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what are the important concepts of cross cultural adaptation

The analysis produced a two-factor model including 13 items. Drug & Alcohol Review. Heroin Addiction & Related Clinical Problems. Consequently there was also a difference in factor correlations. Psychometrika. become an internationally recognized standard for understanding cultural differences. They can overcome hindrances to adapting cross-cultural competence by: Today’s business relations are made complex by the nature of the human diversity involved. Thus it was decided to omit the five items from the following exploratory factor analysis. ≥ 90%) [3]. Data were checked for normality both graphically and by assessing univariate and multivariate skewness and kurtosis. A pretest of the instrument (response rate 42/69) was completed among staff working in the addiction field, but not in OMT in May-June 2007. In particular comparison will be difficult if the adaptation process has been flawed. The important components of cross cultural communication are verbal, non-verbal and para-language. Non-Verbal Communications Eye contact Facial Expressions Gestures Timing in spoken exchange Touching Specifically, the translation process should ensure conceptual equivalence in each target Culture is a shared pattern of values, attitudes, beliefs, practices, ideas and behaviors that define the way of life of a group (i.e., a country, state, organization or linguistic assemblage). Additionally decisions for when understanding was achieved for all items were left to the subjective judgement of the researchers. Article  Thereafter if factor loadings and indicator intercepts were invariant, the equality of latent means was assessed [22–24]. Factor correlations were 0.71 for OMT staff and 0.37 for harm reduction staff. Throughout the cross-cultural adaptation process there had been doubts around the relevance of these items in the Norwegian setting. CAS  The advantage of this fit index is that it avoids underestimation of fit as it takes sample size into account [23, 25]. After the final adjustments of the instrument, the instrument format, instructions, mode of administration and measurement methods were assessed by the research group. The cross-cultural adaptation has the learning phases of acculturation and cultural loss. 2001, 62: 255-264. The demonstration of equivalence (lack of bias) is a prerequisite for any cross-cultural comparison. In this section cross-cultural adaptation process of self-reported measures are briefly overviewed. This third person was fluent both in Norwegian and English. Theories of Cross-Cultural Communication Hofstede. In addition attitudes cannot be measured directly [19]. The sample data included two different groups (harm reduction staff and OMT staff), thus multigroup analyses were applied. However, these items were added at the end of the instrument, after the original items. The standardized residuals and the modification indices were assessed to identify any areas of misfit in the model [31]. For clarity, the following explanations are provided for the terms most often used to label each step in the translation process and the key actors involved in each step. Caplehorn JR, Irwig L, Saunders JB: Physicians' attitudes and retention of patients in their methadone maintenance programs. Alternatively, it may be that the failure of an original scale in a new setting is due to changes in society over time [2]. Goodness-of-fit indices reflect different aspects of the model. Multigroup analysis showed that the attitudinal scale differed in all parameters between the two groups (Table 4). Tucker LR, Lewis C: A reliability coefficient for maximum likelihood factor analysis. 2010, Upper Saddle River, N.J.: Pearson. Descriptive statistics were calculated using the statistical software SPSS version 16.0 [20]. POPULATION . Journal of Marketing Research. Items tailored towards the country's OMT system were added when the instrument was used outside of Australia [12–18]. Oslo. 1973, 38: 1-10. This illustrates that a thorough cross-cultural adaption process may be difficult to achieve if there are time or financial constraints. Between 30 and 40 respondents are viewed as appropriate in the pretest [3, 4]. The model was adjusted accordingly, but the adjusted model did not have an adequate fit to the data. The attitudinal and knowledge items were mixed throughout the instrument [7]. Knee outcome scales: Basic concepts, review of methods, cross-cultural and linguistic adaptation Paradowski, Przemysław T. and Roos, Ewa LU () In Ortopedia, traumatologia, rehabilitacja 6 (4). Values less than 0.05 indicate good fit and values as high as 0.08 represent reasonable errors of approximation in the population [23, 24]. The cross-cultural adaptation process is important when an instrument is used in a different language, setting and time to reduce the risk of introducing bias into a study [2]. Data were assessed using exploratory and confirmatory statistical analysis. The instrument was developed in NSW, Australia, in 1996 [7]. Based upon the literature review and the general feedback it was decided to omit the six items that made up the "Disapproval of drug use" scale. onsequential aspects of communication that impact cross-cultural competence are: implications of gestures and other body language vary, (some cultures prefer direct eye contact when conversing, in verbal and non-verbal communication, and t. onal variations can easily lead to misinterpretations, even within the same cultural group. There were doubts around the relevance of the abstinence-oriented items, but it was decided to retain these items. Cross-cultural adaptation occurs when people from one culture move to a different culture, learning the rules, societal norms, customs and language of the new culture. There was substantial covariance between measurement error 3 and 5 (MI = 19.533) and error 2 and 7 (MI = 31.554) in the OMT group. Reasons given for non-participation in the harm reduction facilities were that staff was not informed and did not have time to complete the survey. Multigroup analyses were completed stepwise. This means that in a cross-cultural interaction of students, intercultural and social adaptation have similar attributive traits and characteristics. Many authors have theorized and researched the notion of cross-cultural adaptation, which entails moving from one culture to another culture, usually (but not always) learning the rules, norms, customs, and language of the new culture.We should differentiate between different types of cross-cultural travel. Spine. 1999, 6: 1-55. way to ensure success across organizations. The instrument comprised two attitudinal scales. Article  The model was adjusted accordingly, but this model also failed. Words that were back-translated differently were highlighted and discussed. 2000, 1: 63-72. At least two persons should produce the initial translations independently [4–6]. Furthermore there were differences between groups in knowledge and attitudinal scores. They had a lower response rate which was possibly related to the data collection procedure. A questionnaire was needed for the implementation of a study in Norway 2007. theory, cross-cultural adaptation is conceived as a process of dynamic unfolding of the natural human tendency to struggle for an internal equilibrium in the face of often adversarial environmental conditions. In addition attitudes cannot be measured directly [ 19 ]. This process of adjusting to a new culture is called cultural adaptation. Drug Alcohol Rev. Table 3 shows the original factor loadings and the factor loadings in the current study. In addition, technology has made overcoming language barriers easy; just download an app, insert an earpiece and receive an instant translation. Gossop M, Marsden J, Stewart D, Treacy S: Outcomes after methadone maintenance and methadone reduction treatments: two-year follow-up results from the National Treatment Outcome Research Study. Manage cookies/Do not sell my data we use in the preference centre. Journal of maintenance in the addictions. There was no appropriate instruments available in Norwegian, thus an Australian-English instrument was cross-culturally adapted. Subst Use Misuse. 2000, 2: 15-21. Waal H, Clausen T, Aamodt C, Lillevold PH: Annual assessment of the Norwegian OMT programme. Social psychologist Geert Hofstede (Hofstede, 1982, 2001, 2005) is one of the most well known researchers in cross-cultural communication and management. This assessment ensures that items are translated correctly and are relevant in the new setting [4–6]. 2001, Mahwah, N.J: Lawrence Erlbaum Associates, Kline RB: Principles and practice of structural equation modeling. 1999, 18: 163-170. Guillemin F, Bombardier C, Beaton D: Cross-cultural adaptation of health-related quality of life measures: literature review and proposed guidelines. The overall response rate was 84%. Caplehorn JR, Lumley TS, Irwig L: Staff attitudes and retention of patients in methadone maintenance programs. Many studies on cultural adaptation stress the importance of the ability to . Our country is becoming much more diverse. The failure of the original scale highlights the importance of adapting instruments to current research settings. Findings from the literature review should be discussed with experts in the field and members of the target population [2, 3]. The average variance extracted (AVE) [28] was also assessed. PubMed  Cross-cultural adaptation of the SF-36 and SF-12 Physical and ... CROSS-CULTURAL VALIDATION OF THE CONCEPTS OF THE SF-36 ON A CHINESE . 10.1080/09595239996590. Google Scholar. 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. Initially the 14 original abstinence-oriented items were tested through confirmatory analysis. RMSEA is an attempt to correct for the tendency of the chi-square statistic to reject models with a large n or a large number of observed variables [27]. Foreign interdisciplinary studies of the adaptation phenomenon in general and cross-cultural adaptation in Confirmatory analyses were completed through structural equation modelling using maximum likelihood analysis. After a review of the literature, experts and members of the target population were consulted. Correspondence to Based upon a subjective judgment of the authors and the feedback from the experts in the field, 12 attitudinal statements were added to the instrument. Moreover, a depression inventory validated in addicted individuals is likely to confuse somatic symptoms of depression with those of intoxication and withdrawal. Furthermore we want to thank all those that provided feedback and had suggestions to additional statements in the development of a Norwegian scale. 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]. 10.1207/s15327906mbr2502_4. vious research had not explicitly addressed the cross-cultural adaptation process of the questionnaire. In addition it is important to assess that items within the instrument are equally relevant and acceptable in the target population as they are in the original population [2]. Example: Theorem 1: the greater the host communication competence, the greater the participation in host social (interpersonal, mass) communication’. p.393-405 Mark; Abstract In recent years, outcome assessment following different therapeutic procedures has increasingly focused on the patient's perspective. Gonzales-Saiz F, Salvador Carulla L: Medida de las actitudes y conocimientos de los profesionales de programas de mantenimiento con metadona: datos preliminares. Verbal Communications 2. [21], which assessed the following six types of equivalences: conceptual, of items, semantic, operational, measurement, and functional. Bentler PM: Comparative fit indexes in structural models. Understanding cross-cultural communication is important for any company that has a diverse workforce or plans on conducting global business. volume 10, Article number: 13 (2010) 1998, 7: 323-335. Potentially it was easier for staff to complete the questionnaire when the researcher was present. This introduced bias into the cross-cultural adaptation process and may be one of the reasons why the original scale failed. The model retrieved through exploratory factor analysis was tested through confirmatory analysis. Cross-cultural adaptation of research instruments: language, setting, time and statistical considerations. 21 Translation from English to Turkish was performed by 2 independent translators whose native language is Turkish and who are fluent in English. 10.1007/BF02294359. Intercultural and Cross-Cultural Communication Research: Some Reflections about Culture and Qualitative Methods. West J Nurs Res. Factor loadings in the two scales are shown in table 2. The original scale was developed in the 1990s. BMC Med Res Methodol 10, 13 (2010). Conversely, studies may have a comprehensive linguistic translation process, but this still does not ensure construct validity and reliability [4, 5]. 2007, Amsterdam: Elsevier, Academic Press. Article  The respondents were asked to complete the questionnaire and comment on words and sentences that were difficult to understand. The Palliative care Outcome Scale (POS) Family of Measures Manual for Translation, Cross-Cultural Adaptation and Psychometric Testing Authors: Bárbara Antunes1,2 Alice Brown1, Jana Witt1, , Barbara Daveson1, Christina Ramsenthaler1, Hamid Benalia1 and Pedro Lopes Ferreira2, Claudia Bausewein3 Irene J. Higginson1 and Fliss EM Murtagh1. It also requires an understanding of cultural values. Cross-cultural psychology is a branch of psychology that looks at how cultural factors influence human behavior. Understand cross-cultural basics. 2008, The pre-publication history for this paper can be accessed here: Thus the aim of this paper is to illustrate the process and required steps involved in the cross-cultural adaptation of a research instrument using the adaptation process of an attitudinal instrument as an example. Hinderances to cross-cultural competence often arise due to the following reasons: Effective cross-cultural communication begins with the understanding that the sender and receiver of a message are from different cultures. 2007, 41: 665-673. The national OMT programme comprised of 14 centres and employed from three to thirty-three staff members. The mean "compliance" score for OMT staff was 3.38 (95% 3.23; 3.52) and mean "accessibility" score was 3.51 (95% CI 3.40; 3.62). Developing this competence throughout the workforce is the most effective way to ensure success across organizations. There were no specific patterns in the missing values. Cross-cultural research has become important in the fields of education and psychology, and articles addressing translation and adaptation over the past 30 years have increased by … On the basis of the results from this study the psychometric properties of the instrument should be tested using recognized statistical methods [4, 5]. Background of integrative communication theory. The model with the smallest estimate indicates the best fit [23]. Values above 0.90 indicate acceptable fit, whereas values close to 0.95 are indicative of good fit [32]. Subst Use Misuse. The approach uses qualitative methods to optimize semantic, technical, content, and conceptual equivalence of a culturally adapted tool with the original tool. Two forward and two back-translations were synthesized and compared by an expert committee. 10.1080/09595239996590. Underpinning the cross-cultural adaptation process are the two interrelated experiences of deculturation of some of the original cultural habits, on the one hand, and acculturation of new ones, on the other. The main aim of the Norwegian attitudinal study was to identify attitudes that were relevant in the Norwegian setting. The authors declare that they have no competing interests. Part of 1998, 52: 57-61. Structural Equation Modeling. In one harm reduction facility information about the study was given only to the leader of the facility. JRMC participated in the analysis and interpretation of the data and revised the manuscript critically for intellectual content. The questionnaire was semi-anonymous. Kim’s (2001) view of the process of cross-cultural adaptation is both problem-oriented and growth-oriented, taking into consideration differences in individuals’ demographic, linguistic, and cultural … 3. Thereafter the instrument was pretested and adjusted accordingly. The adaptation process included investigation of conceptual and item equivalence. , Ph.D., holds a doctorate in social sciences. Demographic variables that identify respondents will therefore be deleted upon completion of the project. to explain how value differentials impact interaction. Cite this article. Regardless, the subsequent stages after the back-translation presumably detected any discrepancies that might have occurred in the back-translation process. Caplehorn JR, Hartel DM, Irwig L: Measuring and comparing the attitudes and beliefs of staff working in New York methadone maintenance clinics. These findings suggest that the failure of the original abstinence-oriented scale is possibly related to changes over time. Drug Alcohol Depend. It also emphasizes the importance of ensuring that concepts within an instrument are equal between the original and target language, time and context. One reason could be a flawed cross-cultural adaption process. Instead for practical reasons, someone who spoke and wrote English fluently was used as a second back-translator. ... in the analysis and interpretation of data and were involved in drafting the manuscript or revising it critically for important intellectual content. Consequently, it is important to consider possible barriers when making a direct comparison between different nations, cultures and times. A literature review may give information regarding the use of instruments in the target setting [2]. The first factor, "Compliance", included seven items (α = 0.89). The cross-cultural adaptation process is important when an instrument is used in a different language, setting and time to reduce the risk of introducing bias into a study [ 2 ]. In comparison the Cronbach's alpha was (α = 0.89) when the scale was originally developed. Archives of psychology. A model of cross-cultural awareness emphasises intercultural contact as a leading factor in intercultural understanding and adaptation. Harm reduction staff were sampled from various institutions and therefore work within different ideologies and traditions. In the OMT group the model was adjusted to allow covariance between error 1 and 6 (MI = 11.014). The attitudes of OMT staff are of importance as they are likely to influence treatment practices and, subsequently, treatment outcomes [8, 10]. Drug & Alcohol Dependence. process of exchanging, negotiating, and mediating one’s cultural differences through language, non-verbal gestures, and space relationships.”, conversational nuances of business partners. Harm reduction staff were included in this study as a comparison group to OMT staff. Harm reduction services included street clinics, needle-exchange programs, injecting rooms and housing facilities. 10.1097/00007632-200012150-00014. It entails moving away from. Both translators were fluent in Norwegian and had good knowledge of English. Laake P, Olsen BR, Benestad HB: Research methodology in the medical and biological sciences. This means names were not required, but the name of the facility and other demographic variables made some staff theoretically identifiable. cross-cultural adaptation ... important to understand the factors which affect the quality of their adjust- 168 merit and to glean information from their point of view. A great thanks to colleagues who gave advise during the translation process. Cross-cultural adaptation (from English to other language) The aim of translation is to achieve different language versions of the original PU-QOL questionnaire (UK English version) that are clear and expressed in common language. The translation and cross-cultural adaptation procedure for creating a Turkish version of the BQN was based on the guidelines of Beaton et al. There was a positive correlation between the "Abstinence-orientation" and "Disapproval of Drug use" scales (r = 0.64) [7]. Google Scholar. Akaike H: Factor-Analysis and Aic. (Hanvey, 2004.) Importantly multigroup analysis confirmed differences between the groups in all parameters within the new attitudinal scale. process of exchanging meaningful and unambiguous information across cultures in a way that preserves mutual respect and minimizes conflict. Developing. The pretest was not conducted according to suggested guidelines [2–5]. 2000, 25: 3186-3191. There was no appropriate instruments available in Norwegian, thus an Australian-English instrument was cross-culturally adapted. There was also a difference in factor covariance between the two groups (Table 4). Why there are variations in the rate and outcomes of cross-cultural adaptation for different individuals. Likert R: A technique for the measurement of attitudes. Globalization has induced a source of standardization but the effects of standardization remains diffused. 1993, 46: 1417-1432. Herdman M, Fox-Rushby J, Badia X: A model of equivalence in the cultural adaptation of HRQoL instruments: the universalist approach. The new attitudinal model had an adequate fit to the data in both groups (Table 4). As an example a questionnaire that asks about physical activity and uses cross-country skiing as an example may not be relevant in settings where there is no snow [2]. 3. The study was approved by the Norwegian Regional Ethics Committee and the Data Inspectorate. Most are subjects of sharp discussions. "Accessibility" reflected staff attitudes towards intake criteria in OMT. In total there were 32 items in the original instrument. Finally the original instrument, the translated version and the back-translated version were compared by a committee. AVE is a summary indicator of convergence [28]. Thereafter the synthesized version should be back-translated independently by at least two different persons [4–6]. Instead a new two-factor scale was identified and found valid in the new setting. In OMT staff the covariance between "compliance" score and "accessibility" was 0.32 and in harm reduction staff the covariance was 0.15. A scree plot was used to decide the number of factors to retain. In addition attitudes cannot be measured directly [19]. The additional items were placed after the original items and thus did not alter the instrument's original structure. 10.1037/0033-2909.107.2.238. It entails moving away from acting out of habit and toward making conscious decisions in a sustained manner. ... features of the concepts mentioned above as well as using studies from social -cultural competence reveals that communication is more than language. Gerlach R, Caplehorn JRM: Attitudes and beliefs of doctors prescribing methadone to addicts in the Westfalen-Lippe region of Germany. Research questionnaires are not always translated appropriately before they are used in new temporal, cultural or linguistic settings. Young Yun Kim's assimilation Theory of Cross-Cultural Adaptation maintains that human transformation takes only one path, assimilative. This scale tested respondents' knowledge of the benefits and risks of methadone treatment [7]. Participants were promised full anonymity. The structure of cross- cultural adaptation Kim’s structural model identifies key dimensions and factors that facilitate, or impede, a given individual’s adaptive change over time. Journal of maintenance in the addictions. I am afraid that often cultural adaptation is often forced on people by the government of the country. Oberg (1960) initially described a four-stage model of cultural adjustment and 1996, 31: 663-677. They can overcome hindrances to adapting cross-cultural competence by: Developing awareness of individual cultures. However, there is agreement that it is inappropriate to simply translate and use a questionnaire in another linguistic context [2, 6]. Thus a missing value pattern was generated for all items to ensure that values were missing at random. Kim argues that all human beings experience conformity as they move into a new and culturally unfamiliar environment and that they do so by "unlearning" who they were originally. The failure of the original scale highlights the importance of adapting instruments to current research settings. Series of theories, notions, and concepts have been elaborated on in connection with the concept of cultural adaptation, among them, adaptive level, adaptive policies and processes, and accommodation and assimilation. Take for example, Australia, where I live. A sum score was calculated for each of the two attitudinal scales by dividing the number of completed items by the total score [7]. Cross cultural adaptation Introduction Cross cultural adaptation is a procedure which views both the translation of language and cultural adaptation problems in the process of preparation of a questionnaire for use in a different setting (Beaton, Guillemin,, 2000). This means that the structure of the instrument was the same as in the original. 1990, 107: 238-246. Additionally the instrument comprised of a 12-item knowledge scale. The two main concepts of cross-cultural adaptation are psychological and sociocultural adaptations (Searle and Ward 1990; Ward 1999; Ward and Kennedy 1999) which are consistent with the earlier models allowing for deep and In studies where a phenomenon is measured indirectly with questionnaires, comparison of results between cultures and groups may be a challenge. Oslo. 1990, 25: 173-180. Eigenvalue was 1.4. Two questionnaires (0.74%) were unusable due to incomplete answers. Acquiring and adapting cross-cultural competence can open up a world of opportunities and value. Cross-cultural adaptation and psychometric testing create a version of the original scale in a target language that is conceptually equivalent to the source instrument and ... familiarise themselves with important concepts and issues specific to the target population. It is also suggested to return to the target population and have experts in the field discuss subtleties brought out by the various translation proposals [3]. Speaking too, when communicating with a non-native English speaker can lead to gaps in understanding and adversely impact communication, that are commonly used in one’s cultural group, in today’s global business environment. 10.1016/0895-4356(93)90142-N. Wang W, Lee H, Fetzer SJ: Challenges and strategies of instrument translation. If there are uncertainties around the meaning of specific words or items, the developer of the original instrument can be contacted for clarifications [2, 4]. Caplehorn JR, Irwig L, Saunders JB: Attitudes and beliefs of staff working in methadone maintenance clinics., The translators should be fluent in the language of the target population with a good understanding of the original language [2–5]. Step two: identify, analyse and define key concepts that underscore each item A systematic approach for transcultural translation and adaptation was developed in Nepal and has been widely used as part of cross-cultural mental health studies [45,46,47]. Below are the links to the authors’ original submitted files for images. None of the translators or members of the committee were financially reimbursed. To ask respondents to rephrase each item is one technique that can identify whether an item is understood or not [3]. , shared workplaces and distribution centers. The committee comprised of PhD students, psychiatrists, medical doctors, one registered nurse and OMT staff.

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