
Nonetheless, despite the long-standing recognition of antibiotic resistance, the literature revealed that to-date, no fully validated KAP questionnaire is available for antibiotics’ use by the general population 7.

KAP modeled questionnaires are instruments that assess the following three dimensions: Knowledge (what the respondents know about antibiotics), Attitude (what the respondents think or believe about antibiotics) and Practice (what they do regarding antibiotics) 5.Īs data obtained from KAP studies are fundamental in assessing the need, planning and implementing public health programs, it is of paramount importance to use reliable and valid instruments in order to ensure a good research quality 6. In this context, intervention programs to improve the use of antibiotics apply a specific questionnaire pre- and post-intervention in order to measure changes in Knowledge, Attitudes and Practices (KAP) in the target population. Increasing awareness and changing behaviors towards a proper use of antibiotics are essential elements in the community intervention package 4.

Health strategies to tackle antibiotic resistance were already defined by the Word Health Organization and encompass interventions that are oriented to health and research centers as well as to community settings 4. It is foreseen that the situation by 2050 will deteriorate even more, with 10 million attributable annual deaths and a cumulative cost of 100 trillion USD, if no proactive solutions are found to slow down the expansion of antibiotic resistance 3. A recent report from the Center of Disease Control showed that the burden of antibiotic resistance remains important in the United States, with 2.8 million antibiotic-resistant infections and more than 35,000 related deaths every year 2. Each year, Europe records 670,000 new infections due to resistance and 33,000 deaths as a direct consequence of these infections. In Europe, the burden of infections due to antibiotic-resistant bacteria is comparable to that of influenza, tuberculosis and HIV/AIDS combined 1. Our fully validated questionnaire could prove useful for research as it permits generating high quality data and reducing measurement error.Īntibiotic resistance remains a global public health threat, despite the exerted regional and international efforts to defeat this problem. The final version of the questionnaire was highly accepted by the general adult population as reflected by the response rate (95.85%) and the low percentage of unanswered questions (0.4–2.7%). We estimated the indicators of model fit and demonstrated that the selected model has a good to excellent fit, thus establishing the construct validity. We carried out Confirmatory Factor Analysis using cross loadings and modification indices to choose the most adequate model in data collected from 844 adults. Following face validity and pilot testing, the Test–Retest Reliability in a sample of 145 adults confirmed the reliability of the questions. The S-CVI statistic showed the content validity of the scale (S-CVI/Ave: 0.95).

The Item Content Validity Index (I-CVI) and modified Kappa statistic (K*), confirmed the content validity of the questions (0.78 ≤ I-CVI ≤ 1.00 and 0.78 ≤ K* ≤ 1.00). We undertook an exhaustive literature review to design a comprehensive KAP questionnaire concerning the personal use of antibiotics in Galicia, North Spain. Numerous questionnaires are available on Knowledge, Attitudes, and Practices (KAP) towards antibiotics' use by adults, but none of these questionnaires is fully validated.
