Testing the face validity of an instrument to measure interprofessional collaboration between midwives and obstetricians in antenatal care (InCo_AC) using cognitive interviews

Antenatal care constitutes an integral component of high-quality maternity care, prominently contingent upon the proficient interprofessional collaboration between midwives and obstetricians, the main care providers. Evaluation of interprofessional collaboration requires valid and reliable measurement tools. We report on the development of a questionnaire measuring interprofessional collaboration between midwives and obstetricians in antenatal care, with an emphasis on testing face validity and enhancing item quality through cognitive interviews. Nine cognitive interviews with six midwives and six obstetricians were conducted. Directed content analysis was employed to analyze and code the data. Tourangeau's model of cognitive processing was used to identify problems. Seventy-three percent of the 52 problems identified were related to the comprehension process, 15% to the decision process, 10% to the response process, and one to the retrieval process. Additionally, three instances of problems with item order emerged as an issue during the interviews. The questionnaire was revised based on the interview results. By employing cognitive interviewing, the study succeeded in identifying problems that may not have been detected otherwise, thus enhancing item quality and face validity of a newly developed questionnaire. The pilot version is now ready for piloting and psychometric testing to assess the instrument's construct validity and reliability.