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Table 1 Questionnaire items tested in cognitive interviews and found to be confusing or misinterpreted

From: A content validity and cognitive interview process to evaluate an Illness Perception Questionnaire for African Americans with type 2 diabetes

Question tested Purpose of the question Sample respondents’ quotes Problem type identified
There is no cure for my diabetes To understand if AAs believe that there is a cure for diabetes and the cure lies in exercise, weight loss and eating health “I agree. Because I’ve been told by the dietician, by the doctor, by mostly everybody you talk to in the health field that that is the way to mostly have it to disappear is by eating the right foods, exercise play a most important part in it. And so it’s, like again, it’s up to you to do those things
Mostly everybody you talk to in the health field that that is the way to mostly have it to disappear is by eating the right foods, exercise play a most important part in it. And so it’s, like again, it’s up to you to do those things.”002
Comprehension of Question
My diabetes has taken away my ability to enjoy the food I grew up eating To understand the impact of diabetes on the food AAs grew up eating and enjoying “Yes, I am. Ooh, I have to watch now what I pretty much the greasiness and all the food we used to eat growing up, ham hocks and different things like that, the way you cook them. You got to re-do it now, which mean you got to keep out some of that butter and lard and grease and all that kind of stuff. So you got to cook a different way. This is only one, you know. But anyway, it’s good for you, to make a change.”003
“Yeah, I’m back with the nutritionist now, but I haven’t seen, the lady I was seeing, she retired. And like I said, I went to meet my new nutritionist, and I got my log book, and you just remember, I meant to put my pedometer on to do my steps. So it’s important to me, I think, to keep a food diary.”002
Comprehension of Question
Because of my physical and mental health, it is important to not worry about my diabetes To understand if AA try not to worry about their diabetes to preserve their mental health and physical health “Because medications, and which I was already borderline, but the medications that I was taking, steroids, and psychotropics, like blew me up. Car accidents, back on steroids
Depression, back on the psych meds. So a lot of them had kind of led to the diabetes. So now the exercising, I’m trying to get back down to my normal size. I’m still working on it. I’m down two sizes now. And I’m trying to get this off.”007
“It means that because where I am physically and mentally, it, I need not to worry about diabetes. Right, so basically, I’m hearing it say that because of where I’m at physically and mentally, it’s important not, for me not to be worrying about my, you know, diabetes in my life.”004
Unclear Reference
As a person of my racial identity, I have to advocate for myself if I want to survive with diabetes To examine if AA’s feel an added pressure to advocate for diabetes care due to their long history of distrust in healthcare professionals “Well, you know, I’ve taken some pills that, you know, that they’ve given me that didn’t do anything. And once, you know, I’ll take it for a period of time, and if it’s not doing anything I stop it, you know, I go noncompliant.”004 Comprehension of question
Diabetes is a silent disease not discussed within my community To examine if there is stigma associated with diabetes in AA communities or it is an illness openly discussed in their communities “When you think of silent, there’s a couple ways you can possibly look at it. And like I said, one way is a disease that silently creeps up on you. Or the other way is a silent disease meaning that people don’t have discussions or don’t really talk about it in, within my community.”009
“When I think like, let me see how it is in context. I guess, hushhush, like people don’t discuss it or have dialogue about it. The other part that I take from that silent disease is like it’s almost like a disease is rare or, you know, that it just sneak up on you violently. So I take it both ways.”005
Wording or tone