Development and validation of an online survey to assess perception of diabetes risk and barriers and facilitators to weight loss following gestational diabetes

Our objective was to describe the development and validation of a survey investigating barriers to weight loss, perception of diabetes risk, and views of diet strategies following gestational diabetes (GDM). The survey underwent three stages of development: generation of items, expert evaluation, and pilot testing. A content validation index (CVI) was calculated from expert responses regarding item relevance, coherence, clarity, and response options. Experts also responded to the domain fit of questions linked to the Theoretical Domains Framework (TDF). Pilot responders answered the survey and responded to review questions. Six experts in the field of nutrition, midwifery, psychology, or other health or medical research completed the expert review stage of the survey. In the pilot test, there were 20 responders who were women with previous GDM and who were living in Australia. The overall CVI from the expert review was 0.91. All questions except one received an I-CVI of >0.78 for relevance (n = 35). Fourteen of the 27 items linked to the TDF received an agreement ratio of <1.0. Twenty-seven of the 31 pilot questions were completed by ≥90% of responders. Pilot review questions revealed an agreement percentage of ≥86% (n = 12) regarding the survey’s ease to complete, understand, importance, length, and interest level. The final survey tool consists of 30 items and achieved content validation through expert evaluation and pilot testing.

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