Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Addis Continental Institute of Public Health, Addis Ababa, Ethiopia.
Sci Rep. 2022 Apr 25;12(1):6740. doi: 10.1038/s41598-022-10811-x.
In areas where children have multiple environmental exposures to enteric pathogens, identifying the sources of exposure by measuring external and internal exposures to enteric pathogens and complementing by questionnaire and observational checklist to capture behaviors resulting risk of exposure is critical. Accordingly, this study was conducted to design valid and reliable questionnaire to assess behaviors and environmental conditions resulting exposure to enteric pathogens in the rural northwest Ethiopia. We began with a thorough exploration of relevant literature to understand the theoretical framework on the research objectives to identify variables to highlight what the questionnaire is measuring. We then generated items in each domain that can effectively address the study objectives and we refined and organized the items in a suitable format. Then after, we conducted face and content validity by involving experts on the research subject. After pre-testing a pre-final version of the instrument generated in the content validity study, we conducted a pilot study in 150 randomly selected rural households to test the internal consistency reliability. We used content validity ratio (CVR), item-level content validity index (I-CVIs), scale-level content validity index (S-CVI/UA), and modified kappa statistics to measure content validity of items. Moreover, we used agreement and consistency indices (i.e., Cronbach's alpha) to assess the internal consistency of items. The content validity test result showed that the value of CVR was 0.95, I-CVIs was 0.97, and modified kappa was 0.97 for the whole items, indicating all the items are appropriate. The scale-level content validity index (S-CVI/UA) was 0.95 for the whole items indicating the agreement among judges to each items is higher. The internal consistency reliability test result indicated that Cronbach's alpha for the pre-final version of the pre-final tool was 0.85, indicating the strong reliability of the tool. The final version of the questionnaire was, therefore, prepared with 8 dimensions and 80 items. In this study, we designed valid and reliable questionnaire to assess behaviors and environmental conditions that result high risk of exposure to enteric infections in rural settings. The questionnaire can be used as a tool in the rural settings of developing countries with some amendments to account local contexts. However, this questionnaire alone does not measure exposure of children to enteric infections. It only complements external and internal exposure assessments.
在儿童面临多种肠道病原体环境暴露的地区，通过测量肠道病原体的内外暴露，并结合问卷调查和观察清单来捕捉导致暴露风险的行为，以确定暴露源至关重要。因此，本研究旨在设计一种有效的、可靠的问卷，以评估在埃塞俄比亚西北部农村地区导致肠道病原体暴露的行为和环境条件。我们首先深入探讨了相关文献，以了解研究目标的理论框架，确定变量，突出问卷的测量内容。然后，我们在每个领域生成了能够有效解决研究目标的项目，并以合适的格式对项目进行了修改和组织。之后，我们邀请了研究课题的专家进行了表面效度和内容效度检验。在对内容效度研究中生成的预终版问卷进行了预测试后，我们在 150 个随机选择的农村家庭中进行了试点研究，以测试内部一致性信度。我们使用内容效度比（CVR）、项目水平内容效度指数（I-CVIs）、量表水平内容效度指数（S-CVI/UA）和修正后的 Kappa 统计量来衡量项目的内容效度。此外，我们还使用了一致性和一致性指标（即 Cronbach's alpha）来评估项目的内部一致性。内容效度检验结果表明，CVR 值为 0.95，I-CVIs 值为 0.97，修正 Kappa 值为 0.97，表明所有项目都是合适的。量表水平内容效度指数（S-CVI/UA）为 0.95，表明评委对每个项目的意见一致性较高。内部一致性信度检验结果表明，预终版问卷的 Cronbach's alpha 值为 0.85，表明工具的可靠性较高。因此，最终准备了包含 8 个维度和 80 个项目的问卷。本研究设计了一种有效的、可靠的问卷，用于评估农村地区导致肠道感染高风险的行为和环境条件。该问卷可作为发展中国家农村地区的一种工具，但需要进行一些修改以考虑当地情况。然而，该问卷本身并不能衡量儿童对肠道感染的暴露程度，它只是对外在和内在暴露评估的补充。
