Design and validation of a self-administered questionnaire to assess knowledge, attitudes and behaviours about Zika virus infection among general population in Italy. A pilot study conducted among Italian residents in public health

Background: Zika (ZIKV), a flavivirus firstly identified in rhesus monkeys in Zika Forest of Uganda, in 1947, is an emerging virus, mainly transmitted by mosquitoes bites. Due to ZIKV adaptation to humans, that can maintain a mosquito-human-mosquito transmission cycle, it is essential to know the attitudes, knowledge and behaviours of general population regarding ZIKV prevention. Our main study aims were to develop and validate a questionnaire administered to the general population, in order to assess attitudes, knowledge and behaviours around prevention and control of Zika infection. The current study was intended as a preliminary, pilot study. Methods: A questionnaire was developed based on a comprehensive review of the extant literature, pre-existing questionnaires and experts focus groups. Results: The final version of the questionnaire comprised 27 items, with good psychometric properties (Kuder-Richardson 21 formula coefficient of 0.886). Overall test/re-test concordance was 0.77. Conclusion: In conclusion, the questionnaire seems to be an appropriate and useful tool to detect cognitive gaps concerning behaviours responsible for possible transmissions of the disease, even in a non-endemic country such as Italy. Future analysis will explore the factorial structure of the questionnaire as well as knowledge, beliefs and attitudes concerning ZIKV among Italian general population.