title: Development and Validation of a Single-Item Screener for Self-Reporting Sexual Problems in U.S. Adults.
abstract: BACKGROUND
  Brief self-assessment of sexual problems in a clinical context has the potential to improve care for patients through the ability to track trends in sexual problems over time and facilitate patient-provider communication about this important topic. However, instruments designed for research are typically too long to be practical in clinical practice.
  
  
  OBJECTIVE
  To develop and validate a single-item self-report clinical screener that would capture common sexual problems and concerns for men and women.
  
  
  METHODS
  We created three candidate screener items, refined them through cognitive interviews, and administered them to a large sample. We compared the prevalence of responses to each item and explored the discrepancies between items. We evaluated the construct validity of the items by comparing them to scores on the Patient-Reported Outcomes Measurement Information System® Sexual Function and Satisfaction (PROMIS® SexFS) measure.
  
  
  METHODS
  Local patients participated in two rounds of cognitive interviews (n = 7 and n = 11). A probability-based random sample of U.S. adults comprised the item-testing sample (n = 3517).
  
  
  METHODS
  The items were as follows: 1) a yes/no item on any sexual problems or concerns ("general screener"), 2) a yes/no item on problems experienced for 3 months or more during the past 12 months, with a list of examples ("long list screener"), and 3) an item identical to the long list screener except that examples appeared individually as response options and respondents could check all that applied ("checklist screener").
  
  
  RESULTS
  All of the screeners tested showed evidence for basic validity and had minimal missing data. Percentages of women and men endorsing the screeners were 10 % and 15 % (general); 20 % and 17 % (long list); and 38 % and 30 % (checklist), respectively. Participants who endorsed the screeners had lower function compared to those who did not endorse them.
  
  
  CONCLUSIONS
  We recommend the checklist screener for its specificity and ability to identify specific problems associated with decreased sexual function.
authors.affiliation: Center for Patient Care and Outcomes Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, 53226, USA. kflynn@mcw.edu.
authors.forename: Kathryn E
authors.initials: KE
authors.lastname: Flynn
authors.affiliation: Department of Obstetrics/Gynecology, University of Chicago, Chicago, IL, USA.|Department of Medicine-Geriatrics, Comprehensive Cancer Center, University of Chicago, Chicago, IL, USA.
authors.forename: Stacy Tessler
authors.initials: ST
authors.lastname: Lindau
authors.affiliation: Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC, USA.
authors.forename: Li
authors.initials: L
authors.lastname: Lin
authors.affiliation: Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, PA, USA.
authors.forename: Jennifer Barsky
authors.initials: JB
authors.lastname: Reese
authors.affiliation: Defense Health Agency, Department of Defense, Falls Church, VA, USA.
authors.forename: Diana D
authors.initials: DD
authors.lastname: Jeffery
authors.affiliation: Departments of Surgery and Psychiatry, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
authors.forename: Jeanne
authors.initials: J
authors.lastname: Carter
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
authors.forename: Shirley R
authors.initials: SR
authors.lastname: Baron
authors.affiliation: Department of Obstetrics/Gynecology, University of Chicago, Chicago, IL, USA.
authors.forename: Emily
authors.initials: E
authors.lastname: Abramsohn
authors.affiliation: Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC, USA.|Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA.
authors.forename: Kevin P
authors.initials: KP
authors.lastname: Weinfurt
mesh_terms: D000293:Adolescent; D000328:Adult; D057189:Checklist / Q000592:standards; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000592:standards*; D008875:Middle Aged; D057566:Self Report / Q000592:standards*; D012735:Sexual Dysfunction, Physiological / Q000175:diagnosis* / Q000453:epidemiology*; D011795:Surveys and Questionnaires / Q000592:standards*; D014481:United States / Q000453:epidemiology; D055815:Young Adult