%0 Journal Article
%T Cross-cultural adaptation of research instruments: language, setting, time and statistical considerations
%A Linn Gjersing
%A John RM Caplehorn
%A Thomas Clausen
%J BMC Medical Research Methodology
%D 2010
%I BioMed Central
%R 10.1186/1471-2288-10-13
%X A questionnaire was needed for the implementation of a study in Norway 2007. There was no appropriate instruments available in Norwegian, thus an Australian-English instrument was cross-culturally adapted.The adaptation process included investigation of conceptual and item equivalence. Two forward and two back-translations were synthesized and compared by an expert committee. Thereafter the instrument was pretested and adjusted accordingly. The final questionnaire was administered to opioid maintenance treatment staff (n=140) and harm reduction staff (n=180). The overall response rate was 84%. The original instrument failed confirmatory analysis. Instead a new two-factor scale was identified and found valid in the new setting.The failure of the original scale highlights the importance of adapting instruments to current research settings. It also emphasizes the importance of ensuring that concepts within an instrument are equal between the original and target language, time and context. If the described stages in the cross-cultural adaptation process had been omitted, the findings would have been misleading, even if presented with apparent precision. Thus, it is important to consider possible barriers when making a direct comparison between different nations, cultures and times.There is much emphasis on using standardized and validated research instruments [1]. One reason for this is the assumption that it enables comparisons of results across different studies both nationally and internationally [1]. Another assumption is that the use of validated instruments increases the certainty with which the instruments accurately reflect what they are supposed to measure [1]. However, a previously validated instrument does not necessarily mean it is valid in another time, culture or context [2-5].There is no universal agreement on how to adapt an instrument for use in another cultural setting. However, there is agreement that it is inappropriate to simply translate and use a
%U http://www.biomedcentral.com/1471-2288/10/13