Development and Validation of Questionnaire to Assess Knowledge, Attitude and Practice of Frontline Health Workers on...

Understanding frontline health workers knowledge and attitude about different facets of oral cancer identification and management is important in development and evaluating interventions to promote timely cancer diagnosis yet there is a lack of validated, culturally relevant measurement tools. This study aimed to develop and validate a new questionnaire (HWOCI-Q) to assess KAP of frontline health workers on oral cancer identification.

The study was conducted in seven phases. In phase I, 46 English language items across five domains were generated through a literature search. In phase II and III, face and content validity were assessed using Cohen's Kappa and the Content Validity index at both the item-level and scale-level by 13 subject matter experts. In phase IV and V final English questionnaire with 54 items were prepared and then rigorously translated into local Hindi. Finally, in phase VI and VII, pilot testing of the tool and reliability analysis using Cronbach's alpha were conducted.

The new semi-structured, questionnaire called the Health Worker's Oral Cancer Identification- Questionnaire (HWOCI-Q), comprised of 54 items under five domains. The final questionnaire had an overall Cohen's Kappa of 0.93, an S-CVI/Ave of 0.94, and Cronbach's α coefficient of 0.82 indicating excellent validity and reliability.

This study indicates that the developed questionnaire is a valid and reliable instrument for assessing the KAP of frontline health workers on oral cancer identification. Thus, it represents a valuable tool that may contribute to more positive evidence-based research in future.