Development and psychometric validation of a novel patient survey to assess perceived quality of substance abuse treatment in South Africa
Date
2015-11
Journal Title
Journal ISSN
Volume Title
Publisher
BioMed Central
Abstract
Background: A hybrid performance measurement system that combines patient-reported outcome data with
administrative data has been developed for South African substance abuse treatment services. This paper describes
the development and psychometric validation of one component of this system, the South African Addiction
Treatment Services Assessment (SAATSA).
Methods: First, a national steering committee identified five domains and corresponding indicators on which
treatment quality should be assessed. A decision was made to develop a patient survey to assess several of these
indicators. A stakeholder work group sourced survey items and generated additional items where appropriate. The
feasibility and face validity of these items were examined during cognitive response testing with 16 patients. This
led to the elimination of several items. Next, we conducted an initial psychometric validation of the SAATSA with
364 patients from residential and outpatient services. Exploratory (EFA) and confirmatory factor analyses (CFA) were
conducted to assess the latent structure of the SAATSA. Findings highlighted areas where the SAATSA required
revision. Following revision, we conducted another psychometric validation with an additional sample of 285
patients. We used EFA and CFA to assess construct validity and we assessed reliability using Cronbach’s measure of
internal consistency.
Results: The final version of the SAATSA comprised 31 items (rated on a four-point response scale) that
correspond to six scales. Four of these scales are patient-reported outcome measures (substance use, quality of
life, social connectedness and HIV risk outcomes) that together assess the perceived effectiveness of treatment.
The remaining two scales assess patients’ perceptions of access to and quality of care. The models for the final
revised scales had good fit and the internal reliability of these scales was good to excellent, with Cronbach’s α
ranging from 0.72 to 0.89.
Conclusion: A lack of adequate measurement tools hampers efforts to improve the quality of substance abuse
treatment. Our preliminary evidence suggests that the SAATSA, a novel patient survey that assesses patients’
perceptions of the outcomes and quality of substance abuse treatment, is a psychometrically robust tool that
can help fill this void.
Description
CITATION: Myers, B. et al. 2015. Development and psychometric validation of a novel patient survey to assess perceived quality of substance abuse treatment in South Africa. Substance Abuse Treatment, Prevention, and Policy, 10:44, doi:10.1186/s13011-015-0040-3.
The original publication is available at http://substanceabusepolicy.biomedcentral.com
The original publication is available at http://substanceabusepolicy.biomedcentral.com
Keywords
Substance abuse -- Treatment -- South Africa, Psychometrics -- Validity
Citation
Myers, B. et al. 2015. Development and psychometric validation of a novel patient survey to assess perceived quality of substance abuse treatment in South Africa. Substance Abuse Treatment, Prevention, and Policy, 10:44, doi:10.1186/s13011-015-0040-3.