RELIABILITY AND VALIDITY OF A QUESTIONNAIRE TO EVALUATE DIABETIC PATIENTS' INTENTION TO ADOPT HEALTH INFORMATION TECHNOLOGY: A PILOT STUDY

arahman@iium.edu. my ABSTRACT All the efforts put in developing questionnaire by a researcher are in vain if it measures what is not intended to measure. A questionnaire can only be useful if it produces meaningful and trustworthy data. The aim of this study was to develop and assess the validity and reliability of an instrument to measure the perception and attitude of diabetic patients toward acceptance of Health Information Technology (HIT). An extended Technology Acceptance Model (TAM) based questionnaire was distributed to a sample of 80 diabetic patients. The content validity was assessed by experts, while Exploratory Factor Analysis (EFA) was used to measure the construct validity. Cronbach's alpha was used to measure the internal consistency of the questionnaire. The response rate of the questionnaire was 93%. In the exploratory factor analysis, seven factors that correspond with the constructs were extracted using principal component analysis. The factors examined using varimax rotations explained 72.15%, 74.21%, 72.67%, 80.84%, 72.72%, 74.22% and 74.84% variance in the respective constructs. Construct validity was measured using convergent and discriminant validity. Most of the variables load in the range of 0.60 - 0.98, which shows a good convergent validity, and the significant loading of the variables on one factor without cross-loadings is an evidence of the discriminant validity. Similarly, the average Cronbach's alpha coefficient of the seven extracted components was 0.822 indicating a good internal consistency or reliability. This study presents the result of reliability and validity of the extended TAM based instrument for assessing the perception and attitude of diabetic patients toward acceptance of HIT. The findings of this study showed the feasibility of using the questionnaire, since it has high reliability and validity. Keywords: Health Information Technology (HIT), Technology Acceptance Model (TAM), Developing Countries, Diabetic Patients, Questionnaire 1. INTRODUCTION Health Information Technology (HIT) applications such as Electronic Health Record (EHR) and Clinical Decision Support System (CDSS) assists clinicians, patients, and staff with decision making tasks related to diagnosis, analysis of patient data, medication, prediction, reminder, etc. at the right time. EHR makes patient's record available any time which help to provide more effective and coordinated care, similarly CDSS improves physician's performance and patient outcomes while at the same time reduces healthcare cost as reported in previous literatures [1-6]. This presents EHR integrated with CDSS as a technology that can be used for diagnosis and management of chronic diseases such as diabetes in order to enhance the healthcare of the patients. On the other hand, diabetes is one of the chronic diseases that require urgent attention due to their spread nature and associated complications. According to WHO [7],[8] about 346 million people are diabetic with more than three-quarter in developing countries where there are economic and healthcare challenges. Nevertheless, a great number of existing HIT systems are not in use due to factors such as security concern, work flow change, interoperability issues, user resistance, lack of awareness, associated cost, etc. [3],[9-11]. Therefore, the acceptance of HIT would be improved when the perception and factors that affect users' acceptance are investigated and tackled. Although there are various studies that evaluate behaviours and attitudes of users toward using a new technology from different perspective, there is lack of studies and instruments that focused on patients from developing countries. The limited ones available mostly either focused on healthcare practitioners or do not cover important aspects such as the cost and the quality from the patients' point of view [3],[12-14].