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Validation of an instrument to assess barriers to care-seeking for accidental bowel leakage in women: the BCABL questionnaire

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Abstract

Introduction and hypothesis

Fewer than 30% of women with accidental bowel leakage (ABL) seek care, despite the existence of effective, minimally invasive therapies. We developed and validated a condition-specific instrument to assess barriers to care-seeking for ABL in women.

Methods

Adult women with ABL completed an electronic survey about condition severity, patient activation, previous care-seeking, and demographics. The Barriers to Care-seeking for Accidental Bowel Leakage (BCABL) instrument contained 42 potential items completed at baseline and again 2 weeks later. Paired t tests evaluated test–retest reliability. Factor analysis evaluated factor structure and guided item retention. Cronbach’s alpha evaluated internal consistency. Within and across factor item means generated a summary BCABL score used to evaluate scale validity with six external criterion measures.

Results

Among 1,677 click-throughs, 736 (44%) entered the survey; 95% of eligible female respondents (427 out of 458) provided complete data. Fifty-three percent of respondents had previously sought care for their ABL; median age was 62 years (range 27–89); mean Vaizey score was 12.8 (SD = 5.0), indicating moderate to severe ABL. Test–retest reliability was excellent for all items. Factor extraction via oblique rotation resulted in the final structure of 16 items in six domains, within which internal consistency was high. All six external criterion measures correlated significantly with BCABL score.

Conclusions

The BCABL questionnaire, with 16 items mapping to six domains, has excellent criterion validity and test–retest reliability when administered electronically in women with ABL. The BCABL can be used to identify care-seeking barriers for ABL in different populations, inform targeted interventions, and measure their effectiveness.

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Authors and Affiliations

  1. Department of OB/GYN, University of Wisconsin-Madison School of Medicine and Public Health, 600 Highland Avenue, Box 6188, Madison, WI, 53792, USA

    Heidi Wendell Brown, Danielle Westenberg & Nicholas B. Schmuhl

  2. Sonderegger Research Center, University of Wisconsin-Madison School of Pharmacy, Madison, WI, USA

    Meg E. Wise

  3. Healthy Mature Living Foundation, PO Box 1100, Los Gatos, CA, 95030, USA

    Kelly Lewis Brezoczky

  4. Dell Medical School at The University of Texas at Austin, Austin, TX, USA

    Rebecca G. Rogers

  5. Division of Health Policy & Management at UMN, Minneapolis, MN, USA

    Melissa L. Constantine

Authors
  1. Heidi Wendell Brown
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  2. Meg E. Wise
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  3. Danielle Westenberg
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  4. Nicholas B. Schmuhl
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  5. Kelly Lewis Brezoczky
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  6. Rebecca G. Rogers
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  7. Melissa L. Constantine
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Corresponding author

Correspondence to Heidi Wendell Brown.

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Funding

This study was funded by the National Institutes of Health (NIH K12DK100022).

Financial disclaimers/conflicts of interest

Heidi Brown serves as a consultant for Grand Rounds, Inc; Kelly Brezoczky is the founder and former Chief Executive Officer of Butterfly Health, Inc; and Rebecca Rogers is a paid author for UpToDate and receives royalties from McGraw Hill. Meg Wise, Danielle Westenberg, Nicholas Schmuhl, and Melissa Constantine have nothing to disclose.

Ethical committee/institutional review board

Our protocol was deemed exempt by the Health Sciences—Minimal Risk Institutional Review Board (#2015-0785) at the University of Wisconsin-Madison and exempt category 4 (existing data) at the University of Minnesota IRB (#1509E78527).

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Brown, H.W., Wise, M.E., Westenberg, D. et al. Validation of an instrument to assess barriers to care-seeking for accidental bowel leakage in women: the BCABL questionnaire. Int Urogynecol J 28, 1319–1328 (2017). https://doi.org/10.1007/s00192-016-3261-8

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  • DOI: https://doi.org/10.1007/s00192-016-3261-8

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