Dataset Information

Bridging the gaps among research, policy and practice in ten low- and middle-income countries: development and testing of questionnaire for health-care providers.

ABSTRACT:

Background

The reliability and validity of instruments used to survey health-care providers' views about and experiences with research evidence have seldom been examined.

Methods

Country teams from ten low- and middle-income countries (China, Ghana, India, Iran, Kazakhstan, Laos, Mexico, Pakistan, Senegal and Tanzania) participated in the development, translation, pilot-testing and administration of a questionnaire designed to measure health-care providers' views and activities related to improving their clinical practice and their awareness of, access to and use of research evidence, as well as changes in their clinical practice that they attribute to particular sources of research evidence that they have used. We use internal consistency as a measure of the questionnaire's reliability and, whenever possible, we use explanatory factor analyses to assess the degree to which questions that pertain to a single domain actually address common themes. We assess the questionnaire's face validity and content validity and, to a lesser extent, we also explore its criterion validity.

Results

The questionnaire has high internal consistency, with Cronbach's alphas between 0.7 and 0.9 for 16 of 20 domains and sub-domains (identified by factor analyses). Cronbach's alphas are greater than 0.9 for two domains, suggesting some item redundancy. Pre- and post-field work assessments indicate the questionnaire has good face validity and content validity. Our limited assessment of criterion validity shows weak but statistically significant associations between the general influence of research evidence among providers and more specific measures of providers' change in approach to preventing or treating a clinical condition.

Conclusion

Our analysis points to a number of strengths of the questionnaire--high internal consistency (reliability) and good face and content validity--but also to areas where it can be shortened without losing important conceptual domains.

SUBMITTER: Guindon GE

PROVIDER: S-EPMC2825186 | biostudies-literature | 2010 Jan

REPOSITORIES: biostudies-literature

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Publications

Bridging the gaps among research, policy and practice in ten low- and middle-income countries: development and testing of questionnaire for health-care providers.

Guindon G Emmanuel GE Lavis John N JN Boupha Boungnong B Shi Guang G Sidibe Mintou M Turdaliyeva Botagoz B

Health research policy and systems 20100129 1

<h4>Background</h4>The reliability and validity of instruments used to survey health-care providers' views about and experiences with research evidence have seldom been examined.<h4>Methods</h4>Country teams from ten low- and middle-income countries (China, Ghana, India, Iran, Kazakhstan, Laos, Mexico, Pakistan, Senegal and Tanzania) participated in the development, translation, pilot-testing and administration of a questionnaire designed to measure health-care providers' views and activities re ...[more]

PMID: 20205838

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Project description:BackgroundPrimary care has the potential to address a large proportion of people's health needs, promote equity, and contain costs, but only if it provides high-quality health services that people want to use. 40 years after the Declaration of Alma-Ata, little is known about the quality of primary care in low-income and middle-income countries. We assessed whether existing facility surveys capture relevant aspects of primary care performance and summarised the quality of primary care in ten low-income and middle-income countries.MethodsWe used Service Provision Assessment surveys, the most comprehensive nationally representative surveys of health systems, to select indicators corresponding to three of the process quality domains (competent systems, evidence-based care, and user experience) identified by the Lancet Global Health Commission on High Quality Health Systems in the Sustainable Development Goals Era. We calculated composite and domain quality scores for first-level primary care facilities across and within ten countries with available facility assessment data (Ethiopia, Haiti, Kenya, Malawi, Namibia, Nepal, Rwanda, Senegal, Tanzania, and Uganda).FindingsData were available for 7049 facilities and 63?869 care visits. There were gaps in measurement of important outcomes such as user experience, health outcomes, and confidence, and processes such as timely action, choice of provider, affordability, ease of use, dignity, privacy, non-discrimination, autonomy, and confidentiality. No information about care competence was available outside maternal and child health. Overall, scores for primary care quality were low (mean 0·41 on a scale of 0 to 1). At a domain level, scores were lowest for user experience, followed by evidence-based care, and then competent systems. At the subdomain level, scores for patient focus, prevention and detection, technical quality of sick-child care, and population-health management were lower than those for other subdomains.InterpretationFacility surveys do not capture key elements of primary care quality. The available measures suggest major gaps in primary care quality. If not addressed, these gaps will limit the contribution of primary care to reaching the ambitious Sustainable Development Goals.FundingBill & Melinda Gates Foundation.

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Dataset Information

Bridging the gaps among research, policy and practice in ten low- and middle-income countries: development and testing of questionnaire for health-care providers.

Background

Methods

Results

Conclusion

Publications

Bridging the gaps among research, policy and practice in ten low- and middle-income countries: development and testing of questionnaire for health-care providers.

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