title: Content validity and nursing sensitivity of community-level outcomes from the Nursing Outcomes Classification (NOC).
abstract: OBJECTIVE
  To evaluate the content validity and nursing sensitivity of six community-level outcomes from the Nursing Outcomes Classification (NOC; Johnson, Maas, & Moorhead, 2000).
  
  
  METHODS
  A survey research design was used. Questionnaires were mailed to 300 public health nursing experts; 102 nurses responded. Experts evaluated between 11 and 30 indicators for each of the six outcomes for: (a) importance of the indicators for measuring the outcome, and (b) influence of nursing on the indicators. Content validity and nursing sensitivity of the outcomes were estimated with a modified Fehring technique.
  
  
  RESULTS
  All outcomes were deemed important; only Community Competence had an outcome content validity score < .80. The outcome sensitivity score for Community Health: Immunity was .80; other outcome scores ranged from .62-.70. Indicator ratios for all 102 indicators met the study criterion for importance, with 87% designated as critical and 13% as supplemental. Sensitivity ratios reflected judgments that 45% of the indicators were sensitive to nursing intervention.
  
  
  CONCLUSIONS
  The study provided evidence of outcome content validity and nursing sensitivity of the study outcomes; further validation research is recommended, followed by testing of the study outcomes in clinical practice. Community-level nursing-sensitive outcomes will potentially enable study of the efficacy and effectiveness of public health interventions focused on improving health of populations and communities.
authors.affiliation: University of Nebraska Medical Center, College of Nursing, Omaha Division, 985330 Nebraska Medical Center, Omaha, NE 68198-5330, USA. bhead@unmc.edu
authors.forename: Barbara J
authors.initials: BJ
authors.lastname: Head
authors.forename: Mary Lober
authors.initials: ML
authors.lastname: Aquilino
authors.forename: Marion
authors.initials: M
authors.lastname: Johnson
authors.forename: David
authors.initials: D
authors.lastname: Reed
authors.forename: Meridean
authors.initials: M
authors.lastname: Maas
authors.forename: Sue
authors.initials: S
authors.lastname: Moorhead
mesh_terms: D001291:Attitude of Health Personnel; D002908:Chronic Disease / Q000451:nursing; D002983:Clinical Competence / Q000592:standards; D003140:Communicable Disease Control / Q000592:standards; D006304:Health Status; D006801:Humans; D007114:Immunization / Q000592:standards; D007855:Lead Poisoning / Q000209:etiology / Q000517:prevention & control; D024802:Nurse's Role; D009726:Nurses / Q000523:psychology; D015403:Nursing Evaluation Research / Q000379:methods* / Q000592:standards; D017063:Outcome Assessment, Health Care / Q000145:classification* / Q000379:methods* / Q000592:standards; D011637:Public Health Nursing / Q000193:education / Q000458:organization & administration*; D019984:Quality Indicators, Health Care / Q000145:classification / Q000592:standards*; D012307:Risk Factors; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires