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Developing and validating a questionnaire to assess an individual's perceived risk of four major non-communicable diseases in Myanmar.

ABSTRACT: Adopting healthy lifestyles is greatly influenced by an individual's perceived risk of developing non-communicable diseases (NCDs). This study aimed to develop and validate a questionnaire that can assess an individual's perceived risk of developing four major NCDs. We used the exploratory sequential mixed methods design. The qualitative part developed a questionnaire by two rounds of Delphi expert panels. The quantitative part validated the questionnaire using both exploratory (EFA) and confirmatory factor analysis (CFA). We used separate samples for EFA (n = 150) and CFA (n = 210). The participants were aged between 25-60 years of both sexes with no known history of NCDs, and face-to-face interviews were conducted. First, we generated an 86-item questionnaire based on the health belief model. Two expert panels ensured the questionnaire's content validity. The experts removed the overlapped items and items that did not represent the specific construct and developed a 51-item questionnaire. Next, we validated the questionnaire. We conducted a parallel analysis to determine the number of factors to be extracted. EFA constituted a five-factor model with 22 high loading items, which extracted 54% of the variance. We run four CFA models (single factor, five-factor, bifactor, and hierarchical) and tested the hypothesized five-factor model. It was found that the 21-item questionnaire (removed one efficacy item due to low loading) was satisfied with good psychometric properties and fitted with observed data in the bifactor model (RMSEA = 0.051, CFI = 0.954, TLI = 0.938, SRMR = 0.054). Hence, an individual's perceived risk of getting NCDs was constituted with a general perceived risk construct and five specific constructs (perceived susceptibility, perceived barrier, perceived benefit, perceived self-efficacy, and perceived behavioral change intention). It can be measured using the developed questionnaire (NCD-PR5-21). Further research is warranted to assess the questionnaire's utility in a mismatch between risk perception and current risk; and individualized counseling for behavioral change communication.

SUBMITTER: Mya KS

PROVIDER: S-EPMC8078785 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundThe Four-Dimensional Symptom Questionnaire (4DSQ) is a self-report questionnaire that has been developed in primary care to distinguish non-specific general distress from depression, anxiety and somatization. The purpose of this paper is to evaluate its criterion and construct validity.MethodsData from 10 different primary care studies have been used. Criterion validity was assessed by comparing the 4DSQ scores with clinical diagnoses, the GPs' diagnosis of any psychosocial problem for Distress, standardised psychiatric diagnoses for Depression and Anxiety, and GPs' suspicion of somatization for Somatization. ROC analyses and logistic regression analyses were used to examine the associations. Construct validity was evaluated by investigating the inter-correlations between the scales, the factorial structure, the associations with other symptom questionnaires, and the associations with stress, personality and social functioning. The factorial structure of the 4DSQ was assessed through confirmatory factor analysis (CFA). The associations with other questionnaires were assessed with Pearson correlations and regression analyses.ResultsRegarding criterion validity, the Distress scale was associated with any psychosocial diagnosis (area under the ROC curve [AUC] 0.79), the Depression scale was associated with major depression (AUC = 0.83), the Anxiety scale was associated with anxiety disorder (AUC = 0.66), and the Somatization scale was associated with the GPs' suspicion of somatization (AUC = 0.65). Regarding the construct validity, the 4DSQ scales appeared to have considerable inter-correlations (r = 0.35-0.71). However, 30-40% of the variance of each scale was unique for that scale. CFA confirmed the 4-factor structure with a comparative fit index (CFI) of 0.92. The 4DSQ scales correlated with most other questionnaires measuring corresponding constructs. However, the 4DSQ Distress scale appeared to correlate with some other depression scales more than the 4DSQ Depression scale. Measures of stress (i.e. life events, psychosocial problems, and work stress) were mainly associated with Distress, while Distress, in turn, was mainly associated with psychosocial dysfunctioning, including sick leave.ConclusionThe 4DSQ seems to be a valid self-report questionnaire to measure distress, depression, anxiety and somatization in primary care patients. The 4DSQ Distress scale appears to measure the most general, most common, expression of psychological problems.

Project description:IntroductionBasic emergency management in urban and rural areas is a critical challenge. This paper presents the protocol for developing, validating and piloting an instrument to assess the preparedness of non-hospital health centres which deliver initial emergency care.Methods and analysisThis study will be designed based on a sequential exploratory mixed method in two phases, in each of which there are three steps. In the first step of phase I, an extensive systematic review will be conducted. In the second step, through focus group discussions (FGDs), the experts' views on the definition of domains and items of the instrument will be compiled. In addition, semistructured interviews with the target group will be performed. Then, qualitative framework analysis will be performed. In the last step of phase I, the results of both steps will be triangulated by a panel of experts to define the domains and items to be included in the instrument. Phase II will include content validity, feasibility and reliability of the instrument. Content validity of the instrument will be assessed using modified Kappa coefficient based on clarity and relevance criteria. Feasibility of the instrument will be assessed through its implementation in 10 non-hospital health centres in Tabriz, which will be selected randomly. Reliability will be assessed in a pilot on 30 non-hospital health centres through using stratified random sampling method. Reliability of the instrument will be assessed through measuring internal consistency, test-retest reliability and inter-rater agreement. The main statistical methods for assessing reliability will include Cronbach's alpha, intraclass correlation coefficient and Kendall's tau-b. All the statistical analyses will be performed using Stata V.14.Ethics and disseminationThis study is approved by Tabriz University of Medical Sciences Research Ethics Committee (IR.TBZMED.REC.1397.145). The results of the study will be presented at national scientific conferences and published in peer-reviewed journals.

Project description:BackgroundHIV infection and normal aging share immune and inflammatory changes that result in premature aging and non-communicable diseases (NCDs), but the exact pathophysiology is not yet uncovered. We identified the common metabolic pathways underlying various NCDs in treated HIV infection.MethodsWe performed untargeted metabolomics including 87 HIV-negative (-) normal controls (NCs), 87 HIV-positive (+) NCs, and 148 HIV+ subjects with only one type of NCDs, namely, subclinical carotid atherosclerosis, neurocognitive impairment (NCI), liver fibrosis (LF) and renal impairment. All HIV+ subjects were virally suppressed.ResultsHIV+ patients presented widespread alterations in cellular metabolism compared to HIV- NCs. Glycerophospholipid (GPL) metabolism was the only one disturbed pathway presented in comparisons including HIV- NCs across age groups, HIV+ NCs across age groups, HIV+ NCs vs HIV- NCs and each of HIV+ NCDs vs HIV+ NCs. D-glutamine and D-glutamate metabolism and alanine-aspartate-glutamate metabolism were presented in comparisons between HIV+ NCs vs HIV- NCs, HIV+ LF or HIV+ NCI vs HIV+ NCs. Consistently, subsequent analysis identified a metabolomic fingerprint specific for HIV+ NCDs, containing 42 metabolites whose relative abundance showed either an upward (mainly GPL-derived lipid mediators) or a downward trend (mainly plasmalogen phosphatidylcholines, plasmalogen phosphatidylethanolamines, and glutamine) from HIV- NCs to HIV+ NCs and then HIV+ NCDs, reflecting a trend of increased oxidative stress.InterpretationGPL metabolism emerges as the common metabolic disturbance linking HIV to NCDs, followed by glutamine and glutamate metabolism. Together, our data point to the aforementioned metabolisms and related metabolites as potential key targets in studying pathophysiology of NCDs in HIV infection and developing therapeutic interventions.FundingChina National Science and Technology Major Projects on Infectious Diseases, National Natural Science Foundation of China, Yi-wu Institute of Fudan University, and Shanghai Municipal Health and Family Planning Commission.

Project description:BackgroundClinical practice guidelines have been developed to assist healthcare practitioners in clinical decision making. Publication of clinical practice guidelines does not automatically lead to their uptake and barrier identification has been recognized as an important step in implementation planning. This study aimed at developing a questionnaire to identify perceived barriers for implementing the Dutch COPD guideline for physical therapists and its recommended measurement instruments.MethodsAn overall questionnaire, based on two existing questionnaires, was constructed to identify barriers and facilitators for implementing the COPD guideline. The construct of the questionnaire was assessed in a cross-sectional study among 246 chest physical therapists. Factor analysis was conducted to explore underlying dimensions. Psychometric properties were analyzed using Cronbach's alpha. Barriers and facilitators were assessed using descriptive statistics.ResultsSome 139 physical therapists (57%) responded. Factor analysis revealed 4-factor and 5-factor solutions with an explained variance of 36% and 39% respectively. Cronbach's alpha of the overall questionnaire was 0.90, and varied from 0.66 to 0.92 for the different factors. Underlying domains of the 5-factor solution were characterized as: attitude towards using measurement instruments, knowledge and skills of the physical therapist, applicability of the COPD guideline, required investment of time & money, and patient characteristics. Physical therapists showed a positive attitude toward using the COPD guideline. Main barriers for implementation were required time investment and financial constraints.ConclusionsThe construct of the questionnaire revealed relevant underlying domains for the identification of barriers and facilitators for implementing the COPD guideline. The questionnaire allowed for tailoring to the target group and may be used across health care professionals as basis for in-depth analysis of barriers to specific recommendations in guidelines. The results of the questionnaire alone do not provide sufficient information to inform the development of an implementation strategy. The infrastructure for developing the guideline can be used for addressing key barriers by the guideline development group, using the questionnaire as well as in-depth analysis such as focus group interviews. Further development of methods for prospective identification of barriers and consequent tailoring of implementation interventions is required.

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Developing and validating a questionnaire to assess an individual's perceived risk of four major non-communicable diseases in Myanmar.

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