Development of a questionnaire to assess mothers? knowledge, attitudes and practice with regard to childhood hearing loss and Universal Newborn Hearing Screening

Background: The assessment of the validity and reliability of measurement tools in research provides quality data. However, evidence of the validity and reliability of parental knowledge and attitude regarding childhood hearing loss and newborn hearing screening is scarce.Objective: To design a Knowledge, Attitudes and Practice (KAP) survey tool regarding childhood hearing loss and a Universal Newborn Hearing Screening Programme of the rural Amajuba district, KwaZulu-Natal, South Africa, and then test for validity and test-retest repeatability. Methods: Face validity was conducted with 20 mothers and a content validity index was determined by two rounds of assessments, the first by 7 experts and the second by 3 experts. The kappa statistic was used to measure the stability of the tool using data from 160 mothers where repeated measurements were applied at two-week intervals. The feasibility of developing a tool was assessed by applying the criteria of science, population and resources.Results: The KAP tool was developed with twenty-nine items. For face validity, 97% of the participants reported that the items were clear, wording was appropriate and easy to read and the language was natural. Content validity produced excellent results with a scale and content validity index of 1. Test-retest repeatability for the KAP tool was good with a Cohen's kappa coefficient of 0.87 (95% CI: 0.87, 0.87). Individually, the knowledge scale had a kappa of 0.86 (95% CI: 0.77, 0.95); the attitude scale had a kappa of 0.87 (95% CI: 0.76, 0.99): the practice scale had a kappa of 0.86 (95% CI: 0.75, 0.97) and the awareness scale had a kappa of 0.92 (0.83, 1.00). The development of a KAP tool was shown to be feasible, given sufficient time, funds, motivation and a study population. Conclusion: The study produced a valid and reliable tool that can be useful in generating quality evidence of a community's KAP with respect to childhood hearing loss and newborn hearing screening. Evidence gathered could be used to tailor health education and health promotion material for a Universal New-born Hearing Screening (UNHS) programme in a culturally sensitive manner to promote service uptake.