Development, Validation and Translation of The Benzene Exposure Knowledge, Attitude, And Practice (BEKAP) Questionnaire
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Abstract
Introduction: Benzene, a hazardous air pollutant, may harm children’s respiratory and developmental systems. This study aims to create, validate, and translate the Benzene Exposure Knowledge, Attitude and Practice (BEKAP) questionnaire for parents of primary school children. Methods: The study comprises of two phases. Phase I: Item development and validation. Phase II: Item translation into Malay through cultural and linguistic adaptations, following the International Society for Pharmacoeconomics and Outcome Research (ISPOR) standards. A panel of four experts and 33 parents assessed BEKAP’s validity, with Microsoft Excel used for the content validity index (CVI) and face validity index (FVI) analysis. Results: Phase I: BEKAP (Version 1.0) consisted of 63 items across three domains—knowledge, attitude, and practice regarding benzene exposure. Only the knowledge domain achieved S-CVI values exceeding the acceptable threshold of 0.8, with S-CVI/UA at 0.88 and S-CVI/Ave at 0.97. Thirty-two items were revised for clarity, and 12 were removed due to redundancy. Phase II: A total of 51 items was prepared for translation. I-FVI exceeded the 0.83 cut-off, leading to revisions for seven items to enhance clarity. The final BEKAP (Version 3.0) - Malay version retained 51 items, ensuring consistency while improving the clarity and relevance. Conclusion: Creating, validating, and translating the questionnaire is a thorough, iterative process. Involving content experts and respondents is crucial for ensuring its validity. Subsequent steps include a pilot study and psychometric analysis to determine the suitability of the Malay-version BEKAP for parents of primary school children in Johor, Malaysia.
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Ilaria P, Campagna M, Marcias G, Fabbri D, Meloni F, Spatari G, et al. Biomarkers of Low-Level Environmental Exposure to Benzene and Oxidative DNA Damage in Primary School Children in Sardinia, Italy. 2021. doi: 10.3390/ijerph18094644
Wu Y. Comprehensive Analysis of Benzene: Synthesis, Applications, and Environmental Impacts. Highlights Sci Eng Technol. 2024;83:181–7. doi: 10.54097/5z3hze71
International Agency for Research on Cancer. Benzene | IARC Monographs on the Evaluation of Carcinogenic Risks to Humans. Vol. 1, Gastronomía ecuatoriana y turismo local. 2018. 5–24 p.
International Programme on Chemical Safety. Benzene [Internet]. World Health Organization, International Programme on Chemical Safety (Environmental Health Criteria 150. 1993 [cited 2023 Nov 26]. Available from: https://www.inchem.org/documents/ehc/ehc/ehc150.htm
Abdo Alkhadher SA, Zakaria MP, Yusoff FM, Kannan N, Suratman S, Magam SM, et al. Distribution and sources of linear alkyl benzenes (LABs) in surface sediments from Johor Bahru Coast and the Kim Kim River, Malaysia. Environ Forensics. 2016;17(1):36–47. doi: 10.1080/15275922.2015.1091405
Hanafi NH, Hassim MH, Noor ZZ, Ng DKS, Harrin Nor Helmi N, Aris NM. Analysis of transported pollution and haze-related diseases via HYSPLIT Trajectory Modelling in the urbanized area of Johor, Malaysia. IOP Conf Ser Earth Environ Sci. 2019;373(1). doi: 10.1088/1755-1315/373/1/012008
Mohd Shahrol A, Mohd Hasni J, Zaleha M. The Chicago Lead Knowledge Test-Malay Version: A Cultural and Linguistic Adaptation for the Malaysian Population. Med Health. 2020;15(2):187–214. doi: 10.0.68.168/mh.2020.1502.18
Goni MD, Naing NN, Hasan H, Wan-Arfah N, Deris ZZ, Arifin WN, et al. Development and validation of knowledge, attitude and practice questionnaire for prevention of respiratory tract infections among Malaysian Hajj pilgrims. BMC Public Health. 2020;20(1):1–10. doi: 10.1186/s12889-020-8269-9
Mohammed AH, Ying LH, Boon Hong ML, Sze Nee AW, Ying LS, Ramachandram DS, et al. Development and validation of a knowledge, attitude, and practice (KAP) questionnaire for skin cancer in the general public: KAP-SC-Q. Res Soc Adm Pharm. 2023. doi: 10.1016/j.sapharm.2023.10.009
Yusoff MSB. ABC of Content Validation and Content Validity Index Calculation. Educ Med J. 2019;11(2):49–54. doi: 10.21315/eimj2019.11.2.6
Polit DF, Beck CT. The Content Validity Index: Are You Sure You Know What’s Being Reported? Critique and Recommendations. Res Nurs Health. 2006;489–97. doi: 10.1002/nur.20147
Polit DF, Beck CT, Owen S V. Focus on Research Methods: Is the CVI an Acceptable Indicator of Content Validity? Appraisal and Recommendations. Res Nurs Health. 2007;459–67. doi:
Shi J, Mo X, Sun Z. Content validity index in scale development. Cent South Univ (Med Sci). 2012;37(2):152–5. doi: 10.3969/j.issn.1672-7347.2012.02.007
Wild D, Grove A, Martin M, Eremenco S, McElroy S, Verjee-Lorenz A, et al. Principles of good practice for the translation and cultural adaptation process for patient-reported outcomes (PRO) measures: Report of the ISPOR Task Force for Translation and Cultural Adaptation. Value Heal. 2005;8(2):94–104. doi: 10.1111/j.1524-4733.2005.04054.x
Lau ASY, Yusoff MSB, Lee YY, Choi SB, Xiao JZ, Liong MT. Development and validation of a Chinese translated questionnaire: A single simultaneous tool for assessing gastrointestinal and upper respiratory tract related illnesses in pre-school children. J Taibah Univ Med Sci. 2018;13(2):135–41. doi: 10.1016/j.jtumed.2017.11.003
Id SD, Ching K, Chan C. Household environmental tobacco smoke exposure in healthy young children in Hong Kong : Prevalence and risk factors. PLoS One. 2020;1–13.
Zhou Y, Zhang S, Li Z, Zhu J, Bi Y, Bai YE, et al. Maternal benzene exposure during pregnancy and risk of childhood acute lymphoblastic leukemia: A meta-analysis of epidemiologic studies. PLoS One. 2014;9(10). doi: 10.1371/journal.pone.0110466
Zhuge Y, Qian H, Zheng X, Huang C, Zhang Y, Li B, et al. Effects of parental smoking and indoor tobacco smoke exposure on respiratory outcomes in children. Sci Rep. 2020;10(1):1–9. doi: 10.1038/s41598-020-60700-4
Yavagal P, Velangi C, Desai J, Gupta H, Sheik F, Kaushal M. Knowledge, attitude, and behavior related to secondhand smoke exposure among pregnant women with smoking spouses in Davangere City: A cross-sectional survey. J Indian Assoc Public Heal Dent. 2021;19(1):37. doi: 10.4103/jiaphd.jiaphd_15_20
Atabekyan L. Knowledge, attitude, and practices of pregnant women regarding environmental tobacco smoke in Yerevan and Nor-Hachn , Armenia 2007 : a Qualitative study. 2007.
Huang K, Chen H, Liao J, Nong G, Yang L, Winickoff JP, et al. Factors associated with complete home smoking ban among chinese parents of young children. Int J Environ Res Public Health. 2016;13(2). doi: 10.3390/ijerph13020161
Shultz KS, Whitney DJ, Zickar MJ. Measurement Theory in Action. Case Studies and Exercises. Third Edit. Measurement Theory in Action. Routledge; 2020.
Schmitt N, Stuits DM. Factors Defined by Negatively Keyed Items: The Result of Careless Respondents? Appl Psychol Meas. 1985;9(4):367–73.
Almanasreh E, Moles R, Chen TF. Research in Social and Administrative Pharmacy Evaluation of methods used for estimating content validity. Res Soc Adm Pharm [Internet]. 2018 [cited 2023 Dec 2];0–1. Available from: http://dx.doi.org/10.1016/j.sapharm.2018.03.066
World Health Organization. Advocacy, communication and social mobilization for TB control: a guide to developing knowledge, attitude and practice surveys. Geneva, Switzerland; 2008.
McKay RB, Breslow M, Sangste RL, Gabbard SM, Reynolds RW, Nukamoto JM, et al. Translating Survey Questionnaires : Lessons Learned. In: New Directions for Evaluation. Jossey-Bass Publishers; 1994. p. 93–104.
Harkness J, Pennell B, Schoua-Glusberg A. Survey Questionnaire Translation and Assessment. In: Presser S, Rothgeb JM, Couper MP, Lessler JT, Martin E, Martin J, et al., editors. Methods for Testing and Evaluating Survey Questionnaires. John Wiley & Sons, Inc; 2004. p. 453–73.
Dewan Bahasa dan Pustaka. Pusat Rujukan Persuratan Melayu [Internet]. 2017 [cited 2023 Mar 25]. Available from: https://prpm.dbp.gov.my/.
NEVO B. Face Validity Revisited. J Educ Meas. 1985;22(4):287–93.