Cognitive testing of candidate items in a wellbeing measure developed for Aboriginal and Torres Strait Islander Peoples

Purpose Health and wellbeing for Aboriginal and Torres Strait Islander peoples is poorly understood, due to commonly used measures of quality of life and wellbeing not aligning with their collectivist worldviews. The need to develop a wellbeing measure, grounded in the aspects of life that Aboriginal and Torres Strait Islander people identify themselves as important, was therefore a priority. The current study aimed to cognitively assess the face and content validity of a new wellbeing measure under development for Aboriginal and Torres Strait Islander adults. Methods We employed a qualitative cross-sectional cohort design. Forty-nine unique draft wellbeing statements underwent cognitive assessment using a modified Think-Aloud method we pioneered, called Think-Aloud Yarns. The statements were made into a question format, and the participants (n=17) were encouraged to verbalise their thoughts while answering the questions. This provided researchers insight into the areas where the draft statements were not performing as intended. Results and Conclusion The current study provided important insights into the cognitive validity of the WM2A wellbeing measure draft statements at a critical timepoint in the overall development of the measure. The findings from this study were synthesised and incorporated into the resultant wellbeing measure, improving the overall accuracy and robustness of the WM2A measure, and ensuring that it is truly grounded in the voices and values of Aboriginal and Torres Strait Islander adults.