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Content validity, rural, content experts, instrument development, lack of anonymity


Purpose: Obtaining feedback from rural content experts is critical in developing valid and reliable instruments to advance the science of rural health. However, traditional methods, i.e., focus groups are impractical due to location and distance. Using an online questionnaire combined with telephone and email contacts to obtain content experts’ feedback is discussed. Item statement analysis and efficiency and effectiveness of the process are presented.
Methods: The process included the development of an online questionnaire, asking experts to rate 51 item statement for their relevancy, sufficiency of description, and clarity and readability. To increase the response rate, a series of four contacts (one telephone and three email) were planned and implemented. An item content validity index (I-CVI) was calculated for all items.
Results: Distribution of the online questionnaire to rural content experts separated by geographic distance was efficient and effective in gathering feedback on item statements for content validity. Content experts completed the questionnaire in less than one hour suggesting the overall efficiency of the process; an 84% response rate supports process effectiveness. Following I-CVI evaluation, item statements were reduced from 51 to 24. The analysis resulted in retaining, with or without revision, 47% of the item statements.
Conclusions: The online questionnaire and four-contact strategy were effective in gathering input from a representative sample of rural content experts separated by great distances; thereby, strengthening the content validity of the item statements. The process demonstrates new opportunities for using online technologies to reach rural content experts.

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Online Journal of Rural Nursing and Health Care





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Rural Nurse Organization


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Creative Commons Attribution 4.0 International License
This work is licensed under a Creative Commons Attribution 4.0 International License.


This version of record was first published in (2018) Online Journal of Rural Nursing and Health Care 18(2), p.189-208.