Applying an Expanded Set of Cognitive Design Principles to Formatting the Kidney Early Evaluation Program (KEEP) Longitudinal Survey

College of Pharmacy, Health Professions Division, Nova Southeastern University, Fort Lauderdale, FL 33314-7796, USA.
American Journal of Kidney Diseases (Impact Factor: 5.9). 05/2008; 51(4 Suppl 2):S83-92. DOI: 10.1053/j.ajkd.2008.01.008
Source: PubMed


The National Kidney Foundation Kidney Early Evaluation Program (KEEP) is a free community-based health-screening program targeting populations at greatest risk of chronic kidney disease (CKD), those with high rates of diabetes and hypertension, and a high proportion of racial/ethnic minorities. The KEEP Longitudinal Survey will adopt methods similar to those used in KEEP to gather follow-up data to measure CKD-related heath status and gauge program effectiveness for repeated KEEP participants with evidence of CKD stages 3 to 5. KEEP has defined objectives to enhance follow-up survey response rates and target vulnerable populations who bear the greatest CKD risk-factor burdens.
The KEEP Follow-up Form was assessed for adherence to 6 cognitive design principles (simplicity, consistency, organization, natural order, clarity, and attractiveness) considered to summate the techniques guiding good survey development and for the additional cognitive design principles of readability and variation of readability across survey items.
The KEEP Follow-up Form was found to include violations of each cognitive design principle and readability principle, possibly contributing to item nonresponse and low follow-up rates in KEEP. It was revised according to empirically substantiated formatting techniques guided by these principles and found during qualitative assessment to be more user friendly, simpler, better organized, more attractive, and easier to read. Subsequent development of the KEEP Longitudinal Survey form also was guided by these principles.
To ensure ease of use by populations with limited literacy skills, poor health literacy, and limited survey literacy, survey researchers must apply cognitive design principles to survey development to improve participation and response rates.

Download full-text


Available from: Erik S Fleming,
36 Reads
  • [Show abstract] [Hide abstract]
    ABSTRACT: The growing interest in patient empowerment in chronic diseases underlines the importance of assessing patients' opinions in planning healthcare strategies. Focus groups are flexible tools for investigating innovative aspects of care. The aim of the study was to use a focus group to define the main requirements for a chronic kidney disease (CKD) outpatient care unit. The focus group met during the opening of a new CKD outpatient facility. It consisted of 12 patients with long-term experience of CKD, dialysis and transplantation; they had been followed previously by the senior physician, who moderated the discussion. The discussion was tape-recorded and the results were summarized and approved by all participants. The group made 10 major suggestions: 1. Therapeutic continuity in all disease phases, from pre-dialysis to transplantation; 2. Possibility to choose the reference physician; 3. Strict integration with the nursing activities; 4. Organizational flexibility, to adapt to the needs of daily life; 5. To be "fully" taken care of, with organizational support for blood tests, imaging and consultations; 6. Need for time with the reference physician in critical phases of the disease; 7. Identification of a network of consultants, in keeping with the need for continuity of care; 8. Educational sessions; 9. Meetings for critical discussion of organizational performances; 10. As a setting: a home for the disease and not a disease to take home. Continuity of care and flexibility of organization, allowing time for education and discussion, are the quality requirements of our CKD patients.
    Journal of nephrology 04/2010; 23(6):699-704. · 1.45 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Underutilization of screening mammography by Latinas continues unabated and may contribute to disparities in disease-free survival and mortality. Comparison of two discussion group-centered educational interventions at enhancing breast cancer knowledge, breast self-exams (BSE), and screening mammography. Pre-test post-test study design. Two cohorts of 200 Latinas each participated in survey screening and discussion groups at baseline. One cohort also viewed an animated video and had BSE training. Breast cancer knowledge, self-reported BSE and mammography history were measured at baseline and three months post-intervention. Breast cancer knowledge scores were good for both groups at baseline, and significantly increased at three month follow-up for both groups (p<.05) but no significant difference was observed between groups at baseline or post-intervention. Community-based discussion groups are a cost-effective method for improving breast cancer knowledge and promoting screening behaviors.
    Journal of Health Care for the Poor and Underserved 08/2010; 21(3 Suppl):76-90. DOI:10.1353/hpu.0.0364 · 1.10 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Scientific language contains features that may impede understanding for non-scientists. Forensic scientists’ written reports are read by police, lawyers, and judges, and thus assessment of readability is warranted. Past studies of readability differed in background theory and approach, but analysed one or more of: content and sequence; language; and format. Using a holistic approach, we assessed the readability of expert reports (n = 78) of forensic glass comparison from 7 Australian jurisdictions. Two main audiences for reports were relevant: police and the courts. Reports for police were presented either as a completed form or as a brief legal-style report. Reports for court were less brief and used either legal or scientific styles, with content and formatting features supporting these distinctions. Some jurisdictions prepared a single report to satisfy both the courts and police. In general, item list, analytical techniques, results, notes on interpretation, and conclusions were included in reports of all types. However, some reports omitted analytical techniques, and results and conclusions were sometimes combined. According to Flesch Reading Ease, language was difficult, with a Flesch–Kincaid grade level of university undergraduate. Sentences were long and contained undefined specialist terms. Information content per clause (lexical density), was typically high, as for other scientific texts. Uncertainty was expressed differently by jurisdiction. Reports from most jurisdictions were cluttered in appearance, with single-line spacing, narrow margins, and gridlines in tables. Simple suggestions, based on theory and past research, are provided to assist scientists to enhance the readability of expert reports for non-scientists.
    Forensic Science International 03/2014; 236:54-66. DOI:10.1016/j.forsciint.2013.12.031 · 2.14 Impact Factor

Similar Publications