Abstract
BackgroundCross-cultural adaptation is a necessary process to effectively use existing instruments in other cultural and language settings. The process of cross-culturally adapting, including translation, of existing instruments is considered a critical set to establishing a meaningful instrument for use in another setting. Using a multi-step approach is considered best practice in achieving cultural and semantic equivalence of the adapted version. We aimed to ensure the content validity of our instruments in the cultural context of KwaZulu-Natal, South Africa.MethodsThe Iowa Infant Feeding Attitudes Scale, Breastfeeding Self-Efficacy Scale-Short Form and additional items comprise our consolidated instrument, which was cross-culturally adapted utilizing a multi-step approach during August 2012. Cross-cultural adaptation was achieved through steps to maintain content validity and attain semantic equivalence in the target version. Specifically, Lynn’s recommendation to apply an item-level content validity index score was followed. The revised instrument was translated and back-translated. To ensure semantic equivalence, Brislin’s back-translation approach was utilized followed by the committee review to address any discrepancies that emerged from translation.ResultsOur consolidated instrument was adapted to be culturally relevant and translated to yield more reliable and valid results for use in our larger research study to measure infant feeding determinants effectively in our target cultural context.ConclusionsUndertaking rigorous steps to effectively ensure cross-cultural adaptation increases our confidence that the conclusions we make based on our self-report instrument(s) will be stronger. In this way, our aim to achieve strong cross-cultural adaptation of our consolidated instruments was achieved while also providing a clear framework for other researchers choosing to utilize existing instruments for work in other cultural, geographic and population settings.
Highlights
Cross-cultural adaptation is a necessary process to effectively use existing instruments in other cultural and language settings
Cross-cultural adaptation is defined as a process that looks at both language and cultural adaptation for use in another setting [2]
Committee approach The committee approach is recommended as a second method to reach semantic equivalence [6]
Summary
Cross-cultural adaptation is a necessary process to effectively use existing instruments in other cultural and language settings. The process of cross-culturally adapting, including translation, of existing instruments is considered a critical set to establishing a meaningful instrument for use in another setting. Cross-cultural adaptation is an approach taken to utilize existing instruments in other cultural, language or geographic settings. Today an increasing body of literature across disciplines [1,2,3,4] describes achieving effective cross-cultural adaptation by following multiple validation steps. This article explores cross-cultural adaptation and the process taken to prepare our instrument, which is a compilation of (1) the Iowa Infant Feeding Attitudes Scale (IIFAS), (2) the Breastfeeding Self-efficacy Scale-Short Form (BSES-SF) and (3) additional newly developed items, for use in another setting
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