Table 1 Changes in the Hindi version of the HARDSHIP questionnaire made prior to the main study
Change | Rationale |
|---|---|
The response option “pricking/other” to the question on headache character was removed | This was an option in the Karnataka study [22], but not well understood by our participants, and not helpful to diagnosis |
The response option “throbbing” to the question on headache character needed supplementary explanation in Hindi | This term was not well understood by our participants, but important to diagnosis |
The question on headache intensity, which required evaluation against a 3-point verbal rating scale (VRS) (1: mild; 2: moderate; 3: severe), was supplemented with a 10-cm visual analogue scale (VAS) | It was easier for illiterate rural participants to describe the severity of headache on the VAS, and it validated the 3-point VRS |
Modifications were made in the standardized health-care utilization section | Questions about professional consultation and investigations required adaptation to local practices |
The willingness-to-pay question series was rephrased in Hindi, with the explanation that this was a hypothetical enquiry. Additionally, the interviewer first asked an open-ended question (“How much would you pay …?”). Only when a participant could not answer this was the bidding-game method employed, commencing with the modest sum of INR 2,500 | Most participants found the open-ended question easier to respond to, and asking it first was time saving |