Development and effectiveness testing of a mobile health education package for stroke prevention among stroke survivors

Background: Addressing limited stroke literacy among stroke survivors based on social cognitive theory, using trending Mobile Health (m-health) devices can be a valuable interventional approach to reduce secondary stroke risk. Objectives of this study were to develop and test effectiveness of m-health based educational package for stroke prevention among stroke survivors. Method: This was a multimodal methodology involving content development and effectiveness testing using Delphi protocol and pre-test and post-test design respectively. Role shifting involved a physiotherapist administering stroke prevention education. Development comprised items selection, rating and retention; script writing, translation and recording into an audio and video educational packages. Effectiveness testing involved 30 consenting, consecutively assigned SSVs in each of audio (AIG) and video (VIG) intervention group. Stroke literacy was assessed at baseline, 2nd and 4th week post-intervention. Data was summarized using descriptive and inferential statistics at p<0.05 Alpha value. Results: Participants were majorly males (63.3%), over 60 years old (51.7%), hypertensive (83.3%) and had tertiary education (31.7%). Knowledge of stroke risk factors improved between AIG and VIG from baseline (11 23 ± 4 01 and 10.07 ± 3.24) to 2nd week (17 73 ± 0.78 and 15.30 ± 1.78) and 4th week (17.97 ± 0.18 and 16.77 ± 1.01) post-intervention respectively. There were significant differences between the two groups (p<0.01). Conclusion: Mobile health education based on social cognitive theory effectively improves stroke literacy among SSVs and should be tested among larger samples in the community

Validity and reliability of a Nigerian-Yoruba version of the stroke-specific quality of life scale 2.0

Abstract Background Psychometric evidence is necessary to establish scientific integrity and clinical usefulness of translations and cultural adaptations of the Stroke-Specific Quality of Life (SS-QoL) scale. However, the limited evidence on psychometrics of Yoruba version of SS-QoL 2.0 (SS-QoL(Y)) is a significant shortcoming. This study assessed the test-retest reliability, internal consistency, convergent, divergent, discriminant and known-group validity of the SS-QoL(Y). Methods Yoruba version of the WHOQoL-BREF was used to test the convergent and divergent validity of the SS-QoL(Y) among 100 consenting stroke survivors. The WHOQoL-BREF and SS-QoL(Y) was administered randomly in order to eliminate bias. The test-retest reliability of the SS-QoL(Y) was carried out among 68 of the respondents within an interval of 7 days. All respondents were purposively recruited from selected secondary and tertiary health facilities in South-west Nigeria. Data were analysed using descriptive statistics of mean and standard deviation, and inferential statistics of Spearman correlation, Cronbach’s alpha, Intra-class Correlation Coefficient (ICC), Independent t-test and One-way ANOVA. Alpha level was set at p < 0.05. Result The physical health, psychological health, social relationship and environment domains on WHOQoL-BREF with correlation coefficient that ranged from 0.214 to 0.360 showed significant correlation with similar domains on SS-QoL(Y). Dissimilar domains between the two scales had r values from 0.035 to 0.366. Discriminant validity of SS-QoL(Y) showed that items’ r value ranged from 0.711 to 0.920 with their hypothesized domains. The scale demonstrated moderate to strong test-retest reliability with Intra-class correlation coefficient (ICC) for the domains and overall scores (r = 0.47 to 0.81) and moderate to high internal consistency (Cronbach’s alpha =0.61 to 0.82) for domains scores. These correlations were also significant for the domains and overall scores (p < 0.05). There were no significant differences across different age groups or gender for the domains or overall scores of SS-QoL(Y). Conclusions Discriminant and known-group validity, test-retest reliability and internal consistency of the Yoruba version of the Stroke Specific Quality of Life 2.0 are adequate while the convergent and divergent validity are low but acceptable. The SS-QoL(Y) is recommended for assessing health-related quality of life among Yoruba stroke survivors

Cross-cultural adaptation and validation of the IGBO language version of the stroke-specific quality of life scale 2.0

Introduction: availability of the Stroke-Specific Quality of Life scale 2.0 (SS-QoL(E)) in Yoruba and Hausa, two of the three major indigenous languages in Nigeria have the potential to promote its uptake among these population, however, its non-availability in the Igbo languages makes its use restrictive among the south-eastern Nigerians. This study was aimed at cross-culturally adapting and assessing validity and reliability of the Igbo version of the SS-QoL. Methods: the SS-QoL(E) was cross-culturally adapted to Igbo following the American Association of Orthopaedic Surgeons’ guideline. This involved forward and back-translations, expert committee review, pretesting and cognitive debriefing interview to produce the final Igbo version, SS-QoL(I). The validity and reliability test involved 50 consenting Igbo stroke survivors. The construct validity was assessed by administering SS-QoL(E) and SS-QoL(I) on all 50 respondents, while SS-QoL(I) was re-administered at 7-day interval to assess test-retest reliability. Each scale was administered in random order. Data were analysed using Spearman’s correlation, Wilcoxon’s signed-rank test, Cronbach’s alpha, Intra-class Correlation Coefficient (ICC), independent t-test and one-way ANOVA at p<0.05. Results: respondents’ domains scores on SS-QoL(E) and SS-QoL(I) did not differ significantly except in mobility and work (r=0.58 to 0.87; p=0.001). Cronbach’s alpha was 0.69 to 0.87 for domains scores. The ICC ranged from 0.48 to 0.84, while no significant differences was found across different age groups or gender for the domains or overall scores of SS-QoL(I). Conclusion: the Igbo version of the SS-QoL has limited alterations from the original version and has moderate to excellent validity and reliability values