The clinical input, together with the Health Belief Model, produced a set of nine domains: (1) symptoms; (2) stigma/acceptability, (3) seriousness/severity; (4) perceptions of susceptibility; (5) consequences; (6) barriers to care; (7) perceptions of quality of life; (8) treatment/ utilization of health care; and (9) triggers/environmental risk. This set of domains formed the conceptual structure used for the subsequent developmental steps. comments
Step 1C: Item Construction
Individual items were then derived to fit into the domains of the conceptual framework. Items were either borrowed from existing patient-focused measures or constructed de novo for those domains for which no relevant published items could be discovered.
Items were selected based on the following criteria: (1) comprehensiveness; (2) avoiding obvious redundancy; and (3) balance of domains represented. Once a sizeable pool of items was accumulated, the items were categorized as representing one or more domains. Initial item selection aimed to be as comprehensive as possible. The pool of items was then reduced through a series of reviews. When two items were deemed essentially redundant, one item was selected and the other excluded. Every effort was made to derive multiple items for each of the selected domains. To balance the survey, items were eliminated so that no one particular domain would predominate.
The working group used simple, commonly accepted rules for the construction and evaluation of items. These rules included selecting items that present a single issue, use everyday language, and are brief enough to administer orally. The result of this process was a pool of 58 survey items distributed across the nine basic domains. In addition, two items with content specific to the Chicago area were added.