Banca de QUALIFICAÇÃO: TÁCITO ZAILDO DE MORAIS SANTOS

Uma banca de QUALIFICAÇÃO de DOUTORADO foi cadastrada pelo programa.
STUDENT : TÁCITO ZAILDO DE MORAIS SANTOS
DATE: 28/02/2023
TIME: 09:00
LOCAL: Remoto
TITLE:

DEVELOPMENT, CONTENT AND STRUCTURAL VALIDATION OF THE ADHERE INSTRUMENT: ASSESSMENT OF BARRIERS AND FACILITATORS FOR BRAZILIAN ADHERENCE TO MEASURES FOR THE PREVENTION AND CONTROL OF INFECTIOUS RESPIRATORY DISEASES.

KEY WORDS:

Surveys and questionnaires; prevention & control; adherence; respiratory tract infections

PAGES: 60
BIG AREA: Ciências da Saúde
AREA: Fisioterapia e Terapia Ocupacional
SUMMARY:

Background:The COVID-19 pandemic highlighted the issue of individual and population adherence to internationally recommended measures for the prevention and control of infectious respiratory diseases. However, low compliance with recommended preventive behaviors and the need for more tools to assess this construct in the same population has challenged managers and researchers. Given all the possible clinical, economic, and psychosocial implications, preventive measures at the population level, integrated into public health policies, can mean effective efforts and assertive decision-making. Objectives: Develop and test the content and structural validity of an instrument for the Brazilian population, capable of measuring barriers and facilitators of adherence to recommended measures for the prevention and control of infectious respiratory diseases. Methods: To contemplate the objectives above, two studies were carried out. Study 1 included a systematic review (SR) that followed the Cochrane recommendations for the global qualitative synthesis of themes and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). The themes emerging in the SR elicited the content for the initial generation of instrument items. These items were classified into the Health Beliefs Model (HBM) and the Capacity, Opportunity, and Motivation Model (COM-B). Study 2 comprised the development of the questionnaire and the content and structural validation of the ADHERE instrument. For the initial construction of the items, in addition to the SR results, in-depth interviews were conducted with representatives of the target population, following the recommendations of the PRO Good Research Practices Task Force Report (ISPOR 1). Then, the content validity was assessed by a panel of judges and pre-tested with the target population in the Survey format, following the modified e-Delphi Method, as well as the recommendations of the COSMIN methodology for content validity and the PRO Good Research Practices Task Force Report (ISPOR 2). The factor structure of the ADHERE questionnaire was investigated using Exploratory Factor Analysis (EFA), considering the varimax rotation model and a coefficient of 0.45. The internal consistency of the data was evaluated using Cronbach's Alpha Coefficient. Partial results:The systematic review included 52 studies and their qualitative synthesis identified 37 findings of barriers and 23 of facilitators, classified into 10 coded themes and 10 dimensions of the frameworks used. Systematic review and in-depth interviews resulted in a preliminary list of items. In content validation, 68 preliminary ADHERE items were judged by a panel of judges, according to the modified e-Delphi method, anonymously in three rounds. Items were judged for clarity, objectivity, relevance, feasibility and comprehensiveness using the Jotform® online platform. After the panel of judges, the remaining 61 items were pre-tested on 138 representatives of the target audience, in the Survey format via Jotform®. Respondents rated clarity, relevance, and comprehensiveness dichotomously and anonymously. With a relevance cutoff established as ≥ 70% of the evaluations, 8 items were eliminated due to direct or indirect relevance and 4 items were eliminated due to redundancy, totaling 49 items after the content validation step. Cronbach's alpha coefficient indicated high internal consistency for the scale with 34 items (α=0.94). Subsequently, the results of the Kaiser-Meyer-Olkin test (KMO=0.80) and Barlett's test of sphericity (χ²= 3488.09; p<0.001) indicated an adequate adjustment of the data, enabling the EFA. After this analysis, version I of the ADHERE questionnaire had 34 items grouped into 4 factors, considering a coefficient of 0.45, which explained 42% of the total variance. The four factors (Factor 1, 2, 3 and 4) gathered 10, 10, 9 and 5 items, respectively. The identified dimensions were: self-perception of personal and environmental barriers (α=0.89); self-efficacy (α=0.87); health policies (α=0.86) and personal interactions (α=0.80). Preliminary conclusions: According to the partial results, the thematic analysis derived from the qualitative synthesis of the literature showed relevant content for the construction of the ADHERE questionnaire. In addition, peculiarities of the target population in the five Brazilian geopolitical regions were considered, including adults of both sexes and representatives of native peoples such as indigenous peoples, quilombolas, and riverside dwellers. It is also necessary to conduct cognitive interviews to assess the questionnaire's understanding of items, instructions, time reference, and response options.

COMMITTEE MEMBERS:
Externa à Instituição - ISABEL CRISTINA VASCONCELOS DE OLIVEIRA - UFPB
Presidente - 2291421 - KARLA MORGANNA PEREIRA PINTO DE MENDONCA
Externa ao Programa - 2446479 - LILIAN LIRA LISBOA - null