大学生结核病知识、态度和行为问卷（CS-TBKAPQ）的编制与验证
Development and validation of college students' tuberculosis knowledge, attitudes and practices questionnaire (CS-TBKAPQ).
作者信息
Jiang Hualin, Zhang Shaoru, Ding Yi, Li Yuelu, Zhang Tianhua, Liu Weiping, Fan Yahui, Li Yan, Zhang Rongqiang, Ma Xuexue
机构信息
Health Science Center, Xi'an Jiaotong University, Xi'an city, China.
Department of Pharmacy, Xijing Hospital, Fourth Military Medical University, Xi'an city, China.
出版信息
BMC Public Health. 2017 Dec 12;17(1):949. doi: 10.1186/s12889-017-4960-x.
BACKGROUND
China faces many challenges in controlling tuberculosis (TB). One significant challenge is the control of college students' TB. In particular, cross-sectional studies of college students' knowledge, attitudes and practices (KAP) in regard to TB have attracted substantial attention. However, few measurement tools have been developed to aid processes related to expert consultation, pre-testing, reliability and validity testing. Our study developed the College Students' TB Knowledge Attitudes and Practices Questionnaire (CS-TBKAPQ) following the scale development steps.
METHODS
The construction of the CS-TBKAPQ was based on the Theory of Knowledge, Attitude, Belief, and Practice (KABP or KAP). The item pool was compiled from literature reviews and individual interviews. The reliability validation was assessed by calculating Cronbach's α coefficient, the split-half reliability coefficient, and the test-retest reliability coefficient. Construct validity was assessed using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). The diagnostic accuracy was evaluated using the World Health Organization Advocacy, Communication and Social Mobilization KAP Survey Questionnaire (WHO-TBKAPQ) as the reference standard.
RESULTS
A total of 31 questionnaire items were proposed. Cronbach's α coefficient, the split-half reliability coefficient and the test-retest reliability coefficient were 0.86, 0.78 and 0.91. Four factors that explained 62.52% of the total variance were also identified in EFA and confirmed in CFA. The CFA model fit indices were x /df = 1.82 (p < 0.001), GFI = 0.925, AGFI = 0.900, RMR = 0.068, and RMSEA = 0.049. The CS-TBKAPQ was significantly correlated with the WHO-TBKAPQ and the Chinese Public TB KAP Questionnaire (CDC-TBKAPQ) developed by the Chinese Center for Disease Control and Prevention (r = 0.59, 0.60, p < 0.001). The receiver operating characteristics curve (ROC) analysis suggested a cut-off point of 47.5, with which the CS-TBKAPQ showed a sensitivity of 73.63% and a specificity of 80.51% in identifying students with low-level KAP. The positive and negative predictive values were 83.23% and 69.91%.
CONCLUSIONS
The findings of this study demonstrate that the CS-TBKAPQ is a reliable and valid tool for measuring the KAP towards TB in college students.
背景
中国在控制结核病方面面临诸多挑战。其中一个重大挑战是大学生结核病的防控。特别是，针对大学生结核病知识、态度和行为（KAP）的横断面研究引起了广泛关注。然而，用于专家咨询、预测试、信效度检验等相关流程的测量工具却很少。我们的研究按照量表开发步骤编制了大学生结核病知识态度行为问卷（CS-TBKAPQ）。
方法
CS-TBKAPQ的构建基于知识、态度、信念和行为理论（KABP或KAP）。条目池通过文献综述和个人访谈编制而成。通过计算克朗巴哈α系数、分半信度系数和重测信度系数来评估信度效度。使用探索性因子分析（EFA）和验证性因子分析（CFA）来评估结构效度。以世界卫生组织倡导、沟通和社会动员KAP调查问卷（WHO-TBKAPQ）作为参考标准评估诊断准确性。
结果
共提出31个问卷条目。克朗巴哈α系数、分半信度系数和重测信度系数分别为0.86、0.78和0.91。在EFA中确定了四个解释总方差62.52%的因子，并在CFA中得到证实。CFA模型拟合指数为x²/df = 1.82（p < 0.001），GFI = 0.925，AGFI = 0.900，RMR = 0.068，RMSEA = 0.049。CS-TBKAPQ与WHO-TBKAPQ以及中国疾病预防控制中心编制的中国公众结核病KAP问卷（CDC-TBKAPQ）显著相关（r = 0.59，0.60，p < 0.001）。受试者工作特征曲线（ROC）分析表明，截断点为47.5，据此CS-TBKAPQ在识别低KAP水平学生时的灵敏度为73.63%，特异度为80.51%。阳性预测值和阴性预测值分别为83.23%和69.91%。
结论
本研究结果表明，CS-TBKAPQ是一种可靠且有效的工具，用于测量大学生对结核病的KAP。
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