Items collected during the review of literature and existing instruments or frameworks formed the basis of an item pool. This was then further extended with items emerging from interviews with medical practitioner and discussed based on expert opinions and behavior change and social-cognitive theory. Parsimony was achieved by combining multiple items into one, and the number of items was reduced by several expert meetings. The first version was field tested in single interviews among clinicians from Zhongnan Hospital of Wuhan University. A series of draft versions were piloted.

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