Innovative use of a standardized debriefing guide to assist in the development of a research questionnaire with low literacy demands

Prevalence and impact of low literacy has resulted in greater attention to developing written materials at lower reading levels for both patient education and research. The purpose of this study was to develop and evaluate how well a research questionnaire about self-management preferences, intentionally developed as a tool for individuals with low literacy skills, performed. The investigators created a standardized debriefing guide to evaluate comprehension and ease of instrument completion to accompany the administration of the Conventional and Alternative Management for Asthma (CAMA) instrument. The use of a standardized debriefing guide following cognitive interviewing techniques, allowed for the identification of problematic words, unclear meanings and confusion over scaling despite a deliberate attempt to develop a tool with low literacy demands. Such approaches might be considered critically important to insure the accuracy of patient-reported outcomes when self-administered tools are used to collect research and clinical data.