RT Journal Article
SR Electronic
T1 Creating and testing a low literacy asthma questionnaire
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P503
VO 40
IS Suppl 56
A1 Ruth Pinilla
A1 Judy A. Shea
A1 Maureen George
YR 2012
UL http://erj.ersjournals.com/content/40/Suppl_56/P503.abstract
AB Background. Nearly half of the US population reads at or below the 8th grade level. Recognition of low literacy has resulted in greater attention to developing written materials at lower reading levels. However, less attention has been paid to the development of low literacy questionnaires for research beyond assessing grade reading level.Objective. To systematically develop a research questionnaire that accurately captures subjects' responses when self-administered.Methods. Following traditional instrument development steps (comprehensive review of the literature and selection of items using content experts), researchers created a low literacy questionnaire. A standardized guide for recording difficulties encountered by subjects during self-administration was used to evaluate comprehension and ease of completion.Results. The 39-item Conventional and Alternative Management for Asthma questionnaire was written at a 5.7 grade level and completed by 210 adults (88% female; mean age 48; 76% Black; 20% White; 62% with ≤ high school education). On average, subjects completed the questionnaire in <5 minutes. Three subjects requested the questionnaire be read to them; one was legally blind. Eight (4%) had difficulty with the Likert scale. As many as 31 (15%) asked for clarification on the wording of 15 distinct items. Four (2%) requested help in reading one or two unfamiliar words. Only 1 item elicited no comments.Conclusions. The use of a standardized debriefing guide allowed for the identification of problematic words, unclear meanings and confusion over scaling despite a deliberate attempt to develop a low literacy tool. These data suggest that a lower reading level is not sufficient to remove the potential for misreporting.