Design and validation of questionnaires investigating access and utilization of cervical cancer treatment and palliative care

Abstract

BACKGROUND : Standardized tools to evaluate access and utilization of cervical cancer treatment and care remain scarce in developing countries. The objective of this study was to validate questionnaires to investigate access and uptake of cervical cancer treatment and palliative care. MATERIALS AND METHODS : We designed and validated two questionnaires for patient and community and health worker surveys to determine the main constructs of each of the draft questionnaires. Pilot data was collected randomly amongst 50 patient and community participants and 14 health workers respectively in Chitungwiza, Zimbabwe. Content and face validity were assessed qualitatively from expert evaluations. Construct validity, reliability and internal consistency testing were conducted using exploratory factor analysis and Cronbach’s alpha correlation coefficient respectively. RESULTS : Twelve (12) experienced researchers, based on convenience, reviewed the questionnaires and validated their draft constructs based on experience and literature. Each of the questionnaires was sub-divided into 4 separate mini-questionnaires respectively. All the eight mini-questionnaires were analyzed independently and Kaiser-Meyer-Olkin coefficients ranged from 0.5-0.9 and Bartlett’s sphericity tests were all significant, p<0.001, showing promising good constructs. Patient and community questionnaire had 15 meaningful constructs while the health worker questionnaire had 13. Cronbach’s alpha (α) coefficients for internal consistency reliability testing of all the final constructs were greater than the minimum acceptable threshold of 0.70. CONCLUSION : This analysis revealed the validity and reliability of questionnaires that could be used to evaluate access and utilization of cervical cancer treatment and palliative care in countries affected by the disease.