Interviewing in Goa: Methodological issues in the study of a bilingual culture

Abstract

The method described in this paper was used in a epidemiologic study, exploratory in nature, done in 1973 in a city in Goa, India, to examine symptom prevalence as it related to sociocultural integration in two groups, Christians and Hindus, representing two different levels of exposure to sociocultural change. Goa was conquered by the Portuguese in 1510 and remained under their rule till 1961. During this period of time, part of the Goan population converted from Hinduism to Christianity. While all Goans could speak the native language, Konkani, the Latin European culture and the Portuguese language penetrated more deeply among Christians. In 1961 Goa was suddently brought under Indian administration after a military action lasting less than 24 hr. Since then Goa has been exposed to rapid and extensive deprivation of the Latin European culture, replaced by the Indian one. The interview instrument consisted of multiple-choice questions on social characteristics, general health status, and psychosomatic symptoms. Two forms were used, one in Portuguese, the other in Konkani, made equivalent in meaning by the method of translation and back-translation. Several methodological steps were thought to be useful in making the instrument both valid and reliable and in approximating linguistic equivalence. Symptom prevalence, rather than prevalence of diagnosed cases, was measured, and the symptoms were defined within the culture. A known source, the Langner scale, was used for questions on symptoms. Reliability and validity checks were included in the instrument itself, as well as in its translation and use. Bilingual physicians and bilingual experts in Goan culture worked in the instrument construction. Bilinguals and monolinguals were pretested. Other steps involved: careful wording of questions, use of redundancy and decentering, provision of context, warning translators against biases and supervising their work, approaching subjects in local ways and through local leaders, and having the instrument administered by a bilingual physician. In general, the response to the interviews was excellent. The usefulness of the method in similar studies in comparative epidemiology remains to be ascertained.