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cognitive interviewing, patient-reported outcomes, scale development, sensitive topics, sexual health



  1. Arthur, Elizabeth K.
  2. Menon, Usha
  3. Browning, Kristine
  4. Overcash, Janine
  5. Wills, Celia E.


Background: Cognitive interviewing is a qualitative methodology for generating valid, reliable patient-centered outcome measures. There are challenges inherent in research on sensitive topics that require thoughtful approach by the scientist for data collection methods, analysis, and interpretation.


Objective: The purpose of this article is to provide principles of cognitive interviewing for sensitive health topics.


Methods: We review the challenges inherent in cognitive interviewing for sensitive topics scale development. We illustrate adaptations to general cognitive interviewing for sensitive topics through the presentation and analysis of a research exemplar.


Results: Researchers must consider threats to quality of sensitive topic data collection and potential harms to participants and researchers. We provide specific examples of how these risks were mitigated in a sensitive topic scale development study.


Discussion: Unique challenges of cognitive interviewing for sensitive health topics can be addressed with a well-planned data collection strategy, anticipating participant safety concerns, and consideration to researcher well-being.