(B-217) Development and validation of the knowledge, attitude, and practice questionnaire for tuberculosis patients with type II diabetes mellitus: A study from India

Background: The coexistence of tuberculosis (TB) with type 2 diabetes mellitus (T2DM) presents a complex comorbidity that currently impedes the effective execution of the end TB strategy. Individuals with T2DM are three times more likely to contract TB compared to those without T2DM. Evaluating the knowledge, attitude, and practices (KAP) of TB with T2DM (TB-T2DM) patients is vital to reducing the burden of the disease, especially for advancing the end TB strategy for 2030. To our knowledge, no reliable and validated tool is currently designed to assess the KAP among patients with concurrent TB-T2DM.

Objectives: To develop and validate a questionnaire evaluating KAP for TB-T2DM co-morbid patients.

Methods: This quantitative study was performed in Karnataka, India, between January to July 2024. The inclusion criteria were patients with TB-T2DM condition. In the first phase, we developed the questionnaire through a comprehensive literature review and a semi-structured interview with five specialists. In the second phase, we validated the questionnaire by content validity, face validity, and reliability. Content validity was performed by taking the expert opinion from a panel of 6 experts, and then the item content validity index (ICVI) and scale content validity index (SCVI) were calculated. The impact score estimated face validity. Reliability was performed by IBM SPSS 22.0. by internal consistency from the Cronbach’s alpha value.

Results: In the development phase, initially, 27 items (questions) were developed, comprising 15 knowledge, 5 attitude, and 7 practice items. The ICVI score for seven questions was 0.83. For one question, it was 0.5, and the remaining questions were 1. So, the question with an ICVI score of 0.5 from the knowledge section of the questionnaire was removed. Therefore, the total number of questions after content validation were 26. However, the SCVI score obtained was 0.95. All items were easy to understand based on face validity results, except three that needed to be revised. Furthermore, the impact scores showed that all the items had a score equal to or greater than 1.5, therefore included in the questionnaire. Reliability was determined by calculating the internal consistency by Cronbach’s alpha values, obtained as 0.765, 0.700, 0.643, and 0.870 for knowledge, attitude, practice, and overall questionnaire, respectively, which were acceptable.

Conclusions: The validated questionnaire provides a reliable tool for future research to assess the KAP, improve treatment outcomes in TB-T2DM patients, and effectively achieve the end TB strategy by 2030.