Cognitive evaluation of the AABBUniform Donor History Questionnaire

Abstract

This article reports key findings of an evaluation of the AABB Uniform Donor History Questionnaire (a self-administered form completed before blood donation). The purpose of the study was to examine how respondents understand the questions and assess the nature of inaccurate responses. Another goal was to determine whether men who have sex with men (MSM) interpreted questions differently from non-MSM and whether questions were interpreted differently in various regions of the country. Cognitive interviewing was used for the study. This is a qualitative method that investigates how survey questions perform. It consists of semistructured interviews that explore whether respondents understand questions as intended and whether they can provide accurate answers. A total of 166 interviews were conducted. Respondents had an overwhelmingly similar understanding of the purpose of the questionnaire as assessing the safety of their blood for donation. This understanding framed respondents' interpretations such that each question was understood as asking the same thing; that is, "Is my blood safe to donate?" This interpretation did not vary among MSM versus non-MSM or by region. Respondents understood the questionnaire as assessing the safety of their blood. This interpretation served as the backdrop for the question-response process for each individual question. Specifically, rationale for answers was framed as much or more by the questionnaire's general purpose as by the specific topic of individual questions. This pattern of interpretation was the key factor responsible for both false-positive and false-negative response errors and did not vary by demographic, including in MSM.