Development and Validation of an Adapted Tool to Measure Health-Related Social Needs for the Prostate Cancer Population in Nigeria

Abstract

PURPOSE: The lack of culturally appropriate tools is a key obstacle to the identification of unmet social needs in the cancer population of Nigeria. To support sustainable strategies for social needs screening and intervention, this study aimed to develop and validate a health-related social needs screening tool for the prostate cancer population in Nigeria. PATIENTS AND METHODS: The study was performed in three stages at three Nigerian tertiary hospitals: (1) instrument adaptation using the Health Leads social needs screening toolkit as the primary framework, which involved domain specification and question item prioritization through three rounds of Delphi surveys among 15 health care workers, 15 patients with prostate cancer, and 15 caregivers; (2) face validation among 10 patients with prostate cancer through cognitive interviews for feedback on format, language clarity, ease of answering, comprehensiveness and applicability, and then member checking to review and approve question modifications; and (3) pilot testing for reliability analysis and readability assessment among 30 patients with prostate cancer. Descriptive and inferential statistics and qualitative analysis were performed. RESULTS: During the first Delphi round, the highest three of the 10 top-ranking domains were financial resource strain (84%), sociodemographics (80%), and behavioral/mental health (80%). For single-question item prioritization, an agreement was reached in the employment, education, social isolation, and supports domains during the second round, and for the remaining domains during the third round. The format, clarity, ease of answering, and comprehensiveness of seven question items were modified, and two question items were substituted during face validation. The modified tool had a Cronbach's α of .67 and was considered appropriate for second-grade readers. CONCLUSION: To our knowledge, this study developed the first screening tool with acceptable internal validity and understandability to assess social needs in the prostate cancer population of Nigeria.