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I. Swanson, T. McClure, G. Cioffi, W. Lambert, S. Mansberger; Content Validity of a Glaucoma Compliance Focus Group. Invest. Ophthalmol. Vis. Sci. 2008;49(13):3600.
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To determine whether compliance with glaucoma medications corresponds to the constructs of the Health Belief Model (HBM).
We recruited a 6-person focus group from a tertiary glaucoma practice. A trained moderator used open discussion and a script based on the HBM to elicit responses regarding compliance. Two investigators independently categorized the content of the transcript into one of six HBM categories: severity, susceptibility, benefits, barriers, cues to action, and self-efficacy, and a seventh category "other reasons". These investigators adjudicated any disagreements, and a third investigator mediated any continuing disagreements. We used an intraclass correlation coefficient to determine agreement between the investigators. We determined the frequency of responses, the number of unique responses, and distribution of responses.
The focus group provided 150 statements related the compliance with ocular medications. The agreement between investigators was 83% initially, and 98% after adjudication. The intraclass correlation coefficient was 0.88. The investigators were able to categorize 99% (148/150) of responses into the constructs of the HBM. Barriers were most common (n=69; 46%), followed by cues-to-action (n=29; 19.3%), self-efficacy (n=19; 12.7%), severity (n=15; 10%), susceptibility (n=8; 5.3%), benefits (n=8; 5.3%), and other reasons (n=2; 1.3%). Sixty-four statements (43%) were deemed unique. Distribution of responses was 100% for barriers, 66% for self-efficacy, 83% for severity, 83% for cues-to-action, 33% for susceptibility, 66% for benefits, and 33% for other reasons.
This preliminary analysis suggests good content validity of the HBM for factors related to compliance in glaucoma patients. While barriers were most common, multiple other factors are related to compliance. We need results in a diffuse group of glaucoma patients to generalize the results.
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