Background:
Upper Respiratory Infections (URIs) are common in children. The cause is usually viral, but parents' attitude often contributes to inappropriate antibiotic prescribing, promoting antibiotic resistance. The objective is to describe the process of developing a questionnaire to assess parents' Knowledge, Attitude and Practices (KAP) concerning the role of antibiotics when children suffer from URIs, as well as to evaluate the response rates, the completeness and the reliability (Cronbach) of the questionnaires. Finally, to note any limitations of the study.
Methods:
Literature review, along with pre-testing yielded a questionnaire designed to assess the parents' KAP-level. A postal survey was set, in a national sample of 200 schools stratified by geographical region. The participants consist of a multistage geographical cluster sample of 8000 parents. The influence of demographic characteristics (i.e. sex, age, education) was analyzed. Cronbach index test and factor analysis were used to assess the reliability of the questionnaire.
Results:
The response rate of the parents was 69%. Islands presented the lowest response rate while in Northern Greece the response rate was the highest. Sixty-eight point nine percent of the sample returned questionnaires fully completed, while 91.5% completed 95% of the questions. Three questions out of 70 were answered in a very low rate which was associated mostly with immigrant respondents. The section describing parents' attitude toward antibiotic use was not completed as much as the sections of knowledge or practices. The questions were factor analyzed and 10 out of the 21 extracted factors were finally evaluated, reducing the number of independent variables to 46. The reliability of the questionnaire was 0.55. However, only items that increased the Cronbach when added were eventually included in the final scales raising the internal consistency to 0.68. Limitations of the study, such as the vocabulary and form of the questionnaire and the idiocycrancy of the respondents, emerged during the analysis.
Conclusion:
The response rate and the completeness of the questionnaires were higher than expected, probably attributed to the involvement of the teachers. The study findings were satisfactory regarding the development of a reliable instrument capable to measure parents' KAP characteristics.
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