Phase 4: Revision, Refinement, and Development of HCBS Measures
In phase #4, researchers will use an iterative process to refine or develop items addressing the most critical NQF domains and subdomains identified by stakeholders in phase #1 and the resulting gaps in measures identified in phase #2 of the project. Measures will be prioritized based on the input of key stakeholder groups with those measures with the highest importance weightings being the first to address. Following measure refinement and development, we will implement an iterative validation process, which includes content expert review, cognitive testing, and a pilot study focusing on testing feasibility and usability.
During the process of development, review, and testing, we will also address differences in item response formats either through revisions, making the response formats more consistent, or determining statistical methods to analyze measures with different item response formats. Data from phase #4 will determine the most appropriate and valid measure compositions, item wordings and response formats. Feedback from the expert reviewers will focus on both content and response formats of items. Additionally, the information and feedback obtained during cognitive and pilot testing will guide in the final measure compositions and response formats used for each measure. The results of phase #4 will lead directly to national testing of the selected measures in phase #5.