Validation of a modified questionnaire to assess Ukrainian Family Physicians’ readiness to implement the evidence-based screening recommendations into their clinical practice, using a mixed method study

Abstract

Abstract Background Ukrainian Family Doctors' knowledge and readiness for the implementation of new guidelines recommendations into practice has to be evaluated and taken into consideration, meanwhile they often use the old protocols of annual checkups. This study aimed to perform a linguistic and cultural validation of Ukrainian adopted questionnaire designed on the German prototype “Readiness of general practitioners to recommend and implement evidence-based screening recommendations questionnaire”. Methods This was a mixed method study. The English version of the original German prototype questionnaire was translated into Ukrainian with forward–backward method. Additionally Ukrainian version was modified by including an extra questions about evidence based screening of cardiovascular risks, infectious diseases, type 2 diabetes mellitus, depression, and some old-fashioned annual checkups which are still commonly used in routine family doctors’ practice. During the face validation process, 10 practicing general practitioners assessed all the items in the questionnaire as adequately structured, grammatically correct, and understandable. During qualitative part of content validation process 11 experts found and corrected some grammatical errors, indicated that items of the questionnaire were comprehensible and related to Ukrainian culture. During the quantitative part of content validation process experts accessed 5 of 6 items as essential, relevant, and clear. Internal consistency of the items, assessed by using Cronbach’s alpha method was acceptable. To access how stable can be results provided by the questionnaire, test–retest reliability was performed, where 19 general practitioners filled in the same questionnaire twice over a period of two weeks. Results In our study CVR > 0.79 and CVI > 0.59 were acceptable. The internal consistency was evaluated by using Cronbach’s alpha method and had to be above 0.7. According to the test–retest reliability results of weighted kappa and Cohen's kappa coefficients, test–retest agreement of the questionnaire was moderate for 29%, substantial for 38%, and almost perfect for 5% of the items (p ≤ 0.05). Kappa coefficients were not computed for 10% of items as there was no variability in the assessments. Conclusions The Ukrainian version of the questionnaire can be used for the assessment Ukrainian Family Doctor’s readiness to implement the evidence-based screening recommendations into their clinical practice.

Keywords

• Validation
• Questionnaire
• Family medicine
• Evidence-based screening
• Guidelines