Cognitive Interviews to develop the Anticipated Adherence Index (AAI).

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The proposed study is a health research study. We are currently developing a new scale (The Anticipated Adherence Index) to measure adherence before people start to take their medication. This measure aims to identify those who may possibly struggle with medication adherence. To make sure each of the items are understood and interpreted as expected, we want to run in-person cognitive interviews with 25 participants who have been taking a long-term medication (1 year or more). This study consists of a cross-sectional design with 25 minimum participants. Participants will include patients that have been on a long-term prescribed medication or a year or more. These patients will participate in a cognitive interview about the newly developed Anticipated Adherence Index. The 25 participants will be recruited by advertising via facebook community pages, community message boards and community email lists. A poster with a QR code, and researcher contact information will be used. The QR code and researcher will direct potential participants to a qualtrics link which assesses eligibility by ensuring that individuals meet inclusion criteria. The research team will then send an email to those who register their interest in the study and provide them with a full participant information sheet and consent form. At this stage, these individuals will have the option to book an appointment with the student researcher to conduct the interview. Potential participants will also have an option to ask the researcher any questions. The cognitive interviews will be conducted in person at the University of Auckland Clinical Research Centre. Participants will then be notified of their appointment confirmation and meet the researcher at the agreed-upon location and time. To ensure consistency, the same researcher will be conducting all cognitive interviews. The 'think aloud' cognitive interviewing procedure developed by Willis (2007) will be utilised during the interview. In this protocol, participants are provided with a training question to introduce them to the think-aloud protocol. This protocol asks participants to verbally respond to each item, and also verbalise their thought processes that led to their response. An audio recording of the participant's verbal think-aloud stream will be taken to capture the nuances in each subjects answer. These will be transcribed following each interview. Thematic analysis will be utilised to identify the main themes related to each item. This information will be used to adapt the Anticipated Adherence Index with the wider research team.

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