Document Type


Publication Date


Publication Title

Heart & Lung


chest pain, signs and symptoms, acute coronary syndrome, myocardial infarction, heart attack, instrument


Background: Even though “chest pain” is often highlighted as a key heart attack symptom for which individuals should seek care, little is known about the ways that the lay public conceives of chest pain related to acute coronary syndrome (ACS).

Objectives: The purpose of this four-step process was to develop an instrument to measure the lay public’s conceptions of chest pain related to ACS.

Methods: The Chest Pain Conception Questionnaire (CPCQ) was drafted based on the Theory of Unpleasant Symptoms and findings from the published literature. We then leveraged two rounds of expert feedback to calculate item-level and scale-level content validity indices. Two rounds of pilot testing (N = 51 and N = 300) were conducted with members of the target population. Psychometric testing was also conducted, including exploratory factor analysis.

Results: The multi-step development process resulted in an instrument that is comprised of 23 items (2 open-ended questions, 13 short scenarios with Likert-type ratings, and 8 multiple-choice questions) and written at a 7th grade level. The scale-level content validity index was 0.99. Exploratory factor analysis findings also supported construct validity.

Conclusions: This paper provides preliminary evidence of the CPCQ’s validity.

Funding Source

Dr. Blakeman was supported financially by the Illinois State University Provost Office's Educational Diversity Enhancement Program. Funds from this program were used to pay for participant recruitment.




This is the accepted manuscript of an article first published in Heart & Lung 61, September–October 2023, Pages 98-106. Please consult the publisher's version at

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