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Development and Validation of the 34-Item Disability Screening Questionnaire (DSQ-34) for Use in Low and Middle Income Countries Epidemiological and Development Surveys

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  • Jean-François Trani
  • Ganesh Muneshwar Babulal
  • Parul Bakhshi

Abstract

Background: Although 80% of persons with disabilities live in low and middle-income countries, there is still a lack of comprehensive, cross-culturally validated tools to identify persons facing activity limitations and functioning difficulties in these settings. In absence of such a tool, disability estimates vary considerably according to the methodology used, and policies are based on unreliable estimates. Methods and Findings: The Disability Screening Questionnaire composed of 27 items (DSQ-27) was initially designed by a group of international experts in survey development and disability in Afghanistan for a national survey. Items were selected based on major domains of activity limitations and functioning difficulties linked to an impairment as defined by the International Classification of Functioning, Disability and Health. Face, content and construct validity, as well as sensitivity and specificity were examined. Based on the results obtained, the tool was subsequently refined and expanded to 34 items, tested and validated in Darfur, Sudan. Internal consistency for the total DSQ-34 using a raw and standardized Cronbach’s Alpha and within each domain using a standardized Cronbach’s Alpha was examined in the Asian context (India and Nepal). Exploratory factor analysis (EFA) using principal axis factoring (PAF) evaluated the lowest number of factors to account for the common variance among the questions in the screen. Test-retest reliability was determined by calculating intraclass correlation (ICC) and inter-rater reliability by calculating the kappa statistic; results were checked using Bland-Altman plots. The DSQ-34 was further tested for standard error of measurement (SEM) and for the minimum detectable change (MDC). Good internal consistency was indicated by Cronbach’s Alpha of 0.83/0.82 for India and 0.76/0.78 for Nepal. We confirmed our assumption for EFA using the Kaiser-Meyer-Olkin measure of sampling well above the accepted cutoff of 0.40 for India (0.82) and Nepal (0.82). The criteria for Bartlett’s test of sphericity were also met for both India (

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  • Jean-François Trani & Ganesh Muneshwar Babulal & Parul Bakhshi, 2015. "Development and Validation of the 34-Item Disability Screening Questionnaire (DSQ-34) for Use in Low and Middle Income Countries Epidemiological and Development Surveys," PLOS ONE, Public Library of Science, vol. 10(12), pages 1-14, December.
    • Handle: RePEc:plo:pone00:0143610
    DOI: 10.1371/journal.pone.0143610
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    References listed on IDEAS

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    1. Mizunoya, Suguru & Mitra, Sophie, 2013. "Is There a Disability Gap in Employment Rates in Developing Countries?," World Development, Elsevier, vol. 42(C), pages 28-43.
    2. Mitra, Sophie & Posarac, Aleksandra & Vick, Brandon, 2013. "Disability and Poverty in Developing Countries: A Multidimensional Study," World Development, Elsevier, vol. 41(C), pages 1-18.
    3. Nora Groce & Maria Kett & Raymond Lang & Jean-Francois Trani, 2011. "Disability and Poverty: the need for a more nuanced understanding of implications for development policy and practice," Third World Quarterly, Taylor & Francis Journals, vol. 32(8), pages 1493-1513.
    4. Deon Filmer, 2008. "Disability, Poverty, and Schooling in Developing Countries: Results from 14 Household Surveys," The World Bank Economic Review, World Bank, vol. 22(1), pages 141-163, January.
    5. Hosseinpoor, A.R. & Williams, J.A.S. & Gautam, J. & Posarac, A. & Officer, A. & Verdes, E. & Kostanjsek, N. & Chatterji, S., 2013. "Socioeconomic inequality in disability among adults: A multicountry study using the world health survey," American Journal of Public Health, American Public Health Association, vol. 103(7), pages 1278-1286.
    6. Trani, Jean-Francois & Bakhshi, Parul & Noor, Ayan A. & Lopez, Dominique & Mashkoor, Ashraf, 2010. "Poverty, vulnerability, and provision of healthcare in Afghanistan," Social Science & Medicine, Elsevier, vol. 70(11), pages 1745-1755, June.
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    1. Mizunoya, Suguru & Mitra, Sophie & Yamasaki, Izumi, 2018. "Disability and school attendance in 15 low- and middle-income countries," World Development, Elsevier, vol. 104(C), pages 388-403.
    2. Bakhshi, Parul & Babulal, Ganesh M. & Trani, Jean-Francois, 2018. "Education and disability in a conflict affected context: Are children with disabilities less likely to learn and be protected in Darfur?," World Development, Elsevier, vol. 106(C), pages 248-259.
    3. Jean-Francois Trani & Kyle A. Pitzer & Juanita Vasquez Escallon & Parul Bakhshi, 2022. "Access to Services from Persons with Disabilities in Afghanistan: Is Community Based Rehabilitation Making a Difference?," IJERPH, MDPI, vol. 19(10), pages 1-26, May.
    4. Trani, Jean-Francois & Bakhshi, Parul & Brown, Derek & Lopez, Dominique & Gall, Fiona, 2018. "Disability as deprivation of capabilities: Estimation using a large-scale survey in Morocco and Tunisia and an instrumental variable approach," Social Science & Medicine, Elsevier, vol. 211(C), pages 48-60.
    5. Sophie Mitra & Wei Chen & Justine Hervé & Sophia Pirozzi & Jaclyn Yap, 2022. "Invisible or Mainstream? Disability in Surveys and Censuses in Low- and Middle-Income Countries," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 163(1), pages 219-249, August.
    6. Parul Bakhshi & Ganesh M. Babulal & Jean-Francois Trani, 0. "Disability, Poverty, and Schooling in Post-civil War in Sierra Leone," The European Journal of Development Research, Palgrave Macmillan;European Association of Development Research and Training Institutes (EADI), vol. 0, pages 1-20.
    7. Tiago S. Jesus & Michel D. Landry & Helen Hoenig, 2019. "Global Need for Physical Rehabilitation: Systematic Analysis from the Global Burden of Disease Study 2017," IJERPH, MDPI, vol. 16(6), pages 1-19, March.
    8. Parul Bakhshi & Ganesh M. Babulal & Jean-Francois Trani, 2021. "Disability, Poverty, and Schooling in Post-civil War in Sierra Leone," The European Journal of Development Research, Palgrave Macmillan;European Association of Development Research and Training Institutes (EADI), vol. 33(3), pages 482-501, June.
    9. Venkata S. Murthy Gudlavalleti, 2018. "Challenges in Accessing Health Care for People with Disability in the South Asian Context: A Review," IJERPH, MDPI, vol. 15(11), pages 1-11, October.

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