Table 1.

Criteria Used to Select Health Behavior Change Assessments

1. PracticalityA composite criterion including length; ease of administration, scoring, and interpretation; appropriateness to a wide range of settings and populations; and in the public domain, to reduce costs
2. Relationship to clinical and public health goalsAssessment of success toward achieving quantifiable public health goals linked to health behavior change objectives. For example, preference was given to results that could be linked to achievement of Healthy People 2010 goals
3. ValidityAgreement with reference standard measures. We gave moderate emphasis to convergent and divergent validity (correlations with other established measures of the same behavior and lack of correlation with other constructs)
4. Sensitivity to changeAbility of a measure to detect improvements resulting from effective interventions was given the largest weight. To achieve sensitivity to change, an instrument must demonstrate other characteristics, such as test-retest reliability. The primary purpose of including behavioral measures was to evaluate whether significant improvements are produced
5. Relation to behavioral interventionsDegree to which instruments were behaviorally based and thus directly related to P4H interventions21 (eg, it is less valuable to have a recall that produces detailed dietary nutrients, than measures that assess changes in eating behavior)
6. Cultural and literacy issuesExtent to which measures were appropriate for and had been translated into and validated in other languages, especially Spanish
7. Norms and breadth of useHaving data on national or regional norms. Data from instruments with well-established norms allow comparison of interventions and populations to larger reference groups
8. Age appropriatenessAppropriate across the full age range and functional levels. Given special attention for children and adolescents
9. ReliabilityGiven the brevity required, we did not place strong emphasis on internal consistency (α coefficients), but gave considerable weight to test-retest reliability
10. Usability for feedback and interventionsScales that can be scored immediately or can identify areas for improvement to help with patient goal setting