Objectives
This study aimed to validate the psychometric properties of the recently developed knowledge, attitudes, and perceptions questionnaire for community-based surveillance of infectious diseases (KAP-CBS-ID questionnaire), using confirmatory factor analysis (CFA) and item response theory (IRT).
Methods
A cross-sectional study using multistage sampling recruited 470 schoolteachers from Kelantan, Malaysia. The self-administered KAP-CBS-ID questionnaire consists of 3 domains: knowledge (31 items), attitudes (23 items), and perceptions (21-items). Two-parameter logistic (2-PL) IRT analysis and CFA were performed to validate the knowledge section. For attitudes and perceptions sections, CFA proceeded using a 4-factor model to evaluate both model fit and construct validity.
Results
Two-PL IRT analysis of the knowledge section resulted in elimination of 14 items due to inadequate discrimination or difficulty parameters. The 3-factor CFA model demonstrated good fit indices for knowledge (root mean square error of approximation [RMSEA], 0.028; comparative fit index [CFI], 0.945; Tucker-Lewis index [TLI], 0.941) without any modifications. The attitudes section required re-specification, ultimately yielding 21 items across 4 factors with acceptable fit indices (standardized root mean square residual [SRMR], 0.067; RMSEA, 0.055; CFI, 0.937; TLI, 0.927). Similarly, the perceptions section was refined to 17 items across 4 factors, showing good model fit (SRMR, 0.055; RMSEA, 0.059; CFI, 0.962; TLI, 0.954). Factor loadings ranged from 0.33 to 0.98, while Raykov’s rho reliability estimates ranged from 0.71 to 0.93. Factor determinacy exceeded 80% for all factors.
Conclusion
The KAP-CBS-ID is a valid and reliable instrument for assessing community representatives’ knowledge, attitudes, and perceptions regarding community-based surveillance of infectious diseases.
Objectives This study aimed to describe and compare health-related quality of life (QoL) as measured by the World Health Organization Quality of Life–BREF (WHOQoL-BREF) and the EuroQol-5 Dimensions (EQ-5D) among the Malaysian population, examining differences by sociodemographic characteristics including age, income, sex, ethnicity, educational level, and occupation. Methods: This cross-sectional study used data from 19,402 individuals collected as part of a health and demographic surveillance system survey conducted in the Segamat district of Malaysia in 2018–2019. Descriptive statistics and measures of central tendency were produced. Differences in QoL among demographic sub-groups were examined using the t-test and analysis of variance, while the correlations between the WHOQoL-BREF and EQ-5D were evaluated using Pearson correlation coefficients. Results: Based on complete case analysis (n=19,129), the average scores for the 4 WHOQoLBREF domains were 28.2 (physical), 24.1 (psychological), 12.0 (social relationships), and 30.4 (environment). The percentages of participants not in full health for each EQ-5D dimension were 12.8% (mobility), 3.1% (self-care), 6.9% (usual activities), 20.9% (pain/discomfort), and 6.8% (anxiety/depression). Correlations between the 4 WHOQoL-BREF domains and the 5 EQ-5D dimensions were relatively weak, ranging from –0.06 (social relationships with self-care and pain/discomfort; p<0.001) to –0.42 (physical with mobility; p<0.001). Conclusion: Although health-related QoL as measured by the WHOQoL-BREF and the EQ-5D are correlated, these 2 measures should not be considered interchangeable. The choice between them should be guided by the specific research questions and the intended use of the data.
Citations
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Objectives This study aimed to examine the scale, characteristics, risk factors, and modes of transmission in a coronavirus disease 2019 (COVID-19) outbreak at a high school in Seoul, Republic of Korea.
Methods An epidemiological survey was conducted of 1,118 confirmed cases and close contacts from a COVID-19 outbreak at an educational facility starting on May 31, 2021. In-depth interviews, online questionnaires, flow evaluations, and CCTV analyses were used to devise infection prevention measures. Behavioral and spatial risk factors were identified, and statistical significance was tested.
Results Among 3rd-year students, there were 33 confirmed COVID-19 cases (9.6%). Students who used a study room in the annex building showed a statistically significant 4.3-fold elevation in their relative risk for infection compared to those who did not use the study room. Moreover, CCTV facial recognition analysis confirmed that 17.8% of 3rd-year students did not wear masks and had the lowest percentage of mask-wearers by grade. The air epidemiological survey conducted in the study room in the annex, which met the 3 criteria for a closed space, confirmed that there was only 10% natural ventilation due to the poor ventilation system.
Conclusion To prevent and manage the spread of COVID-19 in educational facilities, advance measures that consider the size, operation, and resources of each school are crucial. In addition, various survey methodologies should be used in future studies to quickly analyze a wider range of data that can inform an evidence-based quarantine response.
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Results In the analysis of 4,164 complete responses, 93.2% of participants indicated that they would accept the COVID-19 vaccine if it was offered for free by the Malaysian government. The median out-of-pocket cost that participants were willing to pay for a COVID-19 vaccine was Malaysian ringgit (MYR) 100 (interquartile range [IQR], 100) if it was readily available and MYR 150 (IQR, 200) if the supply was limited. Respondents with a low likelihood of vaccine hesitancy had 13 times higher odds of accepting the COVID-19 vaccine (95% confidence interval [CI], 8.69 to 19.13). High perceived risk and severity were also associated with willingness to be vaccinated, with adjusted odds ratios of 2.22 (95% CI, 1.44 to 3.41) and 2.76 (95% CI, 1.87 to 4.09), respectively. Age and ethnicity were the only independent demographic characteristics that predicted vaccine uptake.
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