Creation and Validation of a Comprehensive Instrument to Assess UI in Female Athletes and Active Women

A variety of instruments have been used to measure UI in studies about athletic UI (AUI). However, few studies used instruments with questions about bowel, bladder, and sexual habits. A more comprehensive screening tool has been developed: the Active Women Incontinence Screening Tool (AWIST). The purposes of this study were to identify gaps left by prior UI instruments, describe attributes of the AWIST previously excluded by UI screening tools, and evaluate validity and reliability of the AWIST.

Key concepts were identified using a comparative analysis of 17 instruments used across 92 AUI studies. We used the Delphi method to validate the content of the AWIST, which involved two phases of review by eight experts. The Content Validity Index (CVI) was assessed at the item (I-CVI) and the scale (S-CVI) levels, where consensus among all selected items was determined using a modified Kappa statistic (K*) set at $\ge$ 0.60.

In the first phase, the AWIST demonstrated a mean relevance score of 3.67 (σ = 0.61, range 2-4; mean I-CVI 0.98, σ = 0.07). In the second phase, the AWIST had a main relevance score of 3.67 (σ = 0.57, range 2-4; mean I-CVI 0.99, σ = 0.05). The S-CVI/UA was 0.95 and the S-CVI-Ave was 0.99.

The AWIST is a comprehensive, validated screening tool created to evaluate key factors of AUI in women. Branching logic makes it equally useful for assessing nonathletic women. The AWIST is equally appropriate for research and clinical use.