Item Content Research Articles

한국 대중음악에서의 B급 문화 분석 연구

The purpose of this paper is to study B-class culture in Korean popular music. B-class identity as a subculture was examined, observing the changes in B-class music since the 2000s, and cultural diversity was discussed. Following the literature review, Psy, Norazo, and UV were selected as research subjects. The external items of capital, popularity, and intentionality and the internal items of language, content, format, behavior, and image characteristics were analyzed deductively through NVivo 14. As a result, Psy's music carried B-class features in terms of language, behavior, and image, and Norazo and UV's music had them in all internal aspects. Those meanings have all been transferred to a reconceptualized B-class. They were subordinated to large capital or the mainstream system, and the consumer base expanded from the minority to the majority. Moreover, resistance has weakened and was replaced by interest. The B-class mainstreaming passed through a latent and transitional period in the 2000s and settled on one side of the popular culture in the 2010s, facing the authenticity issue. Opinions on diversifying music culture were presented, with the claims for recovery of the rights of musical cultural subjects and resolution of the imbalance in music culture.

SYSTEMATIC LITERATUR RIVIEW: ASESMEN KOMPETENSI MINIMUM (AKM) PADA DOMAIN BILANGAN

The Minimum Competency Assessment (AKM) is an assessment designed to measure the literacy and numeracy skills needed by all students in developing themselves and actively participating in society and to prepare students to face the 21st century. The urgency of developing math learning outcomes assessment questions by teachers or educators it is deemed necessary to prepare students to face various literacy tests both on a national and international scale. This development resulted in a variation of 4 items for number content with ascientific, cultural, and personal context. The questions developed are in the form of multiple choice and complex multiple choice which ask for evidence/reasons in answering the questions. The questions developed are valid based on the validity of the content carried out by fellow teachers. This development provides a variety of AKM practice questions and initial ideas for developing meaningful assessment of learning outcomes in a particular context.

Validity, reliability, and item characteristics of cell material science literacy assessment instruments

This study aims to examine the validity, reliability, and item characteristics of scientific literacy assessment instruments on cell material. The scientific literacy ability category includes identifying valid scientific arguments, evaluating the validity of a source, evaluating the use and misuse of scientific information, understanding research design elements and how they impact scientific findings, and reading and interpreting graphical representations of data. The research subjects were students of the 5th semester elementary school teacher education study program. The validity test included content validity using Aiken V validity index and construct validity using Exploratory Factor Analysis (EFA). Reliability test is carried out by looking for the price of the reliability coefficient r with correlation product moment test. The characteristic test is carried out by determining the level of difficulty and discriminating power. The results show that the scientific literacy assessment instrument on cell material is a valid instrument based on the analysis of content validity, construct validity, and item characteristics. Thus, the assessment instrument is suitable for use as an assessment instrument in research to measure students' scientific literacy in cell material.

Development of Digital Transformation Instruments and Partnership For MSMEs in Denpasar City

SMEs are a type of industry that is more customer focused and have better opportunities if supported by the use of digitalization transformation and collaboration with partnerships that can provide support for the development of an SME. This research was conducted to analyze the digital transformation and partnership questionnaire in SMEs. Method: The questionnaire will be analyzed using validity and reliability tests, where validity tests include content validity, face validity, Focus Group Discussion and construct validity. The number of respondents in the validity test was 5 respondents and 30 respondents in the reliability test. The results of the questionnaire analysis in the content validity analysis test were declared valid with an items content validity index (1-CVI) value of ≥ 0.78. In the results of face validation, it was found that the statement items in the questionnaire described the construct well. The results obtained after the focus group discussion process were that the majority of panelists agreed on the statements made with a minimum value of 2 which means "easy to understand" and a maximum value of 3 which means "very easy to understand". The number who got a score of 2 (easy to understand) was 25% and the number who got a score of 3 (very easy to understand) was 75%. The reliability test obtained a Cronbach alpha value of 0.940; So according to table 4 above, this value means Very Reliable and suitable to be distributed to respondents. From the results of the table analysis, all question items are reliable. The instruments analyzed in this research, namely the digitalization transformation and partnership instruments, can be categorized as valid and reliable instruments so they can be used as research tools.

A novel application of a self-report comprehensive assessment: Where do telephone assessments fit in home care practice?

Introduction: In Canada, long-stay home care patients are a prevalent group of frail older adults living in the community. Home care patients have a high emergency department visit rate compared to those living independently without formal home care services. In March 2020, concerted efforts were put into place to reduce COVID-19 transmission and spread in health sectors, including older adult home care populations.
 Description: The interRAI home care (HC) assessment is the practice standard for face-to-face comprehensive assessments in home care. The interRAI Check Up is a comprehensive self-report assessment that can be completed in-person, by video call or telephone. Check Up assessment items are consistent with the content items of interRAI HC. During pandemic mandated restrictions, care coordinators used the Check Up to assess new and existing patients over the phone or by video call to ensure continuity of care. Feasibility and utility of the Check Up was evaluated through a staff survey and focus groups in two distinct regions of Ontario.
 Discussion: A total of 48 care coordinators completed the survey, of which 7 consented to provide feedback in the focus groups. Care coordinators found the Check Up easy to pivot to during the pandemic, citing familiarity with questions and risk algorithms. The Check Up results were helpful in gaining an understanding of the patient’s medical issues, functional status, mood, and informal supports, while telephone and video assessments saved travel time. According to the care coordinators, patients and informal care givers were comfortable answering the questions over the phone and appreciative of interaction with a health professional. Although care coordinators were accustomed to telephone check ins, language barriers, hearing impairment, and inability to see the home environment were limitations. Care coordinators found telephone assessments, using the Check Up, most beneficial in the absence of cognitive impairment and with patients previously known and assessed by the care coordinator. 
 Conclusion: The interRAI Check Up was an efficient method of completing a comprehensive assessment over the phone. Care coordinators found the Check Up to be best suited for reassessments and as a new assessment with stable, cognitively intact patients. Our findings support use of the interRAI Check Up as a promising and feasible addition to the suite of tools for home care coordination.

Examination of response time effort in TIMSS 2019: Comparison of Singapore and Türkiye

In this paper, it is aimed to evaluate different aspects of students' response time to items in the mathematics test and their test effort as an indicator of test motivation with the help of some variables at the item and student levels. The data consists of 4th-grade Singapore and Turkish students participating in the TIMSS 2019. Response time was examined in terms of item difficulties, content and cognitive domains of the items in the mathematics test self-efficacy for computer use, home resources for learning, confident in mathematics, like learning mathematics, and gender variables at the student level. In the study, it was determined that all variables considered at the item level affected the response time of the students in both countries. It was concluded that the amount of variance explained by the student-level variables in the response time varied for each the country. Another finding of the study showed that the cognitive level of the items positively related to the mean response time. Both Turkish and Singaporean students took longer to respond to data domain items compared to number and measurement and geometry domain items. Additionally, based on the criterion that the response time effort index was less than .8, rapid-guessing behavior, and therefore low motivation, was observed below 1% for both samples. Besides, we observed that Turkish and Singaporean students were likely to have rapid guessing behavior when an item in the reasoning domain became increasingly difficult. A similar result was identified in the data content domain, especially for Turkish graders.

A Novel Scale for Evaluating Digital Readiness toward Earthquakes: A Comprehensive Validity and Reliability Analysis

New digital technology trends have the potential to mitigate the effects of earthquakes and improve response and recovery efforts such as earthquake prediction, emergency call-out, and earthquake location notification. Earthquake readiness makes it necessary to have a digitally prepared society. However, no scale has been found in the literature that can measure the digital attitudes and skills of individuals regarding earthquakes. For this reason, to fill this gap in the literature, this descriptive research study aimed to develop an original, valid, and reliable scale to determine the digital readiness of individuals toward earthquakes. Data were collected from 621 adult individuals with different socioeconomic characteristics using the convenience sampling method. An item pool was created through a comprehensive literature review, followed by a series of analyses encompassing content validity, construct validity, convergent validity, discriminant validity, criterion-related validity, reliability analysis, and item analysis in the course of the scale’s development process. For the digital readiness toward earthquakes, the Draft scale, with 21 items remaining, a KMO value (0.894), and a Bartlett sphericity test result of χ2 (91) = 2407.76 (p < 0.001) showed the suitability of the data for exploratory factor analysis (EFA). As a result of the EFA, 14 items were categorized into two dimensions based on whether their eigenvalues exceeded 1. The explained variance was 46.823% (eigenvalue = 6.555) in the first factor, while it was 12.832% (eigenvalue = 1.796) in the second factor, and the total variance was 59.655%. After analyzing the scale’s items within these dimensions, the first dimension was named “Technological Skills”, comprising eight items, and the second dimensions was named “Digital Attitudes”, consisting of six items. The factor loadings for these items ranged from 0.562 to 0.900. Confirmatory factor analysis (CFA) affirmed the factorial structure identified by the EFA. For the five-point Likert-type Digital Readiness toward Earthquakes scale, named the DRE scale, with 14 items after validity analyses, Cronbach’s alpha value was obtained as 0.910, demonstrating high internal consistency. Cronbach’s alpha values of the two factors were 0.910 for the “Technological Skills” dimension and 0.837 for the “Digital Attitudes” dimension. It was concluded that the developed scale is a valid and reliable measurement in evaluating the digital readiness of individuals toward earthquakes.

Analysis of the residual effect using neuromarketing technology in audiovisual content entrepreneurship

Considering the informational overwhelm of the last few years and given the rise in new entrepreneurship of communication means, the optimization of commercial communication's marketing has become one of the primary objectives of marketing strategy. The quantitative computation of the number of impacts has been rendered insufficient for evaluating and planning a communication campaign. Strategic planning relies on increasingly more precise models for determining the desired formula. These models do not typically take the physiological parameter essential to decision-making into account: emotion. The technologies applied to the new methodologies that neuromarketing brings rely on great support from theorists and professionals, even though hardly any studies that center on strategic planning media exist. In this study, we present an analysis of the residual effect and the distortion of erroneous attribution stemming from neuromarketing's own technologies with the objective of analyzing the influence of adjacent content items on the subject's decision-making process. Cross-technologies were used: EEG and GSR, with the goal of analyzing the subject's emotional activation and motivation. The results demonstrate an emotional dragging effect and the appearance of bias of attribution with very significant values in every case, showing notable differences regarding the nature and polarity of emotions.

TRAFNOŚĆ TREŚCIOWA WYBRANYCH POZYCJI Z KWESTIONARIUSZA <i>SPEECH, SPATIAL AND QUALITIES OF HEARING</i> <i>DLA RODZICÓW</i> (SSQ-P) ZMIERZONA W BADANIU OPINII EKSPERTÓW

IntroductionThe purpose of this small-scale study was to assess the content validity of a modified subset of ten items from the <i>Speech, Spatial and Qualities of Hearing Scale for Parents</i> (SSQ-P) via a survey of expert opinion.Material and methodsAn online survey was used to obtain opinions from 10 experts in the field of children’s hearing and hearing assessment. Experts were asked to rate the relevance and representativeness of each SSQ-P item to deaf and hard of hearing children aged 5 years and over. Content validity was assessed by the item content validity index (ICVI), with excellent content validity identified as an ICVI above 0.8. Experts were also asked to suggest where they felt the wording of items could be improved.ResultsFor all items, ICVIs > 0.8 were obtained for both relevance and representativeness, indicating excellent content validity. Some minor rewording suggestions were made.ConclusionsThe 10 items tested are candidates for inclusion in an abbreviated version of SSQ-P. Some minor rewording of items may be required, along with assessment of internal consistency and test–retest stability.

DEVELOPMENT AND VALIDATION OF THE COUPLE EFFICACY TO BALANCE WORK AND ELDERCARE SCALE

Abstract This study developed and validated a measure of couple efficacy to balance work and eldercare (i.e., a couple’s shared belief in their conjoint abilities to achieve work-eldercare balance as a couple), a key cognitive factor for work-eldercare arrangements, individual well-being, and work and couple outcomes. Survey data were collected from 408 dual-earner couples in Taiwan who care for an older adult. Exploratory factor analysis identified three factors with eigenvalues greater than 1, but parallel analysis suggested extracting two factors. After considering item contents and factor loadings, a final 2-factor scale comprising 10 items was selected. The first dimension, task-oriented, reflects couple efficacy concerning the execution of various tasks to balance paid work and eldercare (e.g., “I am confident that my spouse/partner and I can work together as a team to devote enough attention to important job and eldercare activities”; α=.81). The second dimension, relationship-oriented, reflects couple efficacy concerning the maintenance of intimate relationship while balancing paid work and eldercare (“I am confident that my spouse/partner and I can work together as a team to support each other in times of stress in trying to balance paid work and eldercare”; α=.87). Confirmatory factor analysis indicated that a hypothesized 2-factor outperforms an alternative 1-factor model. The nomological network involving generalized self-efficacy and life/job/marital satisfaction supported the validity of the new scale. This study contributes to the literature by introducing a new construct and offering a psychometrically sound measure that propels more empirical research on the important population of working informal caregivers.

Detecting non-content-based response styles in survey data: An application of mixture factor analysis

It is common for some participants in self-report surveys to be careless, inattentive, or lacking in effort. Data quality can be severely compromised by responses that are not based on item content (non-content-based [nCB] responses), leading to strong biases in the results of data analysis and misinterpretation of individual scores. In this study, we propose a specification of factor mixture analysis (FMA) to detect nCB responses. We investigated the usefulness and effectiveness of the FMA model in detecting nCB responses using both simulated data (Study 1) and real data (Study 2). In the first study, FMA showed reasonably robust sensitivity (.60 to .86) and excellent specificity (.96 to .99) on mixed-worded scales, suggesting that FMA had superior properties as a screening tool under different sample conditions. However, FMA performance was poor on scales composed of only positive items because of the difficulty in distinguishing acquiescent patterns from valid responses representing high levels of the trait. In Study 2 (real data), FMA detected a minority of cases (6.5%) with highly anomalous response patterns. Removing these cases resulted in a large increase in the fit of the unidimensional model and a substantial reduction in spurious multidimensionality.

Development and validation of Simulation Scenario Quality Instrument (SSQI)

BackgroundDue to the unmet need for valid instruments that evaluate critical components of simulation scenarios, this research aimed to develop and validate an instrument that measures the quality of healthcare simulation scenarios.MethodsA sequential transformative mixed-method research design was used to conduct the study. The development and validation of the instrument involved two phases: the qualitative phase, which included defining the instrument's theoretical background and instrument construction, followed by the quantitative phase, where the instrument was piloted and validated. The qualitative study included 17 healthcare simulation experts, where three focus group was conducted, and the first version of the instrument was constructed based on the focus group analysis and the theoretical framework constructed using the literature review. During the quantitative phase, the instrument’s quantitative piloting included 125 healthcare simulation scenarios; then, the instrument went through construct validity and reliability testing.ResultsContent experts confirmed the theoretical model and instrument framework. The average item content validity index (I-CVI) scores and the average of the I-CVI scores (S-CVI/Ave) for all items on the scale or the average proportion relevance judged by all experts was 0.87. The conformity factor analysis results showed a good fit for the proposed 10-factor model (CFI (the comparative fit index) = 0.998, Tucker-Lewis index = 0.998, Root mean square error of approximation (RMSEA) = 0.061. The final instrument included ten domains: 1. Learning objectives, 2. Target group, 3. Culture, 4. Scenario case, 5. Scenario narrative briefing, 6. Scenario complexity, 7. Scenario flow, 8. Fidelity, 9. Debriefing, and 10. Assessment. The SSQI included 44 items that are rated on a 3-point scale (Meets Expectations = (2), Needs Improvement, (1), Inadequate (0)).ConclusionThis validated and reliable instrument will be helpful to healthcare educators and simulation experts who want to develop simulation-based training scenarios and ensure the quality of written scenarios.

Measuring in-hospital quality multidimensionally by integrating patients’, kin’s and healthcare professionals’ perspectives: development and validation of the FlaQuM-Quickscan

BackgroundMeasuring quality is essential to drive improvement initiatives in hospitals. An instrument that measures healthcare quality multidimensionally and integrates patients’, kin’s and professionals’ perspectives is lacking. We aimed to develop and validate an instrument to measure healthcare quality multidimensionally from a multistakeholder perspective.MethodsA multi-method approach started by establishing content and face validity, followed by a multi-centre study in 17 Flemish (Belgian) hospitals to assess construct validity through confirmatory factor analysis, criterion validity through determining Pearson’s correlations and reliability through Cronbach’s alpha measurement. The instrument FlaQuM-Quickscan measures ‘Healthcare quality for patients and kin’ (part 1) and ‘Healthcare quality for professionals’ (part 2). This bipartite instrument mirrors 15 quality items and 3 general items (the overall quality score, recommendation score and intention-to-stay score). A process evaluation was organised to identify effective strategies in instrument distribution by conducting semi-structured interviews with quality managers.ResultsBy involving experts in the development of quality items and through pilot testing by a multi-stakeholder group, the content and face validity of instrument items was ensured. In total, 13,615 respondents (5,891 Patients/kin and 7,724 Professionals) completed the FlaQuM-Quickscan. Confirmatory factor analyses showed good to very good fit and correlations supported the associations between the quality items and general items for both instrument parts. Cronbach’s alphas supported the internal consistency. The process evaluation revealed that supportive technical structures and approaching respondents individually were effective strategies to distribute the instrument.ConclusionsThe FlaQuM-Quickscan is a valid instrument to measure healthcare quality experiences multidimensionally from an integrated multistakeholder perspective. This new instrument offers unique and detailed data to design sustainable quality management systems in hospitals. Based on these data, hospital management and policymakers can set quality priorities for patients’, kin’s and professionals’ care. Future research should investigate the transferability to other healthcare systems and examine between-stakeholders and between-hospitals variation.

Instruments for measuring self-management and self-care in geriatric patients - a scoping review.

With demographic changes, prioritizing effective care for geriatric patients to maintain functionality, independence, and quality of life is crucial. Well-developed self-management or self-care abilities, which can be maintained and improved through interventions, are of the utmost importance. To implement these interventions tailored and effectively, a thorough assessment of the individual's self-management and self-care abilities is required. This scoping review aimed to identify self-management and self-care instruments suitable for geriatric patients, their underlying theories and definitions of self-management and self-care, and their similarities and differences in item content. A systematic search of the PubMed and CINAHL databases was conducted to identify retrievable full-text articles published in English in the medical and nursing fields since the 1970s, which were validated on a sample with an average age of at least 70 years, used generic rather than disease-specific items, and addressed the broad range of self-management and self-care abilities. Of the 20 included articles, six instruments were identified that were based on different theories and offered varying definitions of self-management or self-care. Despite these differences, all emphasize empowered individuals taking an active role in their care. Most address actual behavior and abilities referring to lifestyle factors and (anticipated) adjustment behavior. However, crucial aspects, such as psychological factors, (instrumental) activities of daily living, and social environment are not fully addressed in these instruments, nor are the types of execution to which the items refer, such as wants, feelings, confidence, or attitudes. To fully understand how geriatric patients implement daily self-management or self-care, a combination of instruments covering the important factors of self-management and self-care and addressing multiple types of item execution, such as behaviors, abilities, wants, or attitudes, is recommended. This review provides the first comprehensive overview of self-management and self-care instruments suitable for geriatric patients.

Validity and reliability of the Arabic version of knowledge, attitudes, and practices toward COVID-19 preventative behaviors (KAP COVID-19).

Even though the innovation of COVID-19 vaccination effectively protects against the virus, practicing preventative behaviors is still essential. However, public adherence to preventive behaviors relies mainly on the individuals' knowledge, attitudes, and practices (KAP) toward COVID-19 preventative behaviors. Therefore, it is crucial to evaluate these aspects. Nevertheless, there is no validated scale that assesses KAP toward COVID-19 preventative behaviors. To evaluate the psychometric properties of the Arabic version of knowledge, attitudes, and practices toward coronavirus disease 2019 (COVID-19) preventative behaviors. A quantitative descriptive cross-sectional design was used to develop and evaluate the psychometric properties of KAP through specific stages: item development, face, content, convergent and construct validity evaluation, and internal consistency. Data were collected online through "google forms" from June 2020 to July 2020. Both exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to assess the construct validity. A total of 1,363 participants completed the scale. The overall Cronbach's alpha was 0.83, indicating good internal consistency. Exploratory factor analysis supported structural validity for all the scale items with KMO 0.78, 0.60, and 0.81, respectively, and Bartlett's Test of Sphericity = (p < 0.05). Convergent validity was confirmed by a moderate correlation between the KAP scale items, knowledge ranging from r = 0.11 (p < 0.01) to r = 0.62 (p < 0.01), attitude ranging from r = 0.158 (p < 0.01) to r = 0.584 (p < 0.01), and practice ranging from r = 0.383 (p < 0.01) to r = 0.774 (p < 0.01). The psychometric properties of the scale indicate that the KAP is a valid and reliable scale that can be utilized to evaluate the level of KAP toward COVID-19 preventative behaviors among the population in Saudi Arabia.

Development and psychometric evaluation of an Azerbaijani-Turkish grammar comprehension test

Due to the lack of appropriate developmental language tests in the Azerbaijani-Turkish language, the present study aimed to develop the Azerbaijani-Turkish grammar comprehension test (ATGCT) for children aged 4–6 years and determine its validity and reliability. This study was conducted in three phases. First, the target grammatical structures were extracted during the item generation phase. Second, item reduction and content validity ratio (CVR) were calculated. The content validity index (CVI) was determined after designing the items. This test was administered to typically developing children (TD) (N = 30). Face validity was confirmed and modifications were applied. The second version of the test was performed on 170 TD and 60 children with developmental language disorder (DLD) aged 4–6 years were selected using the random cluster method. Third, item analysis was performed, and eight items were removed. The construct validity, reliability, and ROC analysis of the final form of the test were evaluated. The psychometric properties considered in the study included construct validity (group, gender, and age discriminative validity) and reliability (test–retest, inter-rater, and internal consistency). The final test version contained 56 items and confirmed face validity. The Scale Content Validity was .91, and the Item Content Validity was between .8 and 1. The test showed a content validity ratio of .96, indicating that it assesses appropriate content. The construct validity analysis revealed significant differences between the TD and DLD groups and among the four age groups. Test–retest and inter-rater reliability were significantly correlated. Furthermore, the high correlation between test items (ICC= .90) demonstrated that the ATGCT had excellent internal consistency. The receiver operating characteristic (ROC) analysis results indicated that the test had high sensitivity and specificity in all four age groups and effectively distinguished children with TD and those with DLD. In conclusion, based on the psychometric assessment of the test, it appears that the ATGCT has appropriate values for reliability and validity measures, and it can be used as the first suitable and quick test by researchers and clinicians.

From screen to bench: unpacking the shifts in chemistry learning experiences during the COVID-19 transition

Abstract This research comprehensively analyzes students’ Chemistry Learning Experience (CLE) during the COVID-19 pandemic, comparing online learning experiences with traditional face-to-face instruction in the post-pandemic phase. Employing a quantitative approach and leveraging the Rasch model, the study focuses on capturing the nuances of individual student perceptions, an aspect often overlooked in group-centric statistical analyses. One hundred students (49 males and 51 females) participated in both study phases. Segmented into behavioral tendencies, content perceptions, and specific learning needs, the evaluation tools provided insights into the students’ CLE across the two instructional modalities. Results from the stacking analysis revealed a positive shift in CLE post-pandemic, with students demonstrating a better grasp of and attitude toward chemistry in face-to-face settings. Racking analysis further underscored the changing difficulty perceptions of specific content items across the two learning environments. Gender-based patterns in CLE were also evident, with male students expressing a more favorable view of online learning during the pandemic than their female counterparts. The research findings advocate for a blended learning approach, harnessing the strengths of both online and traditional instructional methods. Furthermore, insights into gender-specific learning experiences emphasize the need for inclusive and adaptive teaching strategies, ensuring optimal learning experiences for all students. The study underscores educators’ and students’ resilience and adaptability in navigating the challenges of the pandemic. It offers valuable insights for future educational strategies in chemistry education.

Item exposure and utilization control methods for optimal test assembly

Exposure control is an important component of computerized adaptive testing. Exposure control is often used to secure test content by preventing item overexposure, and also to balance item utilization by avoiding item underexposure. Content balancing is another important component of computerized adaptive testing. The shadow-test approach to content balancing has many practical merits, including that it ensures complete satisfaction of all content requirements in every assembled test. Several exposure control methods have been developed over the years. The current study describes modifications to existing exposure control methods for use with shadow-test-based adaptive testing, with the objective of achieving bidirectional exposure control. The performances of the modified methods were compared with respect to item exposure and utilization along with ability estimation accuracy. For the purpose of comparison, a Monte Carlo simulation was performed using realistic item pools and content constraints. Implications for real-world applications are discussed.

User-Centered Development of STOP (Successful Treatment for Paranoia): Material Development and Usability Testing for a Digital Therapeutic for Paranoia.

Paranoia is a highly debilitating mental health condition. One novel intervention for paranoia is cognitive bias modification for paranoia (CBM-pa). CBM-pa comes from a class of interventions that focus on manipulating interpretation bias. Here, we aimed to develop and evaluate new therapy content for CBM-pa for later use in a self-administered digital therapeutic for paranoia called STOP ("Successful Treatment of Paranoia"). This study aimed to (1) take a user-centered approach with input from living experts, clinicians, and academics to create and evaluate paranoia-relevant item content to be used in STOP and (2) engage with living experts and the design team from a digital health care solutions company to cocreate and pilot-test the STOP mobile app prototype. We invited 18 people with living or lived experiences of paranoia to create text exemplars of personal, everyday emotionally ambiguous scenarios that could provoke paranoid thoughts. Researchers then adapted 240 suitable exemplars into corresponding intervention items in the format commonly used for CBM training and created 240 control items for the purpose of testing STOP. Each item included newly developed, visually enriching graphics content to increase the engagement and realism of the basic text scenarios. All items were then evaluated for their paranoia severity and readability by living experts (n=8) and clinicians (n=7) and for their item length by the research team. Items were evenly distributed into six 40-item sessions based on these evaluations. Finalized items were presented in the STOP mobile app, which was co-designed with a digital health care solutions company, living or lived experts, and the academic team; user acceptance was evaluated across 2 pilot tests involving living or lived experts. All materials reached predefined acceptable thresholds on all rating criteria: paranoia severity (intervention items: ≥1; control items: ≤1, readability: ≥3, and length of the scenarios), and there was no systematic difference between the intervention and control group materials overall or between individual sessions within each group. For item graphics, we also found no systematic differences in users' ratings of complexity (P=.68), attractiveness (P=.15), and interest (P=.14) between intervention and control group materials. User acceptance testing of the mobile app found that it is easy to use and navigate, interactive, and helpful. Material development for any new digital therapeutic requires an iterative and rigorous process of testing involving multiple contributing groups. Appropriate user-centered development can create user-friendly mobile health apps, which may improve face validity and have a greater chance of being engaging and acceptable to the target end users.

FC29: Development of an Informant-Reported Lucidity Measure

Objective:The aim was to develop a lucidity measure for use with front-line caregivers to describe lucidity episodes among individuals with dementia, neurological and other illnesses and identify associated individual and episodic event characteristics.Methods:Qualitative: An external advisory board reviewed the clarity, breadth, and scope of the conceptual definition and item content. Modified focus groups were conducted with 20 staff and 10 family members who participated using a web-based survey. Data were extracted from Qualtrics for analysis using NVivo. Semi-structured cognitive interviews were conducted with10 health professionals working with older adults with cognitive impairment.Quantitative: A combined exploratory and confirmatory factor analysis was performed to test for dimensionality. The explained common variance (ECV), calculated as the percent of observed variance was estimated. Estimates of internal consistency such as ordinal alpha and McDonald’s omega were computed in R and Mplus.Results:Data were collected from 50 staff informants on behalf of 302 residents, 25 with lucidity events. The majority (74%) of those interviewed were certified nursing assistants. Most (58%) of the sample of residents were White and 21% Black or African American. One fourth (25%) were Hispanic or Latino. Most (80% to 90%) of those with lucidity events were reported to have memory deficits and at least 70% required maximal assistance in performing basic tasks such as dressing. Most events (60%) were of short duration (10 minutes or less), and included showing facial expressions (83%) and making eye contact (88%). One half spoke multiple sentences. About half were reported to hold a conversation, and speak coherently to convey needs; 40% were able to remember and mention the name of relatives. Staff reactions were of surprise (60%) shock (52%) and happiness (50%).Data for item modification derived from the focus groups and cognitive interviews resulted in the final lucidity measure. Internal consistency estimates were high, with most ranging from 0.76 to 0.98. The ECVs were high for most scales, indicative of essential unidimensionality.Discussion:The dimensionality and reliability analyses results were strong, and supportive of unidimensional scales with high internal consistency. The feasibility of conducting assessments of lucidity events was established.