Article

PURPOSE: To enable an existing survey on primary care so that it can be used to
assess the healthcare experiences reported by adults living with disabilities,
and to evaluate its properties. METHODS: Mixed-methods study. We first identified
content areas for measurement as compared to the items in the existing instrument
and then developed new candidate items. Cognitive testing was conducted in
English and Spanish. After revisions to the primary care instrument based on the
cognitive testing results, the draft-enabled instrument was field-tested by mail
with telephone follow-up, in English and Spanish. RESULTS: Consumer focus groups
and a technical expert panel identified eight content areas in primary care that
are particularly important to maximise function and well-being of people of with
disabilities. Cognitive testing also revealed serious problems with several items
in the existing survey when answered by or about people with disabilities. Field
testing yielded 1086 surveys, of which 40% were completed by a proxy respondent.
Learning disabilities were reported by 38% of respondents. Item non-response for
revised and new questions was less than 4%. CONCLUSIONS: It is feasible to enable
a survey of primary care and its administration. Survey administration
instructions should be modified to accommodate proxy respondents. The screener
item to identify people with mobility impairments on walking a distance should be
replaced with walking for 6 min. Adding questions from the American Community
Survey about functional ability will allow survey sponsors to identify
respondents with various limitations, and to compare their experiences to those
of people with no limitations. Careful development and testing of the items with
input from interested parties throughout the design and testing stages yielded a
survey with good psychometric properties and content validity in multiple
languages. Health delivery systems can use the survey data to identify clinical
processes needing improvement to provide high quality care for people with
disabilities.

Langue : ANGLAIS