title: Application of the content expert process to develop a clinically useful low-literacy Chronic Kidney Disease Self-Management Knowledge Tool (CKD-SMKT).
abstract: BACKGROUND
  Both chronic kidney disease (CKD) and end-stage renal disease (ESRD) have tremendous impacts on health care expenditures. Several CKD knowledge-related instruments are available; however, most tools include content focusing on measuring pre-dialysis or dialysis options of patients with CKD and kidney transplant recipients.
  
  
  OBJECTIVE
  To develop a clinically useful, low-literacy Chronic Kidney Disease Self-Management Knowledge Tool (CKD-SMKT) with the guidance of a panel of content experts.
  
  
  METHODS
  Initially, the authors generated a list of potential items to include in the CKD-SMKT. Sixteen content experts reviewed two drafts of the CKD-SMKT and provided qualitative and quantitative assessments. The Lexile(®) Framework for Reading was used to assess reading grade level of the CKD-SMKT.
  
  
  RESULTS
  Eleven items were rated as "essential" (content validity ratio > 0.49, P < .05) by content experts and composed the final CKD-SMKT. The final version of the CKD-SMKT had an overall Lexile score of 470, equivalent to a ≈3rd grade reading level.
  
  
  CONCLUSIONS
  The CKD-SMKT is a content valid instrument designed to assess kidney disease patients' knowledge of various key self-management behaviors, which upon subsequent field testing will be suitable for use in the clinic setting. Its conciseness and suitability for administration to all kidney disease patients, including those with low literacy makes it an attractive tool for the busy clinician.
authors.affiliation: Department of Pharmaceutical Sciences, Southern Illinois University Edwardsville School of Pharmacy, 200 University Park Drive, Suite 250, Edwardsville, IL 62026, USA. Electronic address: rdevraj@siue.edu.
authors.forename: Radhika
authors.initials: R
authors.lastname: Devraj
authors.forename: Lorraine S
authors.initials: LS
authors.lastname: Wallace
mesh_terms: D007722:Health Knowledge, Attitudes, Practice; D057220:Health Literacy; D006801:Humans; D063868:Patient Outcome Assessment; D010595:Pharmacists; D010820:Physicians; D011361:Professional Competence; D051436:Renal Insufficiency, Chronic; D012648:Self Care