Assessing Community Leaders’ Knowledge, Attitudes, and Perceptions on Community-Based Surveillance of Infectious Diseases: Development and Validation of a Questionnaire

Abstract Background: Community-based surveillance (CBS) plays a crucial role in disease surveillance, enabling early detection of significant health events within the community, and facilitating timely health interventions. However, there is currently no instrument available to assess the community’s knowledge, attitudes, and perceptions regarding CBS. Objective: To address this gap, a questionnaire was developed to evaluate the level of knowledge, attitudes, and perceptions of community leaders toward CBS of infectious diseases in Kelantan, Malaysia. Settings and Design: A cross-sectional study targeting community leaders in Kelantan state, Malaysia. Materials and Methods: The questionnaire development comprised two stages: item development and scale development. Content validity index (CVI) and face validity index (FVI) were employed to ensure content and internal structure validity. The questionnaire covered eight distinct components related to CBS, such as information about infectious diseases, community-level case definition, acceptance, willingness to report, sense of responsibility, impact, support, and perceived benefit. Results: Three domains with 98 items were developed. Findings showed robust content validity, with S-CVI scores of 0.96 for all domains. A few items within these domains exhibited disagreement among the expert panel and were subsequently removed, leaving a total of 98 items. The S-CVI values for the individual components ranged from 0.88 to 1.0, indicating strong content validity. Additionally, the FVI score of 0.90 demonstrated high clarity and comprehensibility of the questionnaire. Conclusions: The new questionnaire has demonstrated validity in terms of content and face validity for evaluating the knowledge, attitudes, and perceptions regarding CBS of infectious diseases among community leaders.