title: Development and validation of the knowledge and attitudes regarding antibiotics and resistance (KAAR-11) questionnaire for primary care physicians.
abstract: The aim of this study was to develop a novel, self-administered questionnaire to identify primary-care physicians' knowledge and attitudes regarding antibiotics and resistance (KAAR).
  
  
  
  The study population comprised primary care physicians. The study was conducted in five phases. Phase I consisted of a systematic review and qualitative focus-group study (n = 33 physicians), in which items were formulated so as to be measured on a continuous, visual analogue scale (VAS); in Phase II, content validation and face validity were evaluated by a panel of experts, which reformulated, added and deleted items; Phase III consisted of a pilot study on a population possessing similar characteristics (n = 15); in Phase IV, we analysed reliability by means of a test-retest study (n = 91) and calculated the intraclass correlation coefficients (ICCs); and in Phase V, we assessed construct validity by applying the known-groups technique, measuring the differences between contrasting groups of physicians formed according to antibiotic prescription quality indicators (group 1, n = 156 versus group 2, n = 191).
  
  
  
  Following Phases I and II, the questionnaire contained 16 knowledge and attitude items. Participants in the pilot study (Phase III) reported no difficulty. The test-retest study (Phase IV) showed that 11 of the 16 initial knowledge and attitude items yielded an ICC > 0.5, while analysis of known-groups validity (Phase V) showed that 13 of the 16 initial items which assessed knowledge and attitudes discriminated between physicians with good and bad indicators of antibiotics prescription.
  
  
  
  The final 11 item KAAR questionnaire appears to be valid, reliable and responsive.
authors.affiliation: Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain.
authors.forename: Paula
authors.initials: P
authors.lastname: López-Vázquez
authors.affiliation: Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain.
authors.forename: Juan Manuel
authors.initials: JM
authors.lastname: Vázquez-Lago
authors.affiliation: Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain.
authors.forename: Cristian
authors.initials: C
authors.lastname: Gonzalez-Gonzalez
authors.affiliation: Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), Santiago de Compostela, Spain.
authors.forename: María
authors.initials: M
authors.lastname: Piñeiro-Lamas
authors.affiliation: Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, Santiago de Compostela, Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: López-Durán
authors.affiliation: Polytechnic and University Teaching Institute (Cooperativa de Ensino Superior Politécnico e Universitário-CESPU), Porto, Portugal Institute for Advanced Research and Training in Health Sciences and Technologies, Gandra PRD, Portugal Northern Pharmacovigilance Unit, Faculty of Medicine, University of Porto, Porto, Portugal.
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Herdeiro
authors.affiliation: Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), Santiago de Compostela, Spain adolfo.figueiras@usc.es.
authors.forename: Adolfo
authors.initials: A
authors.lastname: Figueiras
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use; D001291:Attitude of Health Personnel; D004352:Drug Resistance, Microbial; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D058007:Physicians, Primary Care; D010865:Pilot Projects; D055656:Prescriptions; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires
chemical_list: D000900:Anti-Bacterial Agents