Analysis
Content analysis methodology guided data interpretation.36 This approach uses characteristics and content of language to provide understanding of qualitative data through systematic classification, coding, and theme identification.36 A team-based, inductive process was conducted, beginning with data immersion. Two researchers independently reviewed an initial set of transcripts to inductively identify a set of codes. Codes were organized both by overall impressions of the tool and by specific SexFS Brief item. Subsequently, the research team met to review respective code lists and transcripts, reconciling any discrepancies in the code definitions and applications. This process continued until a final codebook was established and the research team had double-coded 20% of transcripts. The remainder of transcripts was coded by a single member of the research team. Coded transcripts were entered into ATLAS.ti (Version 8) for data management.
Codes were then clustered into related categories for theme development, informed by prior Think-Aloud studies.37-39 Coded data was analyzed within codes, by PROMIS item number, and by gender and age group (15-19 and 20-24) to identify themes and variation across subgroups. This was followed by creation of an overall framework of tool acceptability, usefulness, and validity, again with consideration of differences by age and gender.