Guidelines For Cultural Adaptation Research Articles

Translation and cross-cultural adaptation of the Get Active Questionnaire for Pregnancy in Colombian Spanish.

To ensure safe, optimal, and personalized physical activity, exercise, or sport during pregnancy, the Canadian Society for Exercise Physiology (CSEP), the Society of Obstetricians and Gynaecologists of Canada (SOGC), the College of Family Physicians of Canada, the Women's Health Division of the Canadian Physiotherapy Association, developed the Get Active Questionnaire for Pregnancy (GAQ_P) as a pre-assessment to identify women who may have a relative or absolute contraindication to prenatal exercise that requires further consultation with a health professional to determine if exercise can or should be continued or initiated during pregnancy. This study aims to translate and cross-culturally adapt the GAQ_P for use in Colombian Spanish. The original instrument was developed in English and French for the evaluation of the health of pregnant women before the beginning of physical activity and the guidelines for the same. Ten steps were followed according to the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) Translation and Cultural Adaptation guidelines, with the participation of 4 experts. The comprehensibility of the instrument was 99% which shows a high percentage of intelligibility of the document. This article describes the translation and cross-cultural adaptation of the GAQ_P for use in Colombian Spanish, contributing positively to pre-exercise screening during pregnancy in Colombia.

Tran slation , cultural adap tation an d psycho metric anal ysis of U rd u ver sion of Vic torian; institu te of sp or ts ass es sme nt: Achill es quest i onnaire fo r athletes with achilles tendinopathy.

To translate, culturally adapt and psychometrically analyse the Urdu version of the Victorian Institute of Spor t Assessment-Achilles questionnaire. The cross-sec tional study was conducted at the Pak istan Sports Board, Lahore, Pakistan, from June 17, 2021, to February 15, 2022, and comprised patients with Achilles tendinopathy in group A and healthy controls in group B. Beaton's guidelines for cultural adaptation and validation for self-repor ted measures were followed to translate and validate the Victorian Institute of Sport Assessment-Achilles questionnaire in Urdu language. Data was analysed using SPSS 23. Of the 180 subjects with mean age 28.06±5.95 years, 125(69.6%) were males. There were 130(72.2%) patients in group A and 50(27.8%) controls in group B. The overall mean score of the Victorian Institute of Sport Assessment- Achille s questionnaire was 55.99±25.43; group A 41.14±9.54 and group B 94.60±4.22. The Urdu version exhibited excellent internal consistency with Cronbach's alpha values 0.95, and excellent test-retest reliability (p<0.001). Absolute reliability was expressed by standard error of measurement 5.317 and minimal detectable change (6.38). Convergent validity demonstrated strong correlation with the physical domain (r=0.81) of the Urdu version of the World Health Organisation Quality of Life Brief Version. The Victorian Institute of Sport Assessment-Achilles questionnaire could be utilised for assessing severity of Achilles tendinopathy among Urdu-speaking population for clinical as well as research purposes.

Developing guidelines for the translation and cultural adaptation of the Montreal Cognitive Assessment: scoping review and qualitative synthesis.

Ethnic minorities in countries such as the UK are at increased risk of dementia or minor cognitive impairment. Despite this, cognitive tests used to provide a timely diagnosis for these conditions demonstrate performance bias in these groups, because of cultural context. They require adaptation that accounts for language and culture beyond translation. The Montreal Cognitive Assessment (MoCA) is one such test that has been adapted for multiple cultures. We followed previously used methodology for culturally adapting cognitive tests to develop guidelines for translating and culturally adapting the MoCA. We conducted a scoping review of publications on different versions of the MoCA. We extracted their translation and cultural adaptation procedures. We also distributed questionnaires to adaptors of the MoCA for data on the procedures they undertook to culturally adapt their respective versions. Our scoping review found 52 publications and highlighted seven steps for translating the MoCA. We received 17 responses from adaptors on their cultural adaptation procedures, with rationale justifying them. We combined data from the scoping review and the adaptors' feedback to form the guidelines that state how each question of the MoCA has been previously adapted for different cultural contexts and the reasoning behind it. This paper details our development of cultural adaptation guidelines for the MoCA that future adaptors can use to adapt the MoCA for their own languages or cultures. It also replicates methods previously used and demonstrates how these methods can be used for the cultural adaptation of other cognitive tests.

A Latina Community's Evaluation of the Culturally Adapted Conexiones Program.

Enhancing Connections (EC) is an evidence-based intervention that promotes communication between cancer-diagnosed mothers and their school-age children. EC was validated with college-educated non-Latina White mothers of privileged socioeconomic status. Latina researchers culturally adapted EC for Latina mothers diagnosed with cancer and renamed it Conexiones. Following cultural adaptation guidelines, the next recommended step was to engage the new consumer group (Latina mothers) in evaluating the newly adapted educational materials. The purpose of this study was to evaluate the cognitive and cultural fit of the newly adapted Conexiones educational materials for use with Latina mothers diagnosed with cancer. Eighteen Latina mothers participated in focus groups evaluating the Conexiones educational materials. An inductive approach was used to identify problem areas and recommendations for corrections to the Conexiones program content. Within the cognitive-informational dimension, recommendations were made to improve the ease of comprehension in the Spanish version of the program. Recommendations within the affective-motivational dimension described the cultural adjustments needed to more effectively engage cancer-diagnosed Latina mothers in the Conexiones program. Implications for Practice. Engagement of the new consumer group in evaluating the initial adaptation of Conexiones served to identify additional cognitive-informational and affective-motivational corrections needed to further refine the cultural adaptation of the Conexiones program. This study reinforced the importance of community engagement in evaluating and refining newly adapted evidence-based interventions.

Cognitive Stimulation Therapy

Abstract. Cognitive stimulation therapy (CST) is a manualized psychosocial group intervention for people with mild to moderate dementia. Because of its broad scientific evidence and cost effectiveness, CST is now used globally. To ensure replicability and quality standards of the intervention in other cultures, Aguirre et al. (2014) developed guidelines for cultural adaptation of CST based on the formative method for adapting psychotherapy (FMAP). Following this community-based approach, we adapted and translated the English CST manual into German, including multiprofessional focus groups, two adaptation cycles, and two pilot CST groups ( n = 13) in different settings representative of the German healthcare system. Effectiveness in both groups was assessed by pre-post comparison of standard scales on cognition, depression, quality of life, and self-efficacy. We were able to replicate previous findings of improved cognition as measured by the ADAS-Cog, with effect sizes in the same range as in previous randomized controlled trials. Additionally, self-efficacy increased in post-test compared to the pre-test, indicating that CST might trigger cognition through positive, self-rewarding activation.

Guidelines for culturally adapting mental health interventions in China

ABSTRACT Globally, mental illness ranks first among the causes of disability. In China, 17.5% of individuals have a mental illness, with only 150 people per 100,000 people receiving treatment for their diagnosis. To effectively address the growing unmet mental health needs in China, it is essential that China develops and adapts evidence-based and empirically supported treatment interventions. Although many researchers have begun to disseminate their interventions globally, the literature currently lacks well-defined guidelines for cultural adaptation. To address this gap in the literature, the objectives of this article are to 1) review stages of intervention science and the importance of intervention development in China; 2) examine cultural adaptation processes drawn from the literature; and 3) develop guidelines for the cultural adaptation of mental health interventions in China.

Cultural adaptation for country diversity: A systematic review of injury prevention interventions caused by domestic accidents in children under five years old.

Background: Children under five years old are the most vulnerable in home-injuries. More than half of the accident happens at home. Intervention programs are effective ways to reduce the risk of injuries. The use of cultural strategies has been recommended for effective interventions. The aim of this study was to evaluate cultural adaptability in interventional studies which were performed to prevent injuries caused by domestic accidents in children under five years old in all countries. Methods: This systematic review has been conducted from June to July 2016. Iran Medex, Magiran, SID from Persian databases and Scopus, Web of Science, Science direct, Pub Med, Biomed central from English databases were employed. Available cultural adaptation guidelines were used to compare the cultural adaptation strategies. A search of studies had been conducted from the creation of databases until July 2016. Results: Overall, 15 studies were entered into the analyses. The interventional approach in 11 studies was an educational approach. Consequently, 8 studies from 11 reported that they had significantly achieved all expected outcomes. Three studies had used behavioral change models or theories to achieve the desired changes. Seven studies had considered socio-cultural strategy in their interventions, and six studies had reported achieving outcomes. Only seven studies acquired a minimum score of cultural adaptation. Conclusion: In this systematic review, an educational intervention was effective in preventing child injuries. If cultural strategies are taken into consideration in interventions, they will have a change in behavior in this regard. Also, theoretical frameworks and models can be effective.

The American English version of the validated French Flare Assessment in RA Questionnaire (FLARE-RA).

To evaluate use of a British English version of the validated French FLARE-RA questionnaire among American English speaking patients. In addition, to create a culturally adapted American English (AmE) FLARE-RA questionnaire and to examine its attributes of patient-reported RA flare status. Using standardized cultural adaptation guidelines, we cognitively debriefed 25 American English speaking rheumatoid arthritis (RA) outpatients and created AmE-FLARE-RA with their input. One hundred three additional RA patients were recruited. Patients completed the Routine Assessment of Patient Index Data 3 (RAPID3), patient global visual analogue scale (VAS), AmE-FLARE-RA, and self-reports of flare. Physician global VAS, physician-assessed flare, swollen and tender joint count (TJC), and clinical disease activity index (CDAI) were documented. AmE-FLARE-RA and disease activity measures were compared between patient-reported and physician-reported flare categories. Patients were female (89%), with mean (SD) age 51.1 (± 15.3) years and mean disease duration (SD) 11.9 (± 10.1) years, with 26% in remission/low disease activity. Total AmE-FLARE-RA scores, RAPID3, CDAI, and patient global VAS were significantly higher for both patient-reported flares and physician-reported flares compared with non-flaring patients by self- or physician report (p< 0.05). Total AmE-FLARE-RA scores correlated significantly with RAPID3 (corr = 0.50, p< 0.0001) and with CDAI (corr = 0.45, p< 0.0001). Across "no flares," "one flare," and "several flare" groups, there was a non-significant increase in AmE-FLARE-RA scores (p= 0.07). The British English FLARE-RA was successfully adapted for AmE-speaking RA patients. AmE-FLARE-RA significantly correlated with RAPID3 and CDAI and distinguished between patient-reported and physician-reported flares, making it useful to detect flares in American RA patients.Key Points• The American English FLARE-RA (AmE-FLARE-RA) questionnaire is the result of cognitive debriefing with American RA patients using the British English version of the validated French FLARE-RA and incorporates patient-recommended language modifications..• Patients self-reporting flares had significantly higher AmE-FLARE-RA scores, compared with those without flares at the time of visit. AmE-FLARE-RA scores correlate with RAPID3 and CDAI.• There was a non-statistically significant trend using the AmE-FLARE-RA scores when examining patients with no flare, one flare, or several flares.• AmE-FLARE-RA total scores are uniformly elevated (~ 6.0 on a 0-10 scale), regardless of discordance between patient and MD assessment of flare at time of visit (~ 30%).

Validity, Reliability, and Responsiveness of the Spanish Version of the OPTIMAL Instrument.

The Outpatient Physical Therapy Improvement in Movement Assessment Log (OPTIMAL) is a self-report instrument developed to measure the ability to perform mobility actions. To validate a Spanish version of the OPTIMAL instrument. Cross-cultural adaptation and validation study. Primary and specialized outpatient care settings. Three hundred seven patients beginning physical therapy treatment and 30 subjects from the general population. A 2-part study was designed based on guidelines for cultural adaptation of patient-reported outcome measures. Reliability was estimated by internal consistency (Cronbach α), SE of measurement, and test-retest reliability (intraclass correlation coefficient) at 2 weeks. Confirmatory factor analysis was performed to examine structural validity. The association with the Physical Functioning Subscale was assessed with Spearman correlation coefficients. OPTIMAL scores across different groups were compared with Mann-Whitney U and Kruskal-Wallis tests. Effect size, standardized response mean, and minimal detectable change were determined for responsiveness. The Spanish version of the OPTIMAL instrument showed a similar structure to the original English questionnaire. Cronbach α was 0.95 for the difficulty and confidence scales. Intraclass correlation coefficient was 0.91 (95% CI 0.87-0.94) for the difficulty scale and 0.90 (95% CI 0.85-0.93) for the confidence scale. The SE of measurement was 5.11 for the difficulty scale and 6.54 for the confidence scale. The association with the Physical Functioning Subscale was strong and significant (P < .001). The 2 scales showed significantly different scores for each of the established patient groups. The effect size was 0.61 (95% CI 0.48-0.74) for the difficulty scale and 0.53 (95% CI 0.38-0.69) for the confidence scale. The standardized response mean was 0.97 (95% CI 0.78-1.13) for the difficulty scale and 0.76 (95% CI 0.48-1.01) for the confidence scale. The minimal detectable change, of a possible score of 100, was 14.2 for the difficulty scale and 18.1 for the confidence scale. The Spanish version of the OPTIMAL has appropriate reliability, validity, and responsiveness and it is an adequate self-report instrument for the assessment of mobility actions. III.

Translation, cultural adaptation and preliminary psychometric evaluation of the "Family Management Measure" among Iranian families with a child with a chronic disease.

BackgroundThe basis of any research is the use of valid and reliable tools for collecting information. One of the valid and reliable tools used to identify the family management in chronic childhood diseases is “FaMM” which has never been translated and validated in previous research in Iran.ObjectiveThe present study aimed to translate, incorporate cultural adaptation, and determine psychometric features of FaMM among Iranian families with a child with a chronic disease.MethodsThis study was conducted using the methodological research approach in Tehran, during 2016–2017. The translation of FaMM was done using “World Health Organization Translation and Cultural Adaptation Guidelines”. The preliminary psychometric evaluation of the above tool was performed by determining the validity (face and content validity) and reliability (internal consistency and stability). Data analysis was performed using IBM-SPSS 22. Content validity (CV) was first examined using qualitative and quantitative methods. In the qualitative phase, experts’ opinions were received in order to observe grammar, wording, item allocation and scaling. Then, quantitative CV was examined using Content Validity Ratio (CVR) and Content Validity Index (CVI; Scale-CVI/Avg, Scale-CVI/UA). In order to calculate the internal consistency of the items, Cronbach’s alpha coefficient of statements was calculated. Test-retest method was used for determining the stability of the tool, and the obtained scores were compared using ICC.ResultsThe Persian version of FaMM has conceptual, semantic, idiomatic and by-item equivalence, as well as a desirable preliminary validity and reliability for assessing the management of families with children with chronic disease. The results of CVR determination indicated that all questions were larger than Lawshe’s Table number (0.49). The CVI results showed that all questions had a score higher than 0.79, and therefore were recognized as appropriate. In the Scale-CVI/Avg, the score was 0.98 and in the Scale-CVI/UA, the score was 0.80. The Cronbach’s alpha value for the scales was obtained in the range of 0.55 to 0.87 and the ICC of scales ranged from 0.71 to 0.94.ConclusionThe translation and cultural adaptation process of FaMM led to the design of a tool adapted to Iranian culture which can be applied in this context, and after the implementation of the final psychometric evaluation process, comparing data on how families with a child with chronic disease are managed with other communities can be possible.

Translation and cultural adaptation of the CLEFT-Q for use in Colombia, Chile, and Spain

BackgroundCleft lip and/or palate (CL/P) is a common congenital craniofacial anomaly that may negatively affect an individual’s appearance, health-related quality of life, or speech. In Spain, Colombia, and Chile the overall prevalence of CL/P ranges from 0.53 to 1.59 cases per 1000 live births. Currently, there is no patient-reported outcome (PRO) instrument that is specific for patients with CL/P. The CLEFT-Q is a new PRO instrument developed to measure outcomes of treatment in patients 8 to 29 years of age with CL/P. The aim of this study was to translate and culturally adapt the CLEFT-Q for use in Colombia, Chile, and Spain.MethodsThe CLEFT-Q was translated from English to 3 Spanish language varieties (Colombian, Chilean, and Spanish (Spain)) and Catalan. Translation and cultural adaptation guidelines set forth by the International Society for Pharmacoeconomics and Outcomes Research were followed.ResultsThe field- test version of the CLEFT-Q consisted of 13 scales (total 154 items) measuring appearance, health-related quality of life, and facial function. Forward translations revealed 10 (7%) items that were difficult to translate into Chilean, and back translations identified 34 (22%) and 21 (13%) items whose meaning differed from the English version in at least 1 of the 3 Spanish varieties and Catalan respectively. Twenty-one participants took part in cognitive debriefing interviews. Participants were recruited from plastic surgery centres in Bogotá, Colombia (n = 4), Santiago, Chile (n = 7), and Barcelona, Spain (n = 10). Most participants were males (n = 14, 67%) and were diagnosed with CL/P (n = 17, 81%). Participants reported difficulty understanding 1 item in the Colombian, 1 item in the Spanish (Spain), and 11 items from the Catalan version. Comparison of the 3 Spanish varieties revealed 61 (40%) of the 154 items whose wording differed across the 3 Spanish versions.ConclusionTranslation and cultural adaptation processes provided evidence of transferability of the CLEFT-Q scales into 3 Spanish varieties and Catalan, as semantic, idiomatic, experiential, and conceptual equivalence of the items, instructions, and response options were achieved.

Cultural dimensions of risk perceptions: A case study on cross-strait driftage pollution in a coastal area of Taiwan

Constant exploitations of the ocean render numerous present challenges as the ocean is linked to human development. The study focused on cross-strait driftage pollution that poses a great threat to coastal environment under climate change. Several hundred packs of herbicides drifting across the Taiwan Strait were discovered along the coastline of Guanyin District of Taiwan. We compared risk perceptions of the local ethnic groups, Hakka and Fulao, residing in a coastal area of Taiwan and exposed to the herbicide coastal incident under climate change. It is of concern that society's response to every dimension of global climate change is mediated by culture. The Driver–Pressure–State–Impact–Response (DPSIR) cause-effect framework was applied in semi-structured interviews to explore coastal sensitivity and human adaptability. As a result, we indicated that despite the presence of two ethnic groups in the same place exposed to the incident they presented very different risk perceptions on both environmental degradation (ED) and adaptive capacity (AC) due to cultural values. We argued that the herbicide coastal incident involved people's risk perceptions and subsequently influenced their opinions and attitudes towards environmental problems. We concluded that the ethnic trait contributed to adaptive behaviors during environmental change. Culturally appropriate adaptations appeared to enhance risk perceptions and adaptation actions, suggesting a need for more rigorous cultural adaptation guidelines towards climate resilience when designing adaptation interventions for different ethnic groups.

Reliability and Validity of the MD Anderson Dysphagia Inventory Among Japanese Patients.

This study aimed to validate the Japanese version of a dysphagia-specific quality of life questionnaire, the MD Anderson Dysphagia Inventory (MDADI-J), and to verify trends between MDADI-J and Functional Oral Intake Scale (FOIS) scores. The original 20 MDADI items were translated using a forward-backward method following accepted cultural adaptation guidelines. Seventy-two patients with a history of head and neck cancer treatment completed the MDADI-J between October 2015 and August 2016. Concurrent validity was determined by correlations with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30) and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Head and Neck 35 (EORTC QLQ-H&N35) instruments. Discriminant validity was examined using cancer stage grouping between stages I-II and III-IV. Additionally, trends between the FOIS and the MDADI-J total scores were analyzed using a trend test. The Cronbach's α coefficient of the MDADI-J total score was 0.92, indicating high internal consistency. The average inter-item correlation coefficients ranged from 0.39 to 0.49. ICC, an indicator of test-retest reliability, was 0.84 for the total score, and 0.58 to 0.81 for individual subscales. The total score and all subscales were significantly associated with the scores for each factor of the EORTC QLQ-C30 and EORTC QLQ-H&N35. The total score and all subscales were significantly different between clinical tumor stages I-II and III-IV. The total scores all increased with the progress of the FOIS. In conclusion, this study validated the Japanese version of the MDADI and showed that as FOIS scores deteriorate, MDADI-J scores tend to constantly decrease.

Cross-cultural adaptation of the 12-item Örebro musculoskeletal screening questionnaire to Japanese (ÖMSQ-12-J), reliability and clinicians' impressions for practicality.

[Purpose] To translate and culturally adapt the Örebro Musculoskeletal Screening Questionnaire (ÖMSQ-12) into Japanese (ÖMSQ-12-J), and to preliminarily investigate practicality from the clinicians’ perspectives, and determine inter-session reliability. [Subjects and Methods] This study included four phases: cross-cultural adaptation (Phases 1–2); survey among 14 clinicians (two medical doctors and 12 physiotherapists) about the practicality of using the questionnaire in six perspectives (speed of evaluation/treatment; capacity to detect patients with yellow flags; attitude towards management with bio-psycho-social perspectives; quality of evaluation/treatment; considerations of communications with patients at history-taking, physical assessments and interventions; and general clinical usefulness) based on their experiences with patients (Phase 3); and investigation of inter-session reliability among 50 patients with musculoskeletal disorders (Phase 4). [Results] The ÖMSQ-12-J was developed in Phases 1–2 using the recommended international guidelines for cultural adaptation and translation. In Phase 3, most responses were in the 3-positive options (35.7–78.6%). In Phase 4, the Intraclass Correlation Coefficient for each item ranged from 0.71–0.99 and 0.92 for the total score. [Conclusion] This study developed the ÖMSQ-12-J, which has preliminary evidence of good practicality and moderate-strong inter-session reliability. Further investigation is required to determine the predictive and prognostic capacity within a problematic musculoskeletal Japanese population.

Cultural Adaptation of Dialectical Behavior Therapy for a Chinese International Student With Eating Disorder and Depression

Limited information exists on the application of evidence-based treatments for eating disorders among diverse populations. An increasing number of international and immigrant clients provides a pressing need for culturally responsive treatments. This case study highlights an eating disorder treatment that incorporates dialectical behavior therapy and cultural adaptation guidelines. This study explicates a culturally adapted dialectical behavior therapy (DBT) treatment of a 24-year-old female Chinese international student suffering from an eating disorder, depression, and cultural adjustment issues. In particular, this case addresses Chinese cultural values, including conformity, interdependence, and filial piety, and how these values intersect with the client’s presenting issues and treatment. Cultural modifications made to the case conceptualization and dialectical behavior therapy are discussed. The client reported a significant decrease in distress, an increase in the quality of social relationships, and an increase in satisfaction with social roles. These results provide support for the effectiveness and importance of integrating cultural adaptation and evidence-based treatment. Clinical implications and recommendations for clinicians and students are provided.

Assessing self-management in patients with diabetes mellitus type 2 in Germany: validation of a German version of the Summary of Diabetes Self-Care Activities measure (SDSCA-G).

BackgroundOne of the most widely used self-reporting tools assessing diabetes self-management in English is the Summary of Diabetes Self-Care Activities (SDSCA) measure. To date there is no psychometric validated instrument in German to assess self-management in patients with diabetes mellitus. Therefore, this study aimed to translate the SDSCA into German and examine its psychometric properties.MethodsThe English version of the SDSCA was translated into German following the guidelines for cultural adaptation. The German version of the SDSCA (SDSCA-G) was administered to a random sample of 315 patients with diabetes mellitus type 2. Reliability was analyzed using Cronbach’s alpha coefficient and item characteristics were assessed. Exploratory and confirmatory factor analysis (EFA and CFA) were carried out to explore the construct validity. A multivariable linear regression model was used to identify the influence of predictor variables on the SDSCA-G sum score.ResultsThe Cronbach’s alpha for the SDSCA-G (all items) was α = 0.618 and an acceptable correlation between the SDSCA-G and Self-management Diabetes Mellitus-Questionnaire (SDQ) (ρ = 0.664) was identified. The EFA suggested a four factor construct as did the postulated model. The CFA showed the goodness of fit of the SDSCA-G. However, item 4 was found to be problematic regarding the analysis of psychometric properties. The omission of item 4 yielded an increase in Cronbach’s alpha (α = 0.631) and improvements of the factor structure and model fit. No statistically significant influences of predictor variables on the SDSCA-G sum score were observed.ConclusionThe revised German version of the SDSCA (SDSCA-G) is a reliable and valid tool assessing self-management in adults with type 2 diabetes in Germany.Electronic supplementary materialThe online version of this article (doi:10.1186/s12955-014-0185-1) contains supplementary material, which is available to authorized users.

Measuring instruments in cardiology adapted into Portuguese language of Brazil: a systematic review

This was a systematic review aimed at identifying and characterizing measuring instruments, developed in the context of cardiology, which were adapted into Portuguese language of Brazil. Systematic searches were performed in six databases. Information extracted included cultural adaptation process and measurement properties. To assess the methodological quality of studies, criteria based on international guidelines for cultural adaptation of instruments were used. Among the 114 articles found, 14 were eligible for review. Of these, most evaluated quality of life (35.7%) and health knowledge/learning (28.6%). Most studies followed all stages of the adaptation process recommended in the literature. With respect to measurement properties, internal consistency, verified by Cronbach's alpha, was the property reported in the majority of the studies, as well as construct and criterion validity. This study is expected to provide to the scientific community a critical evaluation of adapted questionnaires available in the context of cardiology.

Effectiveness of a Culturally Adapted Strengthening Families Program 12–16 Years for High-Risk Irish Families

Evidence-based programs (EBPs) targeting effective family skills are the most cost effective for improving adolescent behavioural health. Cochrane Reviews have found the Strengthening Families Program (SFP) to be the most effective substance abuse prevention intervention. Standardized cultural adaptation processes resulted in successful outcomes in several countries. To promote wide-scale implementation and positive outcomes in Ireland, a unique model of inter-agency collaboration was developed plus guidelines for cultural adaptation with fidelity. 250 high-risk youth and families were recruited to complete SFP and its parent questionnaire. A quasi-experimental 2 group pre- and post-test design was employed where the norms were the comparison group. A 2 × 2 analysis of variance (ANOVA) generated the outcome tables including p values and Cohen’s d effect sizes. Evaluation feedback was used to improve outcomes the next year. All 21 measured outcomes had statistically significant positive results. Larger effect sizes were found for the Irish families than the USA families (d = 0.57 vs. 0.48 for youth outcomes, d = 0.73 vs. 0.65 for parenting and d = 0.76 vs. 0.70 for family outcomes). Overt and covert aggression, criminality and depression decreased more in Irish youth, but the USA youth improved more in social skills. This study suggests that SFP 12–16 is quite effective in reducing behavioural health problems in Irish adolescents, improving family relationships and reducing substance abuse. Additionally, the Irish interagency collaboration model is a viable solution to recruitment, retention and staffing in rural communities where finding five skilled professionals to implement SFP can be difficult.

Cultural Adaptation for Ethnic Diversity

Obesity disproportionately affects U.S. ethnic minority preschool children, placing them at risk for obesity related co-morbidities and premature death. Effective culturally appropriate interventions are needed to improve health behaviors and reduce obesity in young high-risk minority children, while their behaviors are still developing. All known obesity intervention studies (e.g., diet and physical activity) since 2000 targeting U.S. ethnic minority preschool children were reviewed. Five electronic databases and eight published literature reviews were used to identify the studies. Intervention studies without identified ethnic minority participants were excluded. Ten obesity interventions studies met the review criteria. Published cultural adaptation guidelines were used to develop a mechanism to analyze, score, and rank the intervention adaptations. Cultural adaptations varied widely in rigor, depth, and breadth. Results indicated a relative absence of appropriately adapted obesity interventions for ethnic minority groups, suggesting a need for more rigorous cultural adaptation guidelines when designing obesity interventions for diverse ethnicities. Culturally appropriate adaptations appeared to enhance intervention relevance, effectiveness, and feasibility. The purpose of this literature review was to evaluate 1) the type and extent of cultural adaptations strategies applied to the interventions, and 2) how these adaptations related to the study outcomes.

Cultural adaptation and psychometric properties of Brazilian Need for Recovery Scale

OBJECTIVE: To translate the Need for Recovery Scale (NFR) into Brazilian Portuguese and culturally adapt it and assess the stability, internal consistency and convergent validity of the Brazilian scale among industrial workers. METHODS: The translation process followed the guidelines for cultural adaptation of questionnaires including the steps of translation, synthesis, back translation, expert committee review, and pre-testing. The Brazilian Portuguese NFR, final version (Br-NFR) was assessed for stability (n=52) and internal consistency (n=192) and for convergent validity through simultaneous assessment with other instruments: the Borg Scale (n=59); the Chalder Fatigue Questionnaire (n=57) and 3 subscales of the SF-36 (n=56). RESULTS: Stability and internal consistency met the criterion for a reliable measure (ICC=0.80 and Cronbach's alpha =0.87, respectively). The convergent validity between Br-NFR and other instruments also showed good results: Borg Scale (r= 0.64); Chalder Questionnaire (r= 0.67); SF-36 subscales: vitality (r= -0.84), physical functioning (r= -0.54), and role-physical (r= -0.47). CONCLUSIONS: The Br-NFR proved to be a reliable instrument to evaluate work-related fatigue symptoms in industrial workers. Furthermore, it showed significant and good correlations with well-established instruments such as the Borg Scale, the Chalder Questionnaire and SF-36 vitality subscale, supporting the validity of the Br-NFR.