Reliability and construct validity of knowledge, attitude and practice of medical doctors on smoking cessation guidelines

Abstract

Introduction: Prevalence of active smokers in Malaysia is increasing despite availability of stop smoking clinics. Thus, practice of the healthcare professionals in providing smoking cessation intervention needs to be assessed. This study aimed to develop and validate a questionnaire to assess the knowledge, attitude and practice of medical doctors on national smoking cessation guidelines and factors contributing to the score. Methods: The 26 items consists of mixture of true/false questions; strongly-agree/agree/don’tknow/disagree/strongly-disagree response; and always/frequent/seldom/never response were created based on domain of 5A’s (ask, assess, advice, assist, arrange) and 5R’s (relevant, risks, rewards, roadblocks, repetitions). The questionnaires were distributed to 141 medical doctors. Reliability was determined using Cronbach’s alpha for internal consistency while construct validity was assessed using factor analysis. Results: A high degree of internal consistency was observed for this 26 items (Cronbach’s alpha= 0.824). Subsequently, 2 items with poor inter-item correlations were removed. Factor analysis extracted 7 meaningful components from this remaining 24 items, in which 3 components with least items were deleted due to overlapping subscale with other components, leaving 4 meaningful components of (1st) practice ask, advice, assess and practice 5R’s, (2nd) practice of assist and arrange for those willing to quit, (3rd) knowledge and (4th) attitude. These final 17 items still demonstrate high internal consistency with Cronbach’s alpha of 0.832. Conclusions: This study indicates that this questionnaire is a reliable and valid tool to assess the knowledge, attitude and practice on stop smoking guidelines. Improvement can be made for attitude items in the future.

Factors influencing the practice of Smoking Cessation Assessment and Management among Primary Care Doctors (SCAAM-DOC) in three districts of Malaysia

“…This validated questionnaire consisted of four component (knowledge, attitude, practice of management in the pre-contemplation phase and practice of management in the contemplation phase) [ 17 ]. There were total of 17 items with 2 items on knowledge, 10 items on the practice of smoking cessation assessment and management at the pre-contemplation phase, 2 items on the practice of smoking cessation assessment and management in the contemplation phase and 3 items on attitude [ 17 ]. These 17 items have demonstrated a good Cronbach’s alpha value for all four component.…”

“…These 17 items have demonstrated a good Cronbach’s alpha value for all four component. The value of Cronbach’s alpha was 0.84 (the practice of smoking cessation assessment and management at the pre-contemplation phase), 0.74 (the practice of smoking cessation assessment and management in the contemplation phase), 0.80 (knowledge) and 0.60 (attitude) [ 17 ]. This questionnaire was validated among 141 primary care doctors from the government health clinics in three districts in the state of Pahang in Malaysia [ 17 ].…”

“…The assessment of the knowledge component was on the 5A components (‘Ask’, ‘Assess’, ‘Advice’, ‘Assist’, ‘Arrange’) [ 17 ]. The two questions mainly assessed the primary care doctors’ familiarity with the sequence and components of the 5As.…”

“…The two questions mainly assessed the primary care doctors’ familiarity with the sequence and components of the 5As. (Refer S1 File ) These were assessed with a dichotomous scale consisting of options of ‘True’ and ‘False’ [ 17 ]. A score of one was given for a correct answer and 0 score for a wrong answer [ 17 ].…”

“…(Refer S1 File ) These were assessed with a dichotomous scale consisting of options of ‘True’ and ‘False’ [ 17 ]. A score of one was given for a correct answer and 0 score for a wrong answer [ 17 ].…”