Using an exploratory sequential mixed methods design to adapt an Illness Perception Questionnaire for African Americans with diabetes: the mixed data integration process

Olayinka O Shiyanbola; Deepika Rao; Daniel Bolt; Carolyn Brown; Mengqi Zhang; Earlise Ward

doi:10.1080/21642850.2021.1976650

Using an exploratory sequential mixed methods design to adapt an Illness Perception Questionnaire for African Americans with diabetes: the mixed data integration process

Health Psychol Behav Med. 2021 Sep 13;9(1):796-817. doi: 10.1080/21642850.2021.1976650. eCollection 2021.

Authors

Olayinka O Shiyanbola¹, Deepika Rao¹, Daniel Bolt², Carolyn Brown³, Mengqi Zhang⁴, Earlise Ward⁵

Affiliations

¹ Division of Social and Administrative Sciences, School of Pharmacy, University of Wisconsin-Madison, Madison, WI, USA.
² Department of Educational Psychology, University of Wisconsin-Madison, Madison, WI, USA.
³ Department of Health Outcomes and Pharmacy Practice, University of Texas at Austin, Austin, TX, USA.
⁴ School of Pharmacy, University of Wisconsin-Madison, Madison, WI, USA.
⁵ School of Nursing, University of Wisconsin-Madison, Madison, WI, USA.

Abstract

Background: Although qualitative methods have been used to develop quantitative behavioral health measurements, studies rarely report on the exact development process of these questionnaires. In this methodological paper, we highlight the procedure of a mixed data integration process in using qualitative data to create quantitative questionnaire items.

Methods: We used an exploratory sequential mixed methods study design to culturally adapt the Illness Perception Questionnaire-Revised (IPQ-R) and address the sociocultural contexts of African Americans with type 2 diabetes. Forty African Americans with type 2 diabetes taking oral diabetes medication completed the qualitative focus groups and 170 participants completed the quantitative phase (surveys). Using the 'building approach' to integration, qualitative themes from the focus groups were matched to survey domains based on the self-regulatory model. Qualitative themes assessing perceptions of diabetes among African Americans were used to develop new survey items for a culturally adapted IPQ-R, as well as adapt original survey items.

Results: Important themes included the effect on friend/family relationships, lifestyle changes, food experiences (consequences domain), importance of medications (treatment control), comparisons with family members (illness coherence), fear, future worries, and anger (emotional representations). A new domain, 'sociocultural influences' was added to the adapted questionnaire based on qualitative themes of race and racism on provider roles, personal control, and community influences. Merging and integration of the qualitative and quantitative phases, (reported via a joint display) showed evidence of congruence between the illness perceptions from the qualitative focus groups and scores on the survey items.

Conclusion: The use of mixed methods allowed for the development of a robust and patient-centered questionnaire. Future research should consider psychometric testing of the adapted IPQ-R, so that it may be used in addressing illness perceptions among African Americans.

Keywords: African Americans; Illness perceptions; data integration; diabetes; mixed methods.

Abstract

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