Applying an expanded set of cognitive design principles to formatting the Kidney Early Evaluation Program (KEEP) longitudinal survey.
BACKGROUND
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.


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Calderón
José Luis
JL
College of Pharmacy, Health Professions Division, Nova Southeastern University, Fort Lauderdale, FL 33314-7796, USA. drcalderon@sbcglobal.net
Fleming
Erik
E
Gannon
Monica R
MR
Chen
Shu-Cheng
SC
Vassalotti
Joseph A
JA
Norris
Keith C
KC
D002908:Chronic Disease; D019336:Cognitive Science / Q000379:methods / Q000592:standards*; D003153:Community Health Services / Q000379:methods / Q000592:standards; D003625:Data Collection / Q000379:methods / Q000592:standards*; D042241:Early Diagnosis; D005500:Follow-Up Studies; D005582:Foundations / Q000592:standards; D006801:Humans; D007674:Kidney Diseases / Q000175:diagnosis / Q000453:epidemiology*; D008137:Longitudinal Studies; D008403:Mass Screening / Q000379:methods / Q000592:standards*; D015397:Program Evaluation / Q000379:methods / Q000592:standards*; D014481:United States / Q000453:epidemiology