Cognitive Interviewing as a Tool for Improving Consent and Communication

Willis, Gordon

doi:10.1037/e538062007-001

Cited by 1,574 publications

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“…(19,20) After initial development of the survey, we pretested it using cognitive interviewing methods with 10 English-speaking and 10 Spanish-speaking patients. (21,22) …”

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confidence: 99%

Patient‐reported barriers are associated with lower hepatocellular carcinoma surveillance rates in patients with cirrhosis

Farvardin

Patel

Khambaty³

et al. 2016

Hepatology

144

130

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Over 20% of patients with cirrhosis are nonadherent with hepatocellular carcinoma (HCC) surveillance recommendations; however, few studies have evaluated the impact of patient-level factors on surveillance receipt. We characterized the association between HCC surveillance receipt and patient knowledge, attitudes, and perceived barriers in a racially diverse and socioeconomically disadvantaged cohort of patients with cirrhosis. Patients with cirrhosis followed at a large urban hospital were invited to complete a survey about HCC surveillance between August 2014 and December 2015. Multivariable logistic regression was performed to identify factors associated with HCC surveillance receipt during the 12-month period preceding and 6-month period after survey administration. We achieved a response rate of 71.8% (n = 541 of 753). Patients demonstrated high levels of HCC-related knowledge (summary score, 77.7%); however, 48.6% believed that eating a healthy diet precluded the need for HCC surveillance, and 34.0% believed that HCC surveillance was not necessary if they had a normal physical exam and/or lacked clinical symptoms. Patients expressed worry about developing and dying from HCC, but nearly half (49.9%) of patients reported barriers to receiving HCC surveillance, including difficulty with the scheduling process (30.5%), costs of surveillance testing (25.3%), and transportation difficulties (17.3%). HCC surveillance receipt was significantly higher in patients who knew cirrhosis is a risk factor for developing HCC (odds ratio [OR], 3.09; 95% confidence ADDRESS CORRESPONDENCE AND REPRINT REQUESTS TO: Amit G. Singal, M.D., M.S., Division of Digestive and Liver Diseases, UT Southwestern Medical Center, 5959 Harry Hines Boulevard, POB 1, Suite 420, amit.singal@utsouthwestern.edu,. * These authors contributed equally to this work and are co-first authors.Potential conflict of interest: Dr. Singal consults for and is on the speakers' bureau for Bayer. Dr. Yopp is on the speakers' bureau for Bayer and received grants from Novartis and Peregrine.Author names in bold designate shared co-first Although provider recommendation is reported to be a strong predictor for HCC surveillance, (9) patient-level factors may also play an important role in surveillance underuse. In prospective cohort studies, nearly 1 in 5 patients were nonadherent with provider recommendations for HCC surveillance. (10,11) The cancer-screening literature has applied theoretical models of behavior change and demonstrated that patients' poor knowledge, negative attitudes, or perceived barriers to cancer screening may be associated with lower screening rates. (12,13) However, most studies evaluating HCC surveillance correlates have primarily focused on patient sociodemographic and clinical characteristics. (7,14) The effect of theory-based, patient-reported psychosocial factors on HCC surveillance completion has not been quantified. A better understanding of patient knowledge, attitudes, and barriers, particularly among low-income minorities, i...

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“…(19,20) After initial development of the survey, we pretested it using cognitive interviewing methods with 10 English-speaking and 10 Spanish-speaking patients. (21,22) …”

mentioning

confidence: 99%

Patient‐reported barriers are associated with lower hepatocellular carcinoma surveillance rates in patients with cirrhosis

Farvardin

Patel

Khambaty³

et al. 2016

Hepatology

144

130

View full text Add to dashboard Cite

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“…The disadvantage of this approach is that the think aloud process can be influenced by the semi-structured probing of the preceding item. Although this effect was not apparent in the pilot study, it cannot be ruled out [14].…”

Section: Questionnaire Itemsmentioning

confidence: 73%

“…We used the Three-Step Test-Interview (TSTI) [13], combining the two subtypes of cognitive interview methods (think aloud interviewing and verbal probing techniques) [14]. In the first step, the respondents are instructed to think aloud while completing questionnaire items.…”

Section: Cognitive Interviewmentioning

confidence: 99%

Clarifying quality of life assessment: do theoretical models capture the underlying cognitive processes?

et al. 2008

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Objective To develop an analysis scheme capturing the cognitive processes underlying QoL assessment to increase our understanding on how to interpret responses to QoL items. Tourangeau et al.'s (The psychology of survey response, 2000) and Rapkin and Schwartz' (Health Qual Life Outcomes 2:14, 2004) cognitive process models form the basis for this analysis scheme. Methods We conducted think aloud interviews with six cancer patients prior to and following radiotherapy to elicit the cognitive processes underlying the assessment of 7 EORTC QLQ-C30 items. Content analysis was carried out by two to four researchers independently. Eighty text fragments were analyzed inductively and combined in an iterative process with deductive analyses based on both models.Results We have developed a comprehensive analysis scheme feasible for analyzing the cognitive processes underlying QoL assessment qualitatively. All cognitive components of both models could be distinguished in our data. The cognitive component 'reporting and response selection' needed extension to fully capture the cognitive processes used. Conclusion The two models combined are useful in describing the cognitive processes cancer patients use in answering QoL items, and as such facilitate insight into patients' self-reported QoL assessments. Interestingly, the content of the cognitive processes not only differed between patients but also between items within patients and over time.

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“…Cognitive interviews can unpack the four stages 248 respondents work through in order to reply to a survey question: comprehension 249 (understanding the question); recalling information; judgment (deciding upon the question 250 relevance); and response (formulating an answer in the format provided by the interviewer) 251 (Willis 2005). 252…”

Section: Qualitative Methods -Cognitive Interviews (Stage Two) 240mentioning

confidence: 99%

Operationalising the capability approach as an outcome measure in public health: The development of the OCAP-18

Lorgelly

Lorimer

Fenwick

et al. 2015

Social Science & Medicine

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5There is growing interest in operationalising the capability approach to measure quality of 6 life. This paper reports the results of a research project undertaken in 2007 that sought to 7 reduce and refine a longer survey in order to provide a summary measure of wellbeing and 8 capability in the realm of public health. The reduction and refinement of the questionnaire 9 took place across a number of stages, using both qualitative (five focus group discussions and 10 17 in-depth interviews) and quantitative (secondary data analysis, N=1,048 and primary data 11 collection using postal surveys and interviews, N=45) approaches. The questionnaire was 12 reduced from its original 60+ questions to 24 questions (including demographic questions). 13Each of Nussbaum's ten Central Human Capabilities are measured using one (or more) of the 14 18 specific capability items which are included in the questionnaire (referred to as the OCAP-15 18). Analysis of the questionnaire responses (N=198) found that respondents differed with 16 respect to the levels of capabilities they reported, and that these capabilities appear to be 17 sensitive to one's gender, age, income and deprivation decile. An index of capability, 18 estimated by assuming equal weight for each capability question, found that the average level 19 of capability amongst respondents was 12.44 (range 3-17.75). This index was found to be 20 highly correlated with a measure of health (EQ-5D) and wellbeing (global QoL), although 21 some differences were apparent. This project operationalised the capability approach to 22 produce an instrument to measure the effectiveness (and cost effectiveness) of public health 23 interventions; the resulting OCAP-18 appears to be responsive and measure something 24 supplementary to health and wellbeing, thus offers a promising addition to the current suite of 25 outcome measures that are available. Sen's Capability Approach (Sen 1985;1993) would appear to provide a possible solution to 77 the limitations of QALYs, as it expands the evaluative space (so it can include non-health 78 outcomes like empowerment, participation, housing, and crime) to consider whether a 79 programme/policy/intervention enhances an individual's capability (Lorgelly et al. 2010). 80Previous evaluative approaches focus on subjective-wellbeing (utilitarism) or the availability 81 5 of means for a good life (resourcism). The alternative paradigm of the capability approach 82 instead suggests that the focus of wellbeing should be a set of valuable 'beings and doings' 83 (for example being in good health or having loving relationships), which can be measured by 84 opportunities (capabilities) or outcomes (functionings) (Sen 1992). Sen desires that policies 85 ought to promote the "capabilities of persons to lead the kind of lives they value -and have 86 reason to value ' (Sen 1999, p.18). Of interest in its application to public health is the 87 evaluative space; it diverges from narrow utility space, which is concerned with the pleasure 88 obtained from...

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Cognitive Interviewing as a Tool for Improving Consent and Communication

Cited by 1,574 publications

References 0 publications

Patient‐reported barriers are associated with lower hepatocellular carcinoma surveillance rates in patients with cirrhosis

Patient‐reported barriers are associated with lower hepatocellular carcinoma surveillance rates in patients with cirrhosis

Clarifying quality of life assessment: do theoretical models capture the underlying cognitive processes?

Operationalising the capability approach as an outcome measure in public health: The development of the OCAP-18

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