Development of a menopause-specific questionnaire: Content and face validation using a modified Delphi technique

BackgroundMenopause is a universal life stage, yet many women face persistent knowledge gaps, misconceptions, and unequal access to care. Existing instruments assess isolated aspects of menopause but do not capture women's access to the conditions necessary for making informed choices about their health.ObjectiveThe aim of this study was to develop and establish content and face validity of a menopause-specific questionnaire designed to assess women's access to the preconditions for making informed choices about their health during the menopausal transition and beyond, using a modified Delphi technique.DesignA modified Delphi study.MethodsFive Delphi rounds were conducted in 2025 involving an expert group (n = 9), a Public and Patient Involvement (PPI) group (n = 7), and a pilot test group (n = 48). Experts reviewed and refined an initial 39-item draft, the PPI group assessed face validity and readability, and experts conducted item prioritization using predefined consensus thresholds. Pilot testing evaluated usability and respondent burden. Final consensus required ≥80% expert agreement. The study followed CREDES guidelines.ResultsFollowing content and face validation, the final instrument comprised 29 items. Expert review informed revisions to terminology, neutrality of menopausal hormone therapy items, and language accessibility. PPI contributors highlighted readability challenges and supported clearer wording. Nine items were removed, five merged into two, and one item added. Pilot testing confirmed acceptable usability and respondent burden. Final expert consensus reached 87.5%.ConclusionA consensus-based, user-informed questionnaire was developed, following content and face validation, to assess women's access to conditions for informed choice during menopause. The instrument may support the identification of barriers and facilitators to informed decision-making in menopause-related care and research.