Comparison of the pre-post and transition question assessments in a health education setting.

Objective: This study examined the classical pre-intervention/post-intervention assessment (pre-post) and the single post-intervention transition question assessment (transition question) to determine how well these methods reflected qualitative interview-based participant-reported outcomes from chronic disease self-management education programs (CDSMEPs).

Study Design And Setting: A mixed-method qualitative and quantitative approach was applied in 25 interviews with participants recruited from CDSMEPs within Australia. Qualitative interviews with participants were used as a relative "gold standard" and compared with questionnaire-based pre-post and transition question assessments.

Results: Comparison of the two questionnaire-based assessments showed that most of the individual paired responses were discordant (61%). Using participant's qualitative narratives as a "true" indicator, the pre-post assessment was found on more occasions to be discordant with participant-reported outcomes than the transition question. The origin of the inconsistency was largely because of a change in respondents' perspective that had occurred after pretest, which was mediated by CDSMEPs' experiences and insights.

Conclusion: This study suggests that the pre-post assessment has poor validity for the assessment of health education program outcomes. Alternative assessments, such as the transition question, may result in a more accurate reflection of the impact of such programs on participants.