Adaptation and validation of a translated questionnaire assessing public awareness, knowledge, attitudes, and practices regarding antibiotic use in Malaysia

Background and aims: Antibiotic misuse is an escalating global health concern, especially in Malaysia, resulting in increased resistance and significant public health challenges. Understanding the public’s awareness, knowledge, attitudes, and practices (AKAP) regarding antibiotic use is essential for implementing effective interventions. Therefore, this study aimed to adapt and validate a questionnaire derived from existing tools and translated from English to Malay to assess the AKAP related to antibiotic use among the Malaysian public. Methods: The questionnaire underwent forward and backward translation to ensure cultural relevance and linguistic accuracy. Content validity was assessed using the content validity index (CVI) based on evaluations conducted by six experts with backgrounds in public health, pharmacy, nursing education, and nursing practice. These experts reviewed the relevance, clarity, and appropriateness of each item. A cross-sectional study was conducted with 50 individuals in Pahang, Malaysia, to evaluate the reliability of the questionnaire. Participants were selected through convenience sampling, emphasizing the inclusion of individuals from diverse age groups, educational backgrounds, and occupations to ensure community representation. Reliability testing was performed using the Kuder-Richardson Formula 20 (KR-20). Results: The CVI for all the developed questionnaire items indicated strong content validity, with item-level CVI (I-CVI) scores exceeding 0.83 for the translated questionnaire. Additionally, the KR-20 analyses demonstrated good internal consistency, with KR-20 scores greater than 0.7, thereby confirming the questionnaire’s suitability for use within the target population. Conclusion: The adapted Malay-language questionnaire revealed acceptable levels of validity, indicating that it is a valid and reliable instrument for assessing antibiotic use among the Malaysian public, particularly within the Malay-speaking population.