Second, this survey development process also demonstrated how the choice of survey introduction might be associated with differences in willingness to respond, as seen in the proportion of respondents with self-reported asthma. The findings suggest that the “asthma introduction” may have been an important source of respondent bias, in that individuals with asthma might have been more likely to agree to be interviewed than unaffected individuals. The use of a “general health introduction” followed by an introductory question on general health may be associated with less bias toward recruiting patients with asthma. This introductory question on general health was chosen because it appeared to be nonthreatening, and concerns a topic of interest to most people.
In recent years, alternative approaches to health system-based asthma education, such as public and community education campaigns, have been promoted.- However, these programs were developed in the absence of information about the baseline levels of asthma knowledge and perceptions of the general public. In the future, programs may find surveys such as the CCAS-32 useful for obtaining baseline assessments, determining community needs, and evaluating program effectiveness.
Survey development is an iterative process, and the CCAS-32 will need to undergo some evolution and refinement before it can be promoted as a final product. While we believe that in its current form, the CCAS-32 is a useful community assessment tool, several limitations should be addressed. First, although a systematic process was used to identify items and content areas, it is possible that important content may have been missed. Also, the development work thus far has occurred in only one geographic area; item performance may differ in other communities. itat on

If the CCAS-32 is to be used in other settings as an evaluative instrument, it would be important to further understand the instrument’s discriminative validity, test-retest reliability and responsiveness, particularly among differing populations. It would also be interesting to examine how social and cultural factors may modify item performance. Users of the CCAS-32 should be aware that modifications to the instrument based on future scientific testing will be made available in a timely manner through the CASI Internet site.
In conclusion, there is a need for valid and reliable measures to study the effects of educational programs. To date, there has been little focus on the asthma knowledge of the general public. With input from experts in asthma and feedback from individuals in the Chicago area, a community survey of general asthma knowledge has been developed, containing items that appear to have both face validity and acceptable performance characteristics. Respective of the limitations described above, we believe that this new instrument will contribute to our ability to assess asthma knowledge, attitudes, and beliefs in the general public.