Core questions were identified based on a scoping review of existing studies and the development of a conceptual map. Subsequently, an initial proposal for a CHW consensus questionnaire was developed. The expected variation in CHW roles associated with the different sexual health support services and organisational structures in Europe was explored by means of widely-applicable (rather than country-specific) questions and answers. Detailed routing was used to make effective use of respondents' time.
A first draft of the questionnaire was circulated to the ESTICOM-associated network for consultation in March 2017. Overall, 28 responses were received from 18 countries representing 25 organisations, including European agencies and national government departments as well as specialist NGOs (e.g. in sexual health, HIV, and LGBTI issues), Checkpoints, public health agencies and other organisations. After further refinement of the questionnaire, a phase of testing took place in May 2017. This phase involved 7 in-depth cognitive debriefing interviews of CHW respondents, and a full pilot test involving 54 CHW respondents.
After collating feedback from these consultation and testing phases and making further amendments, the English version of the questionnaire was finalised in August 2017, before being translated into 15 other European languages.