Assessment of complementary health approaches use in pediatric oncology: Modification and preliminary validation of the "Which Health Approaches and Treatments Are You Using?" (WHAT) questionnaires

Mohammad R Alqudimat; Karine Toupin April; Lindsay Jibb; Charles Victor; Paul C Nathan; Jennifer Stinson

doi:10.1371/journal.pone.0294393

Assessment of complementary health approaches use in pediatric oncology: Modification and preliminary validation of the "Which Health Approaches and Treatments Are You Using?" (WHAT) questionnaires

PLoS One. 2024 Mar 6;19(3):e0294393. doi: 10.1371/journal.pone.0294393. eCollection 2024.

Authors

Mohammad R Alqudimat^{1

2}, Karine Toupin April³, Lindsay Jibb^{1

2}, Charles Victor⁴, Paul C Nathan⁵, Jennifer Stinson^{1

2}

Affiliations

¹ Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada.
² Child Health Evaluation Sciences, Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada.
³ School of Rehabilitation Sciences and Department of Pediatrics, Children's Hospital of Eastern Ontario Research Institute and Institute du Savoir Montfort, University of Ottawa, Ottawa, Ontario, Canada.
⁴ Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.
⁵ Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada.

Abstract

Objective: Complementary Health Approaches (CHA) are commonly used by children with cancer; however, a few health care providers (HCPs) inquire about the use of CHA. A standardized questionnaire could facilitate such clinical discussions. We aimed to adapt and determine the face and content validity of the "Which Health Approaches and Treatments are you using?" (WHAT) child and parent-report questionnaires in pediatric oncology.

Methods: An electronic Delphi survey that included children with cancer (8-18 years), parents, and HCPs and CHA researchers was conducted to reach consensus on the content of the WHAT questionnaires in pediatric oncology. Children and parents from the Hospital for Sick Children (SickKids), and HCPs and researchers from the International Society of Pediatric Oncology and Pediatric Complementary and Alternative Medicine Research and Education Network completed the survey. To determine the face and content validity of the questionnaires, two iterative cycles of individual interviews were conducted with purposive samples of children (8-18 years), parents, and HCPs from SickKids.

Results: Consensus was reached on all domains and items of the original WHAT questionnaires after one Delphi cycle (n = 61). For face and content validity testing, the first cycle of interviews (n = 19) revealed that the questionnaires were mostly comprehensive and relevant. However, the paper-based format of the original WHAT was not user-friendly, and generic items were vague and not aimed at facilitating clinical dialogues about CHA use. The WHAT questionnaires were then modified into electronic cancer-specific self- and proxy-report questionnaires including 13 and 15 items, respectively. The second cycle (n = 21) showed no need for further changes.

Conclusions: The modified electronic cancer-specific WHAT questionnaires showed adequate face and content validity. The next step is to determine inter-rater reliability, construct validity, and feasibility of administration of the modified WHAT questionnaires in pediatric oncology.

Copyright: © 2024 Alqudimat et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

MeSH terms

Advance Directives
Child
Consensus
Humans
Medical Oncology*
Neoplasms* / diagnosis
Neoplasms* / therapy
Reproducibility of Results

Grants and funding

Phases 1 and 2 were funded by the Pediatric Group of Ontario (POGO). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.