Consumer Assessment of Healthcare Providers and Systems

Specific context: Health Promotion

Validation sample population age: Adults: 18 to 64 years

Modes of administration in validation study: Phone-based, Mailed survey

Number of items: 89

Sample size in validation study: 1013

Language of validated version: English

Country where validated: United States of America

Content validity: The HCAHPS Item Set for Addressing Health Literacy was developed using the survey development approach used to develop other CAHPS surveys. First, domains were developed for the item set through an extensive environmental scan and via interviews with content experts. We held meetings with stakeholders to obtain input into the domains identified by the environmental scan, prioritize candidate domains, review draft survey items, and obtain input on how best to disseminate the new health literacy item set and promote its use. 2 stakeholder meetings were held that included representatives from various government agencies (including CMS), hospital representatives, clinicians and other health providers, health literacy experts and advocates, and consumers. 7 health literacy domains were identified through this process. While some of these domains were completely new (e.g., interpreter services, communication about forms), others represented an expansion of domains already included in the core HCAHPS survey, but in stakeholders’ opinions, not sufficiently addressed. We reviewed the survey items that had been collected through the environmental scan and mapped the survey items to the domains. AHRQ issued a call for measures through the Federal Register, but very few responses were submitted. In developing the draft item set, we modified or adapted items in the public domain to conform to the HCAHPS survey structure and format. In addition, new survey items were drafted for domains for which the team was unable to identify existing items.