Establishing survey validity and reliability for American Indians through "think aloud" and test-retest methods

Cindy Horst Hauge, Jacque Jacobs-Knight, Jamie L. Jensen, Katherine M. Burgess, Susan E. Puumala, Georgiana Wilton, Jessica D. Hanson

Research output: Contribution to journalArticlepeer-review

13 Scopus citations


The purpose of this study was to use a mixed-methods approach to determine the validity and reliability of measurements used within an alcohol-exposed pregnancy prevention program for American Indian women. To develop validity, content experts provided input into the survey measures, and a "think aloud" methodology was conducted with 23 American Indian women. After revising the measurements based on this input, a test-retest was conducted with 79 American Indian women who were randomized to complete either the original measurements or the new, modified measurements. The test-retest revealed that some of the questions performed better for the modified version, whereas others appeared to be more reliable for the original version. The mixed-methods approach was a useful methodology for gathering feedback on survey measurements from American Indian participants and in indicating specific survey questions that needed to be modified for this population.

Original languageEnglish (US)
Pages (from-to)820-830
Number of pages11
JournalQualitative Health Research
Issue number6
StatePublished - Jun 6 2015
Externally publishedYes

Bibliographical note

Funding Information:
The authors disclosed receipt of the following financial support for the research, authorship, and publication of this article. This project is supported by the National Center on Minority Health and Health Disparities of the National Institutes of Health under Award U54MD008164.

Publisher Copyright:
© The Author(s) 2015.


  • aboriginal people, North America
  • alcohol/alcoholism
  • contraception
  • qualitative
  • reliability
  • validity


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