Development and validation of an adapted tool to measure health-related social needs for the prostate cancer population in Nigeria.

Abstract

e23103 Background: The lack of a culturally appropriate and locally validated tool is a key obstacle to the identification of unmet social needs in the cancer population in Nigeria. To support sustainable implementation strategies for social needs screening and intervention, this study aimed to develop and validate the first health-related social needs screening tool for the prostate cancer population in Nigeria. Methods: The study was carried out in three stages at three tertiary hospitals in Nigeria between January and June 2024. Stage 1 was instrument adaptation using the Health Leads social needs screening toolkit as the primary framework. It involved prioritizing 10 of 15 social needs domains and their corresponding questions through three rounds of Delphi surveys among 15 healthcare workers, 15 prostate cancer patients, and 15 caregivers. Stage 2 was instrument face validation among 10 prostate cancer patients. It involved cognitive interviews for feedback on question format, language clarity, ease of answering, comprehensiveness, and applicability; then, question refinement based on the feedback, and member checking to approve the modifications. Stage 3 involved instrument pilot testing among 30 prostate cancer patients for reliability analysis and Single Measure of Gobbledygook (SMOG) Index computation for readability assessment. Quantitative and qualitative data analysis were done. Results: During the 1 st Delphi round, the highest three of the 10 top-ranking domains were financial resource strain (84%), sociodemographics (80%), and behavioural/mental health (80%). Agreement was reached in prioritizing a single question for the employment, education, and social isolation and supports domains during the 2 nd round, and questions for the remaining domains during the 3 rd round. The format, clarity, ease of answering, and comprehensiveness of seven questions were modified, and two questions were substituted based on feedback from the interviews. Two questions, “What language are you most comfortable to speak?” in the sociodemographic domain and “Do you put off or neglect to go to the doctor because of distance or transportation?” in the transportation challenges domain, remained unaltered. All ten participants approved the modifications during member checking. This led to the development of the face-validated tool comprising sociodemographics with two adapted questions, core social needs with eight questions, and urgency of social needs with a single question. On pilot testing, the tool had an overall Cronbach’s alpha of 0.67. Its SMOG index was 1.84 which was considered appropriate for readers with second grade education level. Conclusions: The developed tool had acceptable internal validity and understandability. The majority of the questions are not specifically related to prostate cancer and may be useful in other cancer patients upon further validation.