Subject(s)
Foundations , Kidney Failure, Chronic/diagnosis , Mass Screening/methods , Program Evaluation/methods , Residence Characteristics , Follow-Up Studies , Humans , Kidney Failure, Chronic/epidemiology , Kidney Failure, Chronic/prevention & control , Longitudinal Studies , Time Factors , United States/epidemiologyABSTRACT
BACKGROUND: The National Kidney Foundation Kidney Early Evaluation Program (KEEP) is a free community-based health-screening program targeting populations at greatest risk of chronic kidney disease (CKD), those with high rates of diabetes and hypertension, and a high proportion of racial/ethnic minorities. The KEEP Longitudinal Survey will adopt methods similar to those used in KEEP to gather follow-up data to measure CKD-related heath status and gauge program effectiveness for repeated KEEP participants with evidence of CKD stages 3 to 5. KEEP has defined objectives to enhance follow-up survey response rates and target vulnerable populations who bear the greatest CKD risk-factor burdens. METHODS: The KEEP Follow-up Form was assessed for adherence to 6 cognitive design principles (simplicity, consistency, organization, natural order, clarity, and attractiveness) considered to summate the techniques guiding good survey development and for the additional cognitive design principles of readability and variation of readability across survey items. RESULTS: The KEEP Follow-up Form was found to include violations of each cognitive design principle and readability principle, possibly contributing to item nonresponse and low follow-up rates in KEEP. It was revised according to empirically substantiated formatting techniques guided by these principles and found during qualitative assessment to be more user friendly, simpler, better organized, more attractive, and easier to read. Subsequent development of the KEEP Longitudinal Survey form also was guided by these principles. CONCLUSION: To ensure ease of use by populations with limited literacy skills, poor health literacy, and limited survey literacy, survey researchers must apply cognitive design principles to survey development to improve participation and response rates.
Subject(s)
Cognitive Science/standards , Data Collection/standards , Kidney Diseases/epidemiology , Mass Screening/standards , Program Evaluation/standards , Chronic Disease , Cognitive Science/methods , Community Health Services/methods , Community Health Services/standards , Data Collection/methods , Early Diagnosis , Follow-Up Studies , Foundations/standards , Humans , Kidney Diseases/diagnosis , Longitudinal Studies , Mass Screening/methods , Program Evaluation/methods , United States/epidemiologyABSTRACT
BACKGROUND: More than 340,000 individuals were receiving renal replacement therapy in the United States at the end of 1999; this number is projected to double by the year 2010. Almost half had a primary diagnosis of diabetes mellitus particularly type 2, and more than one quarter a primary diagnosis of hypertension. Studies have demonstrated effective maneuvers to prevent or delay the rate of progression of kidney disease, and decrease morbidity and mortality. The objective of early diagnosis is early detection of asymptomatic disease at a time when intervention has a reasonable potential to have a positive impact on outcome. METHODS: In 1997, the National Kidney Foundation launched KEEP trade mark (Kidney Early Evaluation Program), a free community-based screening that targets first order relatives of persons with hypertension, diabetes or kidney disease, and those with a personal history of diabetes or hypertension. RESULTS: Of the 889 individuals screened in the pilot study, 71.4% had at least one abnormality. The program includes an educational component and referral to a physician for follow-up of abnormal values. CONCLUSIONS: Targeted screenings are an effective means of identifying persons at risk for kidney disease, and can identify individuals at risk early enough in the course of their disease to allow for effective intervention.
