Validation of the Arabic and French Versions of a Knowledge, Attitudes and Practices (KAP) Questionnaire on Tranquilizer Misuse

Abstract

Tranquilizer misuse is an emerging international public health concern. The psychosocial determinants of this misuse remain understudied. Instruments to measure the Knowledge, Attitudes and Practices (KAP) of tranquilizer misuse are unavailable, except for a recently published questionnaire validated in the Spanish language. We translated the KAP questionnaire into Arabic and French, adapted it and undertook a complete validation procedure in the general adult population in Lebanon. The content validity indicators were good: item content validity index ranged between 0.89 and 1.00, the content validity index scale average was ≥0.95 and the modified Kappa statistic for each of the KAP items was equal to I-CVI. The intra-class correlation coefficient values (n = 100) were ≥0.62 for all Knowledge and Attitudes items, demonstrating the item reliability. Confirmatory factorial analysis (n = 1450) showed that the selected model of Knowledge and Attitude constructs has adequate fit indicators and encompassed three factors that showed acceptable internal reliability: Knowledge (Cronbach's alpha = 0.72), personal Attitudes towards tranquilizers (Cronbach's alpha = 0.79) and Attitudes towards healthcare providers (Cronbach's alpha = 0.65). The Arabic/French questionnaire was highly accepted, with a response rate of 95.72% and item non-response rate ≤3.6%. The availability of a cross-cultural adapted and multilingual validated questionnaire would stimulate research on tranquilizer misuse.

Keywords: Arabic; French; attitudes and practices; knowledge; misuse; questionnaire validation; tranquilizers.

Figure 1

Chosen model for Knowledge and Attitude statements about tranquilizer in Lebanon. Figure represents the three factors of the model: Knowledge, personal Attitudes towards tranquilizers and Attitudes towards Healthcare providers, along with their corresponding standardized item loadings and item residuals. Double-sided arrows correspond to correlations between the variables. Single-headed arrows indicate the correlation of each item with its respective factor. The asterisks represent the level of significance: *** and * correspond to p-values < 0.0001 and < 0.01, respectively.