Development and Validation of Questionnaire to Assess Knowledge, Attitude and Practice of Frontline Health Workers on Identification of Oral Premalignant Disorders and Oral Cancer

Nawaz, Huma; Priya, Harsh; Purohit, Bharathi M.; Outtamane, Kavipriya; Shukla, Pallavi; Kaur, Charan Kamal; Nayak, Harsavardhan; Bhargava, Stuti S; Meena, Jeetendra Kumar; Parkar, Sujal; Nongkynrih, Baridalyne; Salve, Harshal Ramesh; Kumar, Rakesh; Grover, Shekhar; Nilima, Nilima

doi:10.31557/APJCP.2025.26.12.4623

Development and Validation of Questionnaire to Assess Knowledge, Attitude and Practice of Frontline Health Workers on Identification of Oral Premalignant Disorders and Oral Cancer

Document Type : Research Articles

Authors

¹ Division of Public Health Dentistry, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India.

² State Nodal Officer, National Oral Health Programme, Government of Puducherry, Puducherry, India.

³ Preventive oncology, Dr. B. R. A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India.

⁴ Government Multispeciality Hospital, Sector-16, Chandigarh, India.

⁵ NP-NCD, Ministry of Health and Family Welfare, New Delhi, India.

⁶ Division of Non Communicable Diseases, ICMR Headquarters, New Delhi, India.

⁷ Preventive oncology, National Cancer Institute-Jhajjar, All India Institute of Medical Sciences, New Delhi, India.

⁸ Department of Public Health Dentistry, Government Dental College and Hospital, Ahmedabad, Gujarat, India.

⁹ Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India.

¹⁰ Centre for Health Innovation and Policy [CHIP] foundation, Noida, Uttar Pradesh, India.

¹¹ Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India.

10.31557/APJCP.2025.26.12.4623

Abstract

Introduction: Understanding frontline health workers knowledge and attitude about different facets of oral cancer identification and management is important in development and evaluating interventions to promote timely cancer diagnosis yet there is a lack of validated, culturally relevant measurement tools. This study aimed to develop and validate a new questionnaire (HWOCI-Q) to assess KAP of frontline health workers on oral cancer identification. Methodology: The study was conducted in seven phases. In phase I, 46 English language items across five domains were generated through a literature search. In phase II and III, face and content validity were assessed using Cohen’s Kappa and the Content Validity index at both the item-level and scale-level by 13 subject matter experts. In phase IV and V final English questionnaire with 54 items were prepared and then rigorously translated into local Hindi. Finally, in phase VI and VII, pilot testing of the tool and reliability analysis using Cronbach’s alpha were conducted. Results: The new semi-structured, questionnaire called the Health Worker’s Oral Cancer Identification- Questionnaire (HWOCI-Q), comprised of 54 items under five domains. The final questionnaire had an overall Cohen’s Kappa of 0.93, an S-CVI/Ave of 0.94, and Cronbach’s α coefficient of 0.82 indicating excellent validity and reliability. Conclusion: This study indicates that the developed questionnaire is a valid and reliable instrument for assessing the KAP of frontline health workers on oral cancer identification. Thus, it represents a valuable tool that may contribute to more positive evidence-based research in future.

Keywords