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ALTERNATIVETHERAPIESsepoct2011VOL.17NO.517DeterminantsofMeditationPracticeInventorystandardizedandreplicableprocedureofcontentvalidationwithanexpertpanelEPandcommunity-basedsample.Psychometrictestingincludedevaluationofinternalconsistencyestimationofconstructvalidityandtest-retestreliabilitytestingwithageneralpopulationsampleN150.METHODSx0x0DMPIx0Developmentx0andx0Contentx0ValidationDevelopmentandcontentvalidationfollowedafive-stepstandardizedprocess561delineationofcontentdomains2developmentofoperationaldeGnitionsofthedomains3itemgeneration4contentvalidationbyanexpertpaneland5con-tentvalidationandpilottestingwithacommunity-basedsample.Stepx0Onex0Delineatingx0Contentx0Domains.Atriangulatedapproachwasusedtodelineatethecontentdomainsitentailedafocusedliteraturereviewfollowedbyqualitativeindividualinterviewswithmeditationteachers.Itiscustomarywhenestablishingcontentdomainstorelyonqualitativestudiesofthetopic7howeverourliteraturesearchrevealednoidentiGablepublishedqualitativestudiesofbarrierstomeditationpractice.SubsequentlyEnglishtranslationsoftheancienttextstheBaghavadGita8andtheYogaSutras9werereviewedasweremodern-dayanecdotalunreferencedtextsaboutmeditationpractice.1011ThebarriersidentiGedduringtheliteraturereviewincludedafGnityfordiversiondiscomfortwithbeingwithoneselfandwithsilenceworkandfamilyresponsibil-itieslackofsupportfromfamilyfriendscommunityandsocialleaderslackofknowledgeaboutmeditationandlackofper-ceivedpersonalneedformeditation.QualitativeindividualinterviewswereconductedwithfourmeditationteachersrepresentingVipassanaZenandShambhalalineages.Open-endedquestionswereaskedtoelicittheattitudesbeliefsandculturalcontextstheteachersobservedasinHuencingthedecisiontopracticemeditation.Datasatura-tionwasachieved.Thequalitativeinterviewsindependentlycon-firmedbarriersidentifiedbytheliterature.Interviewnotesanalyzedusingcontentandthematicanalysisyieldedthreecon-tentdomains1perceptionsandmisconceptions2pragmaticconcernsand3socioculturalbeliefs.Stepx0Twox0Developingx0Operationalx0Definitionsx0ofx0thex0Domains.UsingdatafromtheliteraturereviewandqualitativeinterviewstwooftheauthorsAWandJDdevelopedoperation-aldeGnitionsforthedomains.ThedomainsanddeGnitionswerethensenttotheEPdescribedindetailinStepFourContentValidationwiththeinstructionstocommentontheirappropri-atenessandtoidentifyanyoverlookedconcepts.TheEPcon-GrmedthedomainsanddeGnitionswhicharethefollowingPerceptionsandMisconceptions.Itemsaddresstherespon-dentx19sunderstandingofthepracticeofmeditation.Includedareitemspertainingtoperceivedphysicalmentalandemotionalconstraintsnecessarytopracticeaswellaspresumedoutcomesofthepractice.PragmaticConcerns.Itemsaddresstherespondentx19spracti-calandtechnicalbarrierstopracticingmeditation.Includedareitemspertainingtotheenvironmenttimeprioritiesandintrin-sicandextrinsicmotivation.SocioculturalBeliefs.Itemsaddresstherespondentx19ssocialandculturalbarrierstopracticingmeditation.Includedareitemsper-tainingtoreligiousbeliefsfamilyandfriendsupportandbeliefsaboutappropriateinterpersonalbehaviorsandthesupernatural.Stepx0Threex0Initialx0Itemx0Generation.Basedonthethreecontentdomains53itemsweregeneratedfortheDMPI.Stepx0Fourx0Contentx0Validationx0byx0anx0Expertx0Panel.AGve-memberEPwasassembledrepresentingmeditationresearcherspractitionersteachersandclinicians.TheEPreceivedadetaileddescriptionoftheintentoftheDMPIandwasinstructedtofol-lowathree-stepprocess.Steponewastoreadeachitemandpro-videtworatingsforrelevanceandclarityrespectively.OurslightadaptationofthewidelyusedmethoddescribedbyLynn19866separatesrelevanceandclaritybecausetheyaredistinctissuesandweaknessesinrelevancevsclaritymaycallfordifferentrem-edies.ThisapproachhasbeensuccessfullyusedindevelopmentofotherinstrumentsbyoneoftheauthorsJD.12-14Possiblerat-ingsrangedfrom1notrelevantto4highlyrelevantforrele-vanceand1veryconfusingto4veryclearforclarity.ForsteptwotheEPsuggestedhowtorewordtheitemtoimproverele-vanceandclarityifneeded.5ForstepthreetheEPgenerateditemsrepresentingoverlookedconcepts.6TheEPmemberscom-pletedtheirreviewsindependently.Threecontentvalidationreviewswereconductedwith100EPparticipation.AcontentvalidityindexCVIforeachitemwasgeneratedfromtherelevancescoresbycalculatingtheproportionof3or4ratingsfortheitem.7Similarcalculationsweredonewiththeclarityscores.Thesewillhereafterbereferredtoastheitem-CVI-relevanceanditem-CVI-clarityrespectively.Thesearedistinctfromthesurvey-CVIsforclarityandrelevancewhichwerecalcu-latedbytakinganaverageoftheitem-CVIs.15Thedispositionofitemswhethertheywereretainedunchangedrevisedordeletedthenumberofitemsnewlygen-eratedandthesurvey-CVIsforrelevanceandclarityattheendofeachreviewaresummarizedinTable1.Anitemwasretainedunchangedifithaditem-CVIsforbothclarityandrelevancegreaterthanorequalto0.80.Anitemwasrevisediftheitem-CVI-relevancewashighandoneormoreEPmemberssuggestedrewordingtoimproveclarity.Forexampleinreviewonex1cItseemsboringx1dwasrevisedtox1cIx19mconcernedmeditationmightbeboring.x1dx0Anitemwasdeletediftheitem-CVI-relevancewaslowregardlessofitem-CVI-clarity.AnewlygenerateditemwasonethatwasdevelopedbyanEPmemberforevaluationbythewholeEP.x1cIx19mconcernedmeditationwillconHictwithmyreli-gionx1dx0wasnewlygeneratedduringreviewoneandreceivedanitem-CVI-relevanceanditem-CVI-clarityof1.0duringreviewtwoindicatingthehighestratingspossiblefromallEPmembers.Incontrastx1cIwouldjustfallasleepx1dwasnewlygeneratedduringreviewonebutreceivedanitem-CVI-relevanceof0.60inreviewtwosoitwasdeleted.ForreviewtwotheEPreceivedanadditionalinstructionforevaluationofitemsthataddressedthesameconceptinaslightly