How to Test Measures
Making sure that outcomes measures work in the specific context is a good first step before universally collecting them. Testing measures allows them to be adjusted if they do not work as anticipated, builds CHW confidence in collecting them, and can also help refine the workflow. The first part of testing is deciding on criteria to judge the measures. Some examples of criteria:
- Variation in the population (not everyone has the same answers)
- Easily understood by clients and CHWs
- Appropriate cultural context. Some questions may not be directly translatable or may have different connotations in different languages.
Test selected measures for a short period of time. Ideally, more than one CHW would be able to participate in testing and providing perspectives. It is also a good idea to test each measure with a minimum of 5 clients, although 10-15 would be better. Here is a list of steps for how to test outcomes measures.
To create an orientation process for CHWs:
- Have CHWs practice by asking the question to each other in the language(s) used with clients. It may be useful to test similar questions at the same time.
- Solicit feedback on the question. If the question is validated, they must use the same wording. If any changes need to be made, the most important consideration is making sure that each CHW in each program asks the question the same way.
- Have at least two CHWs test the question by asking at least five clients each and recording their answers.
- If possible, have the CHWs ask the clients how they interpreted the question and how difficult it was to answer. Record those answers.
- Compare the results from steps 2-4 with the criteria.
- Change questions as needed based on the results of step 5.