{
  "abstract": "Objective No valid patient-reported outcome measures (PROMs) exist to evaluate fear avoidance behaviour following concussion. This study developed a new PROM to evaluate fear avoidance behaviour following concussion and assessed the PROM content validity.Design PROM development was performed using a qualitative study, and content validation was performed using a mixed-methods approach.Methods The development phase consisted of compiling potentially relevant items (eg, questions) from other PROMs proposed to measure fear avoidance before proceeding to a series of one-on-one semistructured interviews with patient and professional participants. The content validity (relevance, comprehensibility and comprehensiveness) of the PROM was first assessed by professional participants using an online survey, before further assessment by patient participants during one-on-one semistructured interviews.Results For PROM development, seven patient participants (n=4 men) and seven professional participants (n=4 men) from six clinical professions were included, who generated 119 potentially relevant items under seven distinct domains. Key themes that emerged during development were a strong preference for a short PROM, with a simple scale, that has clinical utility. 38 professional participants (47% women) and seven patient participants completed the content validation. Thus, the final PROM (Fear Avoidance after Concussion Tool or FACT) has content validity, consists of 28 items, with four items per domain. The seven domains of the FACT are: general, physical, psychological, hypervigilance, cognitive, social and work.Conclusion The FACT has been developed to evaluate fear avoidance behaviour following concussion and has content validity. Future research should evaluate other measurement properties before implementation.",
  "authors": [
    {
      "affiliations": [
        "Nutrition and Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia",
        "School of Medicine, The University of Notre Dame Australia, Fremantle, Western Australia, Australia",
        "The Rural Clinical School of Western Australia, University of Western Australia, Broome, Western Australia, Australia"
      ],
      "name": "Liam J Sherwood"
    },
    {
      "affiliations": [
        "Curtin Medical School, Curtin University, Bentley, Western Australia, Australia",
        "Curtin School of Population Health, Curtin University, Bentley, Western Australia, Australia",
        "Curtin Medical Research Institute, Curtin University, Bentley, Western Australia, Australia"
      ],
      "name": "Gill Cowen"
    },
    {
      "affiliations": [
        "Mandy Vidovich and Associates, Subiaco, Western Australia, Australia"
      ],
      "name": "Mandy Vidovich"
    },
    {
      "affiliations": [
        "Patient and Public Involvement Representative, Perth, Western Australia, Australia"
      ],
      "name": "Jeanette Hasleby"
    },
    {
      "affiliations": [
        "Wits Institute for Sport and Health (WISH), University of the Witwatersrand Faculty of Health Sciences, Johannesburg, South Africa"
      ],
      "name": "Jon Patricios"
    },
    {
      "affiliations": [
        "Nutrition and Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia",
        "Institute for Health Research, The University of Notre Dame Australia, Fremantle, Western Australia, Australia"
      ],
      "name": "Myles C Murphy"
    }
  ],
  "title": "Fear Avoidance after Concussion Tool (FACT): patient-reported outcome measure development and content validation",
  "uid": "24f2b530-4ed9-51c8-b71e-b3ec9b98d301"
}