Developing and validating of an English questionnaire to assess knowledge, attitudes, and practices regarding Marburg virus disease (EKAP-MVD): A cross-sectional study

Abstract

Knowledge, attitudes, and practices (KAP) of the general population toward Marburg Virus Disease (MVD) have a crucial impact on control and prevention strategies, particularly during outbreaks. The current study aimed to develop, culturally adapt, and validate a questionnaire for assessing KAP toward MVD (EKAP-MVD). A cross-sectional study using face-to-face interview and an anonymous online survey was conducted from March 13 to April 28, 2023 in 8 Sub-Saharan African countries (Ethiopia, Ghana, Kenya, Lesotho, Nigeria, Senegal, South Africa, and Tanzania). Internal consistency was assessed using Cronbach's alpha, split-half reliability, and Spearman-Brown coefficient. We assessed EKAP-MVD face and content validity. Construct validity was determined through convergent and discriminant validity, as well as exploratory and confirmatory factor analyses. A total of 510 participants were included: 51.6% were females, 46.5% were aged 18 to 25 years, 65.5% were residents in urban areas, 52.9% did not have university education, 58.6% were single, 34.7% were students, and 15.7% worked in the medical field. The Cronbach's alpha of the questionnaire was 0.877. All questions showed a statistically significant correlation with their latent factors (P < .05), indicating that the questionnaire had good convergent validity. The correlations between domains were either weak positive or negative, indicating discriminate validity. The KMO measure of sampling adequacy for factor analysis was 0.932 and Bartlett's test of sphericity was significant (P < .0001). The elbow point of the scree plot reveals that the number of factors that were most important and should be kept for further analysis was 3. Confirmatory factor analysis model fit was as follows: normed Chi-square (χ2) = 1.301, the root mean square error of a pproximation (RMSEA) = 0.038, goodness-of-fit index and comparative fit index > 0.9, and root mean square residual (RMR) < 0.08. In conclusion, the developed questionnaire had good psychometric properties and can be used to assess KAP about MVD.