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Determining Content Validity of a Self-Report Instrument for Adolescents Using a Heterogeneous Expert Panel

Schilling, Lynne S.; Dixon, Jane K.; Knafl, Kathleen A.; Grey, Margaret; Ives, Brett; Lynn, Mary R.

doi: 10.1097/01.NNR.0000289505.30037.91

Background: The use of experiential experts, especially children and adolescents, in content validity evaluations of new instruments has not been described well.

Objective: To describe the use of experiential experts in a content validity evaluation of a new instrument.

Methods: Experiential (adolescents and parents, n = 11) and professional (diabetes clinicians and researchers, n = 17) expert judges evaluated the content validity of a new instrument that measures self-management of Type 1 diabetes in adolescents. The content validity index for each of 99 items (I-CVIs) for the total group of experts (n = 28; I-CVI-ALL) and for the experiential experts only (I-CVI-EXPERIENTIAL) were calculated, respectively, and both were used to inform decisions about whether to retain, eliminate, or revise each item.

Results: There were 20 items where the I-CVI-ALL was ≥.80 and the I-CVI-EXPERIENTIAL was <.80. Each of these 20 items was evaluated critically. Some were retained (n = 3), some were eliminated (n = 7), and some were revised as suggested by the experts (n = 10).

Discussion: Using experiential content validity experts (adolescents and parents) and critically evaluating their recommendations regarding items can result in further elimination and revision of items beyond what is suggested by content validity assessment done by professional experts. The result may be a more thorough content validity assessment of the instrument, leading to an instrument with greater relevance for the target population.

Lynne S. Schilling, PhD, RN, is Professor, Associate Dean for Research, and Director of the PhD Program, Graduate School of Nursing, University of Massachusetts, Worcester.

Jane K. Dixon, PhD, is Professor; Margaret Grey, DrPH, RN, FAAN, is Dean and AnnieGoodrich Professor, School of Nursing, Yale University, New Haven, Connecticut.

Kathleen A. Knafl, PhD, FAAN, is Elizabeth N. Gray Distinguished Professor and Professor and Senior Associate Dean for Research and Faculty Affairs, Oregon Health and Sciences University, Portland.

Brett Ives, MSN, RN, is Diabetes Nurse Practitioner, Yale Pediatric Diabetes Program, New Haven, Connecticut.

Mary R. Lynn, PhD, RN, is Associate Professor, School of Nursing, University of North Carolina at Chapel Hill.

Accepted for publication June 8, 2007.

This research was supported by a grant from the National Institutes of Health, National Institute of Nursing Research, R01NR08579.

Corresponding author: Lynne S. Schilling, PhD, RN, Graduate School of Nursing, University of Massachusetts, Worcester, 55 Lake Avenue North, Worcester, MA 01655 (e-mail:

© 2007 Lippincott Williams & Wilkins, Inc.