Development of a scale to measure expected concussion reporting behavior

Background Most concussion education aims to increase athlete self-report of concussive symptoms. Although the population burden of concussion is high, frequency with which this injury occurs on a given sports team in a given season is relatively low. This means that powering concussion education evaluation studies to measure change in post-injury symptom reporting behavior requires what is often a prohibitively large sample size. Thus, evaluation studies are typically powered to measure proximal cognitions. Expected reporting behavior, a cognition that reflects planned and reactive decision-making, is a theoretically indicated construct for inclusion in evaluation studies. However, previously no scales were available to measure this construct with demonstrated reliability and validity among youth athletes. The objective of this study was to develop and assess the validity of a brief single-factor scale to measure expected youth athlete concussion reporting behavior (CR-E) in a sample of youth athletes. Methods A mixed methods approach was used, including cognitive interviews with youth athletes, and quantitative item reduction and validation. Participants were youth athletes (aged 9–16) from the Seattle metropolitan and rural south-Georgia regions. After refining an initial pool of items using cognitive interviews with a diverse group of youth athletes (n = 20), a survey containing these items was administered to youth soccer and football players (n = 291). Item reduction statistics and sequential confirmatory factor analyses were used to reduce the initial scale using a randomly selected half of the sample. Then, a final confirmatory factor analysis and validation tests were applied to the other half of the sample of youth athletes. Predictive validation was conducted longitudinally in a separate sample of youth athletes (n = 155). Results Internal consistency was high (alpha = 0.89), model fit was excellent, validation tests were in the hypothesized directions, and the scale was feasible to use. Using the finalized 4-item scale, we observed that less than one-third of youth soccer and football athletes expect to “always” tell their coach about symptoms of a suspected concussion. Conclusions The CR-E measure should be included in future studies evaluating concussion education programming in youth athlete populations.

A new measure of feeling safe: Developing psychometric properties of the neuroception of psychological safety scale (NPSS)

Objective: Psychological safety is increasingly recognised as central to mental health, wellbeing and post-traumatic growth. To date, there is no psychometrically supported measure of psychological safety combining psychological, physiological and social components. The current research aimed to develop and establish the neuroception of psychological safety scale (NPSS), informed by Polyvagal Theory. Method: The study comprised of three stages: (1) item generation, (2) item reduction, and (3) assessment of factor structure and internal consistency. Exploratory and confirmatory factor analysis was conducted from two samples who completed a survey online (exploratory n = 342, confirmatory n = 455). Results: Initially, 107 items were generated. Item reduction and exploratory factor analysis resulted in a 29-item NPSS with subscales of compassion, social engagement and body sensations. The NPSS was found to have a consistent factor structure and internal consistency. Conclusion: The NPSS is a novel measure of psychological safety which can be used across a range of health and social care settings. This research provides a platform for further work to support and enhance understandings of the science of safety through the measurement of psychological, relational and physiological components of safety. The NPSS will help shape new approaches to evaluating trauma treatments, relational issues and mental health concerns. Research to establish the convergent, discriminant and concurrent validity of the NPSS and to explore its use with diverse community and clinical populations is underway.

Validating the Enright Forgiveness Inventory – 30 (EFI-30)

This study reports the process of item reduction of the Enright Forgiveness Inventory – EFI, a measure of interpersonal forgiveness, from 60 to 30 items for a more practical assessment of this construct. Data from the US were used in the creation of the new measure and applied to seven nations: Austria, Brazil, Israel, South Korea, Norway, Pakistan, and Taiwan. The question was: do the best EFI-30 items from the US have discriminative power in seven other cultures? Results provided the psychometric evidence for the reduced version of the EFI-30 across cultures. The discrimination values are positive, suggesting that the selected items have the sensitivity to differentiate accurately people with different degrees of forgiveness and good psychometric properties of internal consistency.

EXPRESS: Working On My Own: Measuring the Challenges of Gig Work

Gig workers commonly face challenges that differ in nature or intensity from those experienced by traditional organizational workers. To better understand and support gig workers, we sought to develop a measure that reliably and validly assesses these challenges. We first define gig work and specify its core characteristics. We then provide an integrated conceptual framework for a measure of six challenges commonly faced by gig workers—viability, organizational, identity, relational, emotional, and career-path uncertainty. We then present five studies: Item generation in Study 1; item reduction, exploratory assessment of the factor structure of these items, and initial tests of convergent validity in Study 2; and in the remaining three studies, we draw from different gig worker populations to accumulate evidence for the convergent, discriminant, and criterion validity of our gig work challenges inventory, and present initial tests of the universality of the gig challenge inventory across a range of socio-demographic, job type, and regional factors. Our findings establish the reliability and validity of a gig work challenge inventory (GWCI) that can aid researchers seeking to better understand the types and impact of stressors gig workers face, which in turn can help to inform theory, practice, and public policy.

Development and validation of a patient-centered, meningioma-specific quality-of-life questionnaire

OBJECTIVE Meningiomas can have significant impact on health-related quality of life (HRQOL). Patient-centered, disease-specific instruments for assessing HRQOL in these patients are lacking. To this end, the authors sought to develop and validate a meningioma-specific HRQOL questionnaire through a standardized, patient-centered questionnaire development methodology. METHODS The development of the questionnaire involved three main phases: item generation, item reduction, and validation. Item generation consisted of semistructured interviews with patients (n = 30), informal caregivers (n = 12), and healthcare providers (n = 8) to create a preliminary list of items. Item reduction with 60 patients was guided by the clinical impact method, multiple correspondence analysis, and hierarchical cluster analysis. The validation phase involved 162 patients and collected evidence on extreme-groups validity; concurrent validity with the SF-36, FACT-Br, and EQ-5D; and test-retest reliability. The questionnaire takes on average 11 minutes to complete. RESULTS The meningioma-specific quality-of-life questionnaire (MQOL) consists of 70 items representing 9 domains. Cronbach’s alpha for each domain ranged from 0.61 to 0.91. Concurrent validity testing demonstrated construct validity, while extreme-groups testing (p = 1.45E-11) confirmed the MQOL’s ability to distinguish between different groups of patients. CONCLUSIONS The MQOL is a validated, reliable, and feasible questionnaire designed specifically for evaluating QOL in meningioma patients. This disease-specific questionnaire will be fundamentally helpful in better understanding and capturing HRQOL in the meningioma patient population and can be used in both clinical and research settings.

Development and Validation of a Set of Patient Reported Outcome Measures to Assess Effectiveness of Asthma Prophylaxis

Background: Several asthma patient reported outcome measures (PROMs) have been developed in developed countries. Since social and cultural differences may indirectly influence the PROM therefore, this study has been carried out in Northern Sri Lanka to develop an Asthma Control PROM (AC-PROM) Tamil in the local context. Methods: The AC-PROM Tamil was developed in 3 steps: item generation, item reduction and psychometric evaluation as guided by the USA Food and Drug Administration. Items were generated through thematic analysis from six focus group discussions among patients with asthma. Items were generated in Tamil and English Languages. A clinician and a clinical pharmacologist refined the items to suit the cultural context. Items were converted to an interviewer administered questionnaire in Tamil in the format of 5–point Likert scale. Item reduction was done by two rounds of online Delphi surveys among 10 experts and an exploratory factor analysis among 200 patients with asthma. Thus developed AC-PROM Tamil was assessed by experts for face and content validity. Criterion validity was evaluated against the forced expiratory volume in one second of 187 patients with asthma. Cut-off value for PROM to assess the asthma control was determined by receiver operating characteristic curve. Reliability was verified by Cronbach’s alpha coefficient. Results: From thematic analysis of FGD 10 items were generated and these items were refined and subjected to item reduction. During Delphi survey out of 10 items, one was removed. In exploratory factor analysis another one item was removed and remaining 8 items were categorised under 2 factors. Cronbach’s alpha coefficient for AC-PROM Tamil was 0.904, which indicated good reliability. Clarity and relevance of the content of the items were confirmed by the experts. Criterion validity was demonstrated significant correlation between AC-PROM Tamil and forced expiratory volume in one second (r = 0.66, p = 0.001). Cut-off value of AC-PROM Tamil to detect asthma control was 28.5 with sensitivity (79%) and specificity (71%). The AC-PROM Tamil has moderate accuracy (AUC =0.796; 95% CI: 0.73-0.86). Response rate of the AC-PROM Tamil was 100% with no missing data and time taken to complete the PROM was 3-4 minutes. Conclusion: The AC-PROM Tamil is a simple, reasonably accurate, reliable, objective and valid tool to assess effectiveness of asthma control in Tamil speaking patients during clinical practice and researches.