Table 3 Form A and Form B cognitive debriefing results

General impressions

20/20 (100%): survey was clear and easy to understand

…I find the survey very interesting. I think they’re good questions to, um, kind of get a feel…a high-level feel for how someone’s feeling and dealing with things, you know, on a weekly basis. So you kind of get a…a high-level picture, you know, on my stress, on my anxiety, on my physical limitations, emotional limitations

(ID27, male, 55 y/o)

18/20 (90%): survey was clear and easy to understand

2/20 (10%): survey was confusing or difficult to complete

I think it’s pretty comprehensive. It’s talking about your health in all terms of your personhood, um, with the exception of maybe spirituality. But it’s talking about your physical health. It’s talking about your emotional health. It’s talking about your state of mind. It’s talking about how energetic you feel and how your health is impacting your social life

(ID20, female, 37 y/o)

Instructions and recall

20/20 (100%): instructions were clear and easy to understand

14/20 (70%): approved 4-week recall

4/20 (20%): recall was difficult due to COVID-19

2/20 (10%): recommended 2-week recall

…if you were to ask this in a non-global pandemic, um, it may have honestly been easier…I feel like all the days are kind of blending into each other right now [laughs] in life. Um, four weeks ago…so basically all of…well, the second half of October through right now. Um, uh—it was—it was fine. I—I think that if something really affected me, I would have recalled it. But I think for the last four weeks I’ve felt generally fine and so nothing really stuck out to me. I think four weeks is probably a fair, um, time frame for analysis

(ID26, male, 39 y/o)

20/20 (100%): instructions were clear and easy to understand

18/20 (90%): approved 4-week recall

2/20 (10%): recommended 1–2-week recall

I liked that. Usually, people say six months, and you’re like, “Dude, six months. I have two kids.” Uhm, four, four weeks is, is very fresh, so it’s, I think it’s actually, uhm, a better period of time than, than knowing people say six months. Also, when, when you were not feeling well, six months ago is, you’ve had a time to change things. Four weeks is relevant

(ID04, female, 37 y/o)

Physical Functioning

17/20 (85%): item was clear and easy to understand

3/20 (15%): item was confusing or difficult to answer

I don’t do heavy objects, I don’t run, I don’t play any, you know, strenuous sports. I do clean; I have moved tables in the last couple of weeks. You know, bathing and dressing is easy for me. So, those are really good examples of the differences between strenuous and moderate. Yes. They’re good

(ID35, female, 55 y/o)

17/20 (85%): item was clear and easy to understand

3/20 (15%): item was confusing or difficult to answer

…it was easy. Yeah, they had descriptions for each one where it’s like, vigorous activity, then they had the moderate activities, so you kind of understand where they’re going with each thing. So…I understood it pretty clearly

(ID24, female, 35 y/o)

Role Functioning

16/20 (80%): item was clear and easy to understand

4/20 (20%): item was confusing or difficult to answer

…certainly my physical health, um, does not conflict with my ability to accomplish my work tasks or my home tasks. But, uh, as I had mentioned briefly, my—my job is one where I tend to carry some people’s emotional baggage. Um, as they carry it, uh, to—to help them carry it, I guess. And over the last four weeks, there—there’s certainly been a lot of, uh, struggles, um, that I have had to carry for others, and which…I guess now that I think about it in a little more detail has—has certainly affected my, um, my work, which then I carried home with me. [laughs] Um, but, um, I wouldn’t say it affected my home regular activities, but it certainly did impact my work activities, yes. So if I were to focus solely on the emotional component of that question-It’s probably “some of the time.”

(ID26, male, 39 y/o)

16/20 (80%): item was clear and easy to understand

4/20 (20%): item was confusing or difficult to answer

…like going to work and doing my job efficiently. Uh, I mean, even walking and driving, and, uh, going to the store, and cooking dinner and cleaning up, and you know, just, uh, every-day tasks

(ID02, male, 38 y/o)

Pain

13/20 (65%): item was clear and easy to understand

7/20 (35%): item was confusing or difficult to answer

So, when you’re talking about pain, it needed to be description because I have RA, I have knee pain, I have asthma, I have stomach pain. It’s not descriptive and you have to tell me what kind of pain you’re talking about

(ID 30, female, 56 y/o)

11/20 (55%): item was clear and easy to understand

9/20 (45%): item was confusing or difficult to answer

…the only difficulty I had is that it varies for me from day to day. Sometimes I have no pain, sometimes I have a lot of pain, sometimes it’s just a little. So, I try to kind of come up with a generalization over the last four weeks

(ID08, female, 38 y/o)

Vitality

15/20 (75%): item was clear and easy to understand

5/20 (25%): item was confusing or difficult

…this was just me probably overthinking the question, but like is it health-related that I was worn out, or is it because I work nine hours a day in an office and then I came home and did such-and-such, such-and-such, or, you know what I mean? Why am I worn out? So ag—again, I’m probably overthinking it, and so that—that caused the only, um, you know, pause to think or maybe, you know, have to think a little harder before answering

(ID34, female, 53 y/o)

17/20 (85%): item was clear and easy to understand

3/20 (15%): item was confusing or difficult

It sounded like, um, like, it says like, but, I guess like, I don’t really know. I have never heard that word before, but I, with the context of worn out it makes me think of, um, um, I thought worn out was, um, your level of like, um, tiredness, consciousness. I don’t know how to explain it. Like how you’re doing. Um, like how much juice or battery you still have, I guess. I don’t really know how to describe it…I think it might, I don’t even, I don’t, I’ve never heard the word before so I don’t know the definition. I was trying to use context

(ID14, female, 19 y/o)

Social functioning

15/20 (75%): item was clear and easy to understand

5/20 (25%): the impacts of COVID-19 made this item difficult to answer

Well, when you’re talking about socializing in the, uh, in the age of COVID. So, I would have to just answer that question as if there was no COVID. Because, otherwise, we haven’t done that much, any socializing since, uhm, March, you know

(ID33, male, 67 y/o)

15/20 (75%): item was clear and easy to understand

5/20 (25%): the impacts of COVID-19 made this item difficult to answer

That one was a little tricky because I was trying to think about it in the context of in normal life what would my health impact be on my social functioning? But I feel like we’re kind of in a…in a unique time period because I’m making decisions about my health and the health of other people around me due to the pandemic. Um, so ordinarily I would say my health doesn’t limit my social activities at all. But because of the situation that we find ourselves in and whether people are in quarantine or whether they’re not or whether they have health conditions that I’m trying to protect them from my germs or whatever, I feel like it does some of the time…I don’t know if you want the answer for my normal day-to-day life or if you want the COVID-19 social functioning

(ID20, female, 37 y/o)

Mental Health

18/20 (90%): item was clear and easy to understand

2/20 (10%): item was difficult to answer due to outside circumstance

But it honestly, um, was it, it just seems like once the election was over and we kind of, kind of saw where it was going, it was a big sense of relief. And, so I wasn't feeling those feelings anymore. So that's why I was a little torn. But I did pick a little of the time because it was leading up to the election and it does say, and it does say the past four, four weeks

(ID35, female, 55 y/o)

12/20 (60%): item was clear and easy to understand

8/20 (40%): item was difficult to answer due to variability of mental health over 4 weeks

That was actually pretty difficult. Um, I’m diagnosed, I’m diagnosed bipolar, so trying to calculate my episodes or like the map of my mood is really, it’s difficult to remember and just to keep track of in general. So, answering that, especially for four weeks, was quite difficult…I was trying to think like which, like which time, like when was I feeling like nervous or depressed. So, because I, sometimes I’m not and it’s hard to like map out like exactly how long that went for, or how long that was

(ID19, female 33 y/o)