Nápoles-Springer Anna M, Santoyo-Olsson Jasmine, O'Brien Helen, Stewart Anita L
Medical Effectiveness Research Center for Diverse Populations and the Center on Aging in Diverse Communities, University of California at San Francisco, San Francisco, California 94118-1944, USA.
Med Care. 2006 Nov;44(11 Suppl 3):S21-30. doi: 10.1097/01.mlr.0000245425.65905.1d.
Conceptual equivalence of measures is essential in research that compares health across diverse racial/ethnic groups. Cognitive interviews are pretest methods to explore the conceptual equivalence of survey items. Systematic approaches for using these methods are emerging.
We describe an interaction analysis (IA) approach using qualitative data analysis software to analyze transcripts of cognitive interviews in a study to develop a survey instrument of the quality of interpersonal processes of care of diverse patients. Cognitive interviews included standard administration of the survey followed by retrospective probes for selected items.
Interviews were completed with 48 Latino, black, and non-Latino white respondents 18 years of age or older with at least one doctor's visit in the past 12 months. Participants averaged 45.8 years in age (standard deviation [SD] = 18.4), 58% were women, and mean education was 14.7 years (SD = 4.0).
Problems were identified in 126 of 159 items (79%). Behavior coding identified 32 problematic items (20%). IA of the transcript of the survey and retrospective probes identified 94 additional problematic items (59%). IA often revealed the nature of the problems, enabling decisions to modify or drop items based on respondents' comments. Behavior coding and IA identified ethnic and language similarities and differences in the use of response sets and the interpretation of items.
IA and behavior coding of cognitive interview transcripts can identify efficiently problems with items and their source to increase the likelihood of the revised items being conceptually equivalent across ethnic groups.
在比较不同种族/族裔群体健康状况的研究中，测量指标的概念等效性至关重要。认知访谈是探索调查项目概念等效性的预测试方法。使用这些方法的系统方法正在兴起。
我们描述了一种交互分析（IA）方法，该方法使用定性数据分析软件来分析一项研究中认知访谈的转录本，该研究旨在开发一种针对不同患者人际护理过程质量的调查工具。认知访谈包括对调查问卷的标准施测，随后对选定项目进行回顾性探查。
对48名18岁及以上的拉丁裔、黑人及非拉丁裔白人受访者进行了访谈，这些受访者在过去12个月中至少有一次看医生的经历。参与者的平均年龄为45.8岁（标准差[SD]=18.4），58%为女性，平均受教育年限为14.7年（SD=4.0）。
159个项目中的126个（79%）存在问题。行为编码识别出32个有问题的项目（20%）。对调查问卷转录本和回顾性探查的交互分析又识别出94个有问题的项目（59%）。交互分析常常揭示问题的本质，从而能够根据受访者的评论决定修改或删除项目。行为编码和交互分析识别出了不同种族和语言在回答集使用及项目解释方面的异同。
对认知访谈转录本进行交互分析和行为编码能够有效识别项目问题及其根源，从而增加修订后的项目在不同种族群体中概念等效的可能性。
