A community-based betel nut dependence screening questionnaire developed with the modified Delphi method

Objective To develop a betel nut dependence screening questionnaire scale suitable for community general practitioners based on the modified Delphi method. Methods From April to September 2024, a community-based betel nut dependence screening questionnaire was be constructed based on a literature review and group discussion. A two-round electronic questionnaire survey was conducted with 16 experts following the Delphi method, focusing on content representativeness, item importance, and evaluation feasibility. The results were analyzed using SPSS 26.0 software. Results A two-round electronic questionnaire survey was conducted with 16 experts following the Delphi method, focusing on content representativeness, item importance, and evaluation feasibility. The mean scores were as follows: content representativeness: 4.24 ± 1.34, item importance: 4.27 ± 1.30, and evaluation feasibility: 4.24 ± 1.31. The Kendall’s coefficients were 0.086 ( p = 0.065), 0.103 ( p = 0.008), and 0.102 ( p = 0.009) respectively, with an overall mean score of 4.25 ± 1.29 and a Kendall’s coefficient of 0.086 ( p < 0.001). The second round included 12 items, with content representativeness scoring 4.59 ± 0.79, item importance scoring 4.61 ± 0.64, and evaluation feasibility scoring 4.73 ± 0.52. The Kendall’s coefficients were 0.140 ( p = 0.010), 0.155 ( p = 0.004), and 0.138 ( p = 0.012) respectively, with an overall average score of 4.5 ± 0.62 and a Kendall’s coefficient of 0.131 ( p < 0.001). Experts ultimately reached consensus, and a total of 9 items were included. A total of 200 eligible questionnaires were collected through a community pre-survey, and the correlation between the scale and BQDS was 0.824. After exploratory factor analysis, the scale was adjusted to two dimensions: dependency assessment and behavioral cognitive conflict. The reliability coefficient at one month later was 0.780, and the ROC curve AUC was 0.937 (0.906–0.968), with a cutoff value of 6. Conclusion The betel nut dependence screening questionnaire (CBNDS) constructed using the modified Delphi method based on general practitioners is more suitable for the actual situation in domestic communities and conforms to the usage habits of general practitioners. It simplifies the measurement dimensions and questionnaire items, providing assistance for the early identification of betel nut dependency populations and the prevention of betel nut dependency-related complications.