KAP STUDIES (KNOWLEDE, ATTITUDE, AND PRACTICE STUDIES)

A representative study of a specific population to collect information on what is known, believed, and done in relation to a particular topic

It is a quantitative method (predefined questions formatted in standardized questionnaires) that provides access to quantitative and qualitative information. It is also Conducted to collect information on the knowledge (i.e., what is known), attitudes (i.e., what is thought), and practices (i.e., what is done) about general and/or specific topics of a particular population.

The knowledge part is normally used only to assess the extent of community knowledge about public health concepts related to national and international public health programmes. Investigation of other types of knowledge, such as culture-specific knowledge of illness notions and explanatory models, or knowledge related to health systems, e.g., access, referral, and quality, is highly neglected.

Measuring attitudes is the second part of a standard KAP survey questionnaire. However, many KAP studies do not present results regarding attitudes, probably because of the substantial risk of falsely generalizing the opinions and attitudes of a particular group.(Cleland 1973, Hausmann-Muela et al. 2003)

The act of measuring attitudes via a survey has been criticized for many reasons. When confronted with a survey question, people tend to give answers which they believe to be correct or in general acceptable and appreciated, sensitive topics are particularly demanding.

The survey interview context may influence the answer: whether the interview is conducted at a clinic or in a village, whether there are other people present, etc. The question formulation can be manipulative towards a favorable answer. Sometimes, the respondents may be uninformed about the issue and thus find it strange, but their attitudes are nonetheless measured. On occasion, the attitude scales (numbers/verbal) may fail to reflect the respondents' answers. (Cleland 1973, HausmannMuela et al. 2003, Pelto and Pelto 1994)

A third and integral part of KAP surveys is the investigation of health-related practices.

Questions normally concern the use of different treatment and prevention options and are hypothetical.

KAP surveys have been criticized for providing only descriptive data which fails to explain why and when certain treatment prevention and practices are chosen. In other words, the surveys fail to explain the logic behind people's behavior.

1. Gather information about general practices and beliefs.

2. Measure the extent of a known situation, confirm or disprove a hypothesis, or provide new tangents of a situation’s reality.

3. Enhance the knowledge, attitude, and practices of specific themes; identify what is known and done about various health-related subjects.

4. Establish the baseline (reference value) for use in future assessments and help measure the effectiveness of health education activities' ability to change health-related behaviors.

5. Suggest an intervention strategy that reflects specific local circumstances and the cultural factors that influence them; plan activities that are suited to the respective population involved.

6. To assess and identify communications processes and sources important for program implementation and effectiveness.

7. To help set program priorities and make program decisions.

8. To generate baseline levels and measure changes that result from interventions.

Number of Staff Required:

The team will be composed of surveyors and supervisors. The number of supervisors is directly dependent on the number of surveyors, which is determined by the size of the survey and the resources available. Each supervisor should have daily face-to-face contact with each of the surveyors that s/he supervises. For 10-15 surveyors, for example, two supervisors work quite well.

Training:

Training surveyors is crucial. The training lasts two-to-four days depending on the complexity of the survey and questionnaire and the experience level of surveyors recruited.

The training should allow surveyors to master the knowledge, skills, and expertise specific to the KAP survey.

1. Step One: Define the survey objectives: Review existing information, determine the purpose of the survey, identify the areas of enquiry, identify the survey population, and create a sampling plan.

2. Step Two: Develop the survey protocol: Organize the contents of the survey protocol, define the key research questions, determine whether the survey needs ethical review, create a work plan, and develop a budget.

3. Step Three: Design the survey questionnaire: Develop the survey questionnaire, make a data analysis plan, and pre-test and finalize the questionnaire.

4. Step Four: Conduct the KAP survey: Choose survey dates and timeline, recruit survey supervisors and interviewers, train supervisors and interviewers, and ensure the quality of data collected.

5. Step Five: Analyze the data: Clean the data, implement a data analysis plan, and interpret the findings.

6. Step Six: Use the data: Translate findings into action, write the survey report, disseminate findings, and use KAP survey data in programming.

A KAP survey takes between six and twelve weeks.

1. Constructing the survey protocol.

2. Preparing the survey.

3. Course of the KAP survey in the field.

4. Data analysis and presentation of the survey report.

5. Conclusion, references, and abbreviations.

 KAP surveys can identify knowledge gaps, cultural beliefs, or behavioral patterns that may facilitate understanding and action, as well as pose problems or create barriers to development efforts.

 They can identify information that is commonly known and attitudes that are commonly held.

 To some extent, they can identify factors influencing behavior that are not known to most people, reasons for their attitudes, and how and why people practice certain behaviors.

 Data can be hard to interpret accurately.

 Lack of standardized approach to validate findings.

 Analyst biases in KAP surveys.

 Other Criticisms such as:

 Their findings generally lead to prescriptions for mass behavior modification instead of targeting interventions towards individuals, For example:

A study which used KAP surveys to study the AIDs epidemic found that “these unfocused inquiries into diffuse behaviors in undifferentiated populations are not productive in low-seroprevalence populations, especially when the objective is to design interventions to avert further infection. The failure of KAP surveys to distinguish conceptually between the relevance of AIDS-related behavioral data for individuals and for populations makes them fundamentally flawed for such purposes.

 The investigators use the surveys to explain health behavior under the assumption that there is a direct relationship between knowledge and action.