Abstract
BackgroundThe purpose of this study was to cognitively test the Urdu and English language versions of a survey to assess colon cancer screening behaviours among South Asian immigrants in Canada.MethodsThe Colon Cancer Screening Behaviours Survey was cross-culturally translated and adapted into the Urdu language followed by cognitive interviews using an evidence-informed cross-cultural cognitive interview framework. The cognitive interviews were conducted in English and Urdu in three rounds; a preliminary round, round one, and round two. Two bilingual cognitive interviewers administered interviews in person with South Asian immigrants in Hamilton, Ontario. Scripted verbal and emergent probe techniques were used concurrently with survey item administration.ResultsA total of 30 South Asian immigrant participants, 12 English speaking and 18 Urdu speaking completed a cognitive interview. These groups were similar in age, gender, and years of residence in Canada. General design, culture, gender, and translation issues were identified. Revisions were made to improve the survey and the interview protocol was modified for future data collection.ConclusionsThe cross-cultural cognitive interview framework led to a systematic and rigorous process of pre-testing and revising the Colon Cancer Screening Behaviours Survey, which may be used to gain insights on beliefs, benefits, facilitators and barriers to colon cancer screening among South Asian immigrants. The study methods and experience may also inform the cross-cultural translation and adaptation and cognitive testing of other survey tools.
Highlights
The purpose of this study was to cognitively test the Urdu and English language versions of a survey to assess colon cancer screening behaviours among South Asian immigrants in Canada
The source and target versions of the survey were examined using the following criteria: (a) semantic equivalence, the meaning ascribed to words used by South Asian (SA) populations; (b) idiomatic equivalence, the idioms or colloquialisms used by the SA population; (c) experiential equivalence, the context of the activity, colorectal cancer (CRC) screening; and (d) conceptual equivalence, the meaning of concepts examined and defined within the culture [8, 9]
One issue arose during expert committee review from the synthesis report with the question: “Before this test was described, had you ever heard of a home stool test” as it was translated without the word “before”, and the meaning differed
Summary
A scoping study enhanced understanding of factors that influenced cancer screening among SA immigrants residing in the United Kingdom (UK), the United States of America (USA), and Canada [1] This initial work provided knowledge on socio-cultural context including values of family, holistic views of health care, beliefs related to risk perception, low knowledge, and barriers to screening. The factors that supported access to CRC screening uptake were uncovered along with key strategies to Crawford et al Journal of Patient-Reported Outcomes (2017) 1:7 promote CRC screening in SA communities Both studies were essential to inform the development of a survey to assess CRC screening behaviours among SA immigrants
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