Development and Validation of a Single-Item Screener for Self-Reporting Sexual Problems in U.S. Adults

Abstract

BACKGROUND: Brief self-assessment of sexual problems in a clinical context has the potential to improve care for patients through the ability to track trends in sexual problems over time and facilitate patient-provider communication about this important topic. However, instruments designed for research are typically too long to be practical in clinical practice. OBJECTIVE: To develop and validate a single-item selfreport clinical screener that would capture common sexual problems and concerns for men and women. DESIGN: We created three candidate screener items, refined them through cognitive interviews, and administered them to a large sample. We compared the prevalence of responses to each item and explored the discrepancies between items. We evaluated the construct validity of the items by comparing them to scores on the PatientReported Outcomes Measurement Information System® Sexual Function and Satisfaction (PROMIS® SexFS) measure. PARTICIPANTS: Local patients participated in two rounds of cognitive interviews (n=7 and n=11). A probability-based random sample of U.S. adults comprised the item-testing sample (n=3517). MAIN MEASURES: The items were as follows: 1) a yes/no item on any sexual problems or concerns (Bgeneral screener^), 2) a yes/no item on problems experienced for 3 months or more during the past 12 months, with a list of examples (Blong list screener^), and 3) an item identical to the long list screener except that examples appeared individually as response options and respondents could check all that applied (Bchecklist screener^). KEY RESULTS: All of the screeners tested showed evidence for basic validity and had minimal missing data. Percentages of women and men endorsing the screeners were 10 % and 15 % (general); 20 % and 17 % (long list); and 38 % and 30 % (checklist), respectively. Participants who endorsed the screeners had lower function compared to those who did not endorse them. CONCLUSIONS: We recommend the checklist screener for its specificity and ability to identify specific problems associated with decreased sexual function.

Sexual quality of life, body image distress, and psychosocial outcomes in colorectal cancer: a longitudinal study

“…Further, it is critical that patients be assessed regardless of their gender, age, partnered status, specific cancer site, or treatment status [42]. A simple brief validated sexual concerns screener [43, 44], could be used to identify patients with sexual or body image concerns and lead to timely treatments. Recent work offers guidance to clinicians to assess and refer patients who report sexual and body image concerns once identified [44, 45], and a few small intervention studies offer promising findings for interventions addressing sexual outcomes in samples of patients with colorectal cancer [18, 41].…”

Maintaining sexual health throughout gynecologic cancer survivorship: A comprehensive review and clinical guide

“…The NCCN recommends the Brief Sexual Symptom Checklist for Women as a primary screening tool (Figure2) [74, 75]. Another option is a single-item screener for self-reporting sexual problems recently published by the Patient-Reported Outcomes Measurement Information System ® (PROMIS ® ) group and the Scientific Network on Female Sexual Health and Cancer (Figure 2) [76]. More in depth assessment can be achieved by using the FSFI (a 19-item instrument) and the PROMIS ® Sexual Function and Satisfaction measures (PROMIS ® SexFS- an 81-item instrument), both of which have been validated in cancer patients [77, 78].…”

Sexual functioning among young adult cancer patients: A 2‐year longitudinal study

“…6,7,12 Sexual dysfunction describes a disorder that affects 1 or more phases of the human sexual response cycle 13 and potentially leads to psychological and relational distress. 10,13 Although prevalence rates of sexual problems have been reported for 30% to 50% of healthy adults 15 and 44% to 57% of healthy adolescents, 16,17 recent research suggests that the implications of sexual dysfunction for young people diagnosed with cancer in their teenage and young adult years are different from those of healthy peers, childhood cancer survivors, and adult cancer patients. 10,13 Although prevalence rates of sexual problems have been reported for 30% to 50% of healthy adults 15 and 44% to 57% of healthy adolescents, 16,17 recent research suggests that the implications of sexual dysfunction for young people diagnosed with cancer in their teenage and young adult years are different from those of healthy peers, childhood cancer survivors, and adult cancer patients.…”