Comparison of the pre-post and transition question assessments in a health education setting.
OBJECTIVE
This study examined the classical pre-intervention/post-intervention assessment (pre-post) and the single post-intervention transition question assessment (transition question) to determine how well these methods reflected qualitative interview-based participant-reported outcomes from chronic disease self-management education programs (CDSMEPs).


METHODS
A mixed-method qualitative and quantitative approach was applied in 25 interviews with participants recruited from CDSMEPs within Australia. Qualitative interviews with participants were used as a relative "gold standard" and compared with questionnaire-based pre-post and transition question assessments.


RESULTS
Comparison of the two questionnaire-based assessments showed that most of the individual paired responses were discordant (61%). Using participant's qualitative narratives as a "true" indicator, the pre-post assessment was found on more occasions to be discordant with participant-reported outcomes than the transition question. The origin of the inconsistency was largely because of a change in respondents' perspective that had occurred after pretest, which was mediated by CDSMEPs' experiences and insights.


CONCLUSIONS
This study suggests that the pre-post assessment has poor validity for the assessment of health education program outcomes. Alternative assessments, such as the transition question, may result in a more accurate reflection of the impact of such programs on participants.
Jordan
Joanne E
JE
Centre for Rheumatic Diseases, Department of Medicine, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Australia. jjordan@unimelb.edu.au
Haynes
Kerry
K
Livingston
Jennifer A
JA
Osborne
Richard H
RH
D001315:Australia; D002908:Chronic Disease / Q000523:psychology* / Q000534:rehabilitation; D005260:Female; D006266:Health Education / Q000592:standards; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000592:standards; D015397:Program Evaluation; D036301:Qualitative Research; D015203:Reproducibility of Results; D012648:Self Care / Q000379:methods; D011795:Surveys and Questionnaires / Q000592:standards*