Step five: rating and ranking of potential SVI-Kenya items

The final step of our adaptation process was to cull the expanded list of SVI-Kenya items. Our panel was joined by a female Kenyan clinician with > 5 years of experience providing care to women of a variety of ages (BO) and the Kenyan sociobehavioral scientist (GW) who conducted the FGD. After presentation of the preliminary results of the two FGD conducted in step four to explore women’s views on social frailty, these 7 individuals were asked to rate the importance of each of the candidate SVI-Kenya items on a scale of 1–5, with importance rated as 1 being “very important,” 2 “important,” 3 “neutral,” 4 “unimportant,” and 5 being “should be removed. In addition, panel members were asked to rank the items within each domain from most to least important, assigning 1 to the highest ranked item, 2 to the next most important, etc. Only items with an average importance rating less than 2 were considered for retention. For parsimony, averaged rankings were then used to select only the most highly ranked items within a given domain by group consensus.