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The development and validation of a measurement instrument to investigate determinants of health care utilisation for low back pain in Ethiopia


Beyera, GK and O'Brien, J and Campbell, S, The development and validation of a measurement instrument to investigate determinants of health care utilisation for low back pain in Ethiopia, PLoS One, 15, (1) Article e0227801. ISSN 1932-6203 (2020) [Refereed Article]


Copyright Statement

Copyright 2020 Beyera et al. Licensed under Creative Commons Attribution 4.0 International (CC BY 4.0)

DOI: doi:10.1371/journal.pone.0227801


Introduction and Objections: Low back pain (LBP) is a highly prevalent and disabling public health problem globally. However, little is known about factors affecting health care utilisation for optimal management of the pain, and there is no validated instrument to derive epidemiological data for a better understanding of these factors. The aim of this study was to develop and validate an instrument used to measure determinants of health care utilisation for LBP in Ethiopia.

Methods: The relevant domains of potential determinants of health care utilisation for LBP were identified following a comprehensive review of the literature. Items relating to each domain were then generated by considering the context of Ethiopia, and where necessary, existing items were adapted. The instrument was then translated, and an expert panel reviewed the instrument for content validity, clarity and any other suggestions. Using the data collected from 1303 adults with LBP, factorial validity was assessed by conducting principal component and parallel analyses. Internal consistency reliability was also assessed using Cronbach's alpha. Intraclass correlation coefficient (ICC) and Cohen Kappa statistic were calculated to evaluate temporal stability of the instrument.

Results: Parallel analysis showed that there were six components with Eigenvalues (obtained from principal component analysis) exceeding the corresponding criterion values for a randomly generated data matrix of the same size. Cronbach's alpha for the internal consistency reliability ranged from 0.65 to 0.82. In assessing temporal stability, ICC ranged from 0.60, 95% CI: 0.23-0.98 to 0.95, 95% CI: 0.81-1.00 while Cohen Kappa ranged from 0.72, 95% CI: 0.49-0.94 to 0.93, 95% CI: 0.85-1.00.

Conclusions: This study demonstrated that the newly developed instrument has an overall good level of content and factorial validity, internal consistency reliability, and temporal stability. In this way, this instrument is appropriate for measuring determinants of health care utilisation among people with LBP in Ethiopia.

Item Details

Item Type:Refereed Article
Keywords:instrument development, low back pain
Research Division:Health Sciences
Research Group:Epidemiology
Research Field:Epidemiology not elsewhere classified
Objective Division:Health
Objective Group:Evaluation of health and support services
Objective Field:Health policy evaluation
UTAS Author:Beyera, GK (Mr Getahun Beyera)
UTAS Author:O'Brien, J (Dr Jane O'Brien)
UTAS Author:Campbell, S (Professor Steven Campbell)
ID Code:137705
Year Published:2020
Web of Science® Times Cited:3
Deposited By:Nursing
Deposited On:2020-02-27
Last Modified:2021-01-27
Downloads:20 View Download Statistics

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