AuditRRAS-APS: validation of an instrument for Self-Assessment in Primary Health Care

Abstract Objective To construct and validate an instrument for the self-assessment of actions related to the care of chronic health conditions and their associated risk factors. Methods This is a methodological study structured in five stages: (1) definition of the conceptual framework, based on a previous instrument; (2) construction of items and response scales, with an exploratory literature review and analysis of the official Ministry of Health documents, incorporating specific guidelines; (3) selection and organization of items, refining criteria and domains, consulting internal experts; (4) structuring of the initial version of the instrument, ensuring clarity and relevance of the items; and (5) content validation through the Nominal Group Technique, conducted in two rounds with the participation of academic and technical experts from the state and federal levels. A guidance manual for the practical application of the instrument was also developed. Results The development and validation of AuditRRAS-APS involved the three main researchers and 20 experts (five internal and 14 ad hoc). The final version of AuditRRAS-APS has 173 items organized into five dimensions: 1) Organization of Comprehensive Care in Primary Health Care; 2) Organization and management of Primary Health Care; 3) Institutionalization of public policies for chronic conditions and their risk factors; 4) Social participation; and 5) Self-perception of the performance of the Unified Health System. Conclusion Despite its length, AuditRRAS-APS was well evaluated, showing that the approach used in its elaboration was comprehensive enough to meet the expectations of the experts.