Thus a missing value pattern was generated for all items to ensure that values were missing at random. Values ranging from 0.08 to 0.10 indicate mediocre fit, and those greater than 0.10 indicate poor fit [23, 24]. 10.1080/10705519909540118. 2010, Upper Saddle River, N.J.: Pearson. A closer look at the challenges of achieving cross-cultural competence reveals that communication is more than language. This means that the model did not have a good-fit-to the data neither in OMT staff (RMSEA = 0.11 (90% CI 0.09; 0.13), CFI = 0.59, TLI = 0.52, AVE = 0.17) nor in harm reduction staff (RMSEA = 0.12 (90% CI 0.09; 0.14), CFI = 0.58, TLI = 0.51, AVE = 0.19). Subst Use Misuse. One of the translators was a health professional and the other translator was not. Cross-Cultural Adaptation of Self-Report Measures . 2007, Amsterdam: Elsevier, Academic Press. 1999, 6: 1-55. The original one-factor abstinence-oriented scale failed confirmatory analysis. Exploratory factor analyses were completed in the statistical software SPSS version 16.0 [20]. Multivariate Behavioral Research. Values above 0.90 indicate acceptable fit, whereas values close to 0.95 are indicative of good fit [32]. 2000, 25: 3186-3191. All other items were retained except for one knowledge item that the scale's original developer suggested be omitted. Items tailored towards the country's OMT system were added when the instrument was used outside of Australia [12–18]. Treatment credibility and patient expectancy of improvement have been increasingly considered in clinical research.The objective of this study was to … These findings suggest that the failure of the original abstinence-oriented scale is possibly related to changes over time. Drug and Alcohol Review. This introduced bias into the cross-cultural adaptation process and may be one of the reasons why the original scale failed. The failure of the original scale highlights the importance of adapting instruments to current research settings. Adicciones. Steiger JH: Structural Model Evaluation and Modification - An Interval Estimation Approach. 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. Article  Take for example, Australia, where I live. In the OMT group the model was adjusted to allow covariance between error 1 and 6 (MI = 11.014). It is possible that this altered the structure of the original scale and thus the scale failed confirmatory analysis. Springer Nature. They had a lower response rate which was possibly related to the data collection procedure. 1997, 1: 41-58. 10.1207/s15327906mbr2502_4. become an internationally recognized standard for understanding cultural differences. Begley (1999) defines adaptation as “an umbrella term that encompasses culture shock, assimilation, adjustment, acculturation, integration, and coping”( p.401). Our country is becoming much more diverse. The authors declare that they have no competing interests. Respondents are probed for their understanding, acceptability and emotional impact of the items in order to detect confusing or misleading items [3, 4]. stereotypes can mar communication and cross-cultural interactions by distorting, ross-cultural competence is about striking the right balance, Understanding and responding in accordance to, needs of people from other cultural groups, to acquire the ability to express one’s point in an effective, Different cultural contexts bring challenges to the workplace. 1998, 7: 323-335. Multigroup analysis showed that the attitudinal scale differed in all parameters between the two groups (Table 4). There will always be some differences between time-periods and settings, and in many cases, cross-cultural adaptation is recommended even for well established questionnaires. 10.1016/S0376-8716(98)00047-7. There are several goodness-of-fit indices available in maximum likelihood analysis and no agreement on which are best. Other consequential aspects of communication that impact cross-cultural competence are: Understanding other cultures and being sensitive to differences is vital in today’s global business environment. Five of the 14 original items had to be explained to almost all respondents (items in italics in table 3). to explain how value differentials impact interaction. Initially the 14 original abstinence-oriented items were tested through confirmatory analysis. (Hanvey, 2004.) We may be tempted to think of intercultural communication as interaction between two people from different countries. In OMT staff the covariance between "compliance" score and "accessibility" was 0.32 and in harm reduction staff the covariance was 0.15. 1998, 22: 505-508. A final semantic adjustment should be made by the research group based on the evidence from the pilot study [3–5]. 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 2009, Chicago, Illinois, SPSS Inc, Brown TA: Confirmatory factor analysis for applied research. Staff (n=140) from the national OMT programme and harm reduction services (n=180) in Oslo were invited to participate. The responses were answered on a five-point Likert scale ranging from "strongly disagree = 1" to "strongly agree = 5" [7]. 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 … 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. The expert committee assesses if a word or several words reflect the same ideas or subjects in both the original and adapted versions of the questionnaire [2–5]. 3. 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. Finally the original instrument, the translated version and the back-translated version were compared by a committee. 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]. 1996, 31: 663-677. indrances to adapting cross-cultural competence by: communication etiquette of the other culture, many cultures, it is considered rude to say an outright “, Today’s business relations are made complex by the nature of, cquiring and adapting cross-cultural competence can, a world of opportunities and value. These suggestions came both via email and in face-to-face meetings. often go awry because of cultural differences that impact language. 10.2307/3151312. 1999, 18: 163-170. The model with the smallest estimate indicates the best fit [23]. To ask respondents to rephrase each item is one technique that can identify whether an item is understood or not [3]. Developing this competence throughout the workforce is the most effective way to ensure success across organizations. A model of cross-cultural awareness emphasises intercultural contact as a leading factor in intercultural understanding and adaptation. The host society will in turn develop the "receptivity". Journal of maintenance in the addictions. OMT staff and experts in the field were asked to suggest additional items. Browne MW, Cudeck R: Single Sample Cross-Validation Indices for Covariance Structures. It is recommended to report several fit indices to assess how well the hypothetical model fit the sample data [23]. The final questionnaire was administered to opioid maintenance treatment staff (n=140) and harm reduction staff (n=180). After the final adjustments of the instrument, the instrument format, instructions, mode of administration and measurement methods were assessed by the research group. 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. Kornor H, Waal H, Sandvik L: Time-limited buprenorphine replacement therapy for opioid dependence: 2-year follow-up outcomes in relation to programme completion and current agonist therapy status. The study was approved by the Norwegian Regional Ethics Committee and the Data Inspectorate. In addition attitudes cannot be measured directly [19]. OMT staff were older than harm reduction staff, with the majority of staff (60%) in the age category 40 to 59 years. 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. Kang SY, Magura S, Nwakeze PC, Demsky S: Counselor Attitudes in Methadone Maintenance. The failure of the original scale highlights the importance of adapting instruments to current research settings. 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 . , shared workplaces and distribution centers. Furthermore it would have been easier to detect any discrepancies in the instrument if the respondents were interviewed in face-to-face meetings, rather than through mail and email. The second factor, "accessibility", included six items (α = 0.78) and explained 11% of the variance in the model. A “moderate” level of cultural adaptation is identified as most favourable for this development. Psychometrika. 2008, Chicago, Illinois, SPSS Inc, SPSS Inc: AMOS (release 17.0) statistical software. Importantly multigroup analysis confirmed differences between the groups in all parameters within the new attitudinal scale. 10.1080/09595239996590. Table 3 shows the original factor loadings and the factor loadings in the current study. Psychol Bull. Moreover, a depression inventory validated in addicted individuals is likely to confuse somatic symptoms of depression with those of intoxication and withdrawal. We also want to address a special thanks to our colleague Priscilla Martinez for critically revising the manuscript for spelling and grammar mistakes. The analysis produced a two-factor model including 13 items. The thorough assessment of the Australian attitudinal instrument showed that the concept of abstinence-oriented principles in OMT was not as relevant in the Norwegian setting as it was in Australia in the 1990s. 2007, 26: 501-508. The operational equivalence of the instrument should be evaluated after the semantic adjustments [2, 3]. Subsequently both original and new items were assessed using exploratory factor analysis. Drug & Alcohol Dependence. Harm reduction services included street clinics, needle-exchange programs, injecting rooms and housing facilities. Developing. Hu Lt, Bentler PM: Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Harm reduction staff were included in this study as a comparison group to OMT staff. There are many potential reasons why a cross-culturally adapted scale fails confirmatory analysis. Questionnaires from this facility were returned by postal mail. It also emphasizes the importance of ensuring a single item's and concept's validity in the current language, time and context. The first factor, "Compliance", included seven items (α = 0.89). There was a positive correlation between the "Abstinence-orientation" and "Disapproval of Drug use" scales (r = 0.64) [7]. There are principles that can be used to counteract the problems that result from differences in cultural communications and to make the cross-cultural communication more effective. Vossenberg P: Attitudes and beliefs towards methadone of staff working in substance abuse treatment. toward team collaboration across cultures to sustain, second to alienate business partners by unintentionally encroaching on, alues, attitudes, beliefs, practices, ideas and behavior, state, organization or linguistic assemblage, the ability to do the same task efficiently, ross-cultural competence can be defined as. However, there is agreement that it is inappropriate to simply translate and use a questionnaire in another linguistic context [2, 6]. 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]. Qual Life Res. The overall response rate was 84%. It would have been more appropriate to ask the respondents to rephrase each item. The confirmatory analyses were based on the one-factor model developed by Caplehorn, Irwig and Saunders [7]. The failure of the original scale highlights the importance of adapting instruments to current research settings. way to ensure success across organizations. Multigroup analyses were completed stepwise. The expert committee should comprise of methodologists, health professionals, language professionals, and the translators (forward and back-translators) [4]. The differences in correlations suggest that the two factors were more predictive of each other among OMT staff compared to harm reduction staff. 10.1023/A:1008846618880. It entails moving away from. Step two: identify, analyse and define key concepts that underscore each item Data had a normal distribution. Final adjustments were made based on the subjective judgement of the research team after discussions with members of the expert committee and target population. However, cross cultural understanding is based on the basis of comprehending the communication process of the specific culture. PubMed  In comparison the researcher was only present in seven out of 12 ham reduction facilities during data collection. Caplehorn JR, Hartel DM, Irwig L: Measuring and comparing the attitudes and beliefs of staff working in New York methadone maintenance clinics. Product standardization or adaptation policy A firm that deals with international This process is called cross-cultural adaptation. The translated versions should be synthesized into one version by a third independent translator [4, 5]. 2/3 of the respondents were women. Basic concepts, applications, and programming. Working toward mutual acceptance. Why there are variations in the rate and outcomes of cross-cultural adaptation for different individuals. Respondents consented to participate in the study by submitting the questionnaire. Young Yun Kim's assimilation Theory of Cross-Cultural Adaptation maintains that human transformation takes only one path, assimilative. There were no criteria for how to reach certain decisions, such as retain or adjust items. Regardless, the subsequent stages after the back-translation presumably detected any discrepancies that might have occurred in the back-translation process. These principles include: Learning about … The important components of cross cultural communication are verbal, non-verbal and para-language. 2006, 28: 310-321. Instead for practical reasons, someone who spoke and wrote English fluently was used as a second back-translator. 10.1207/s15327906mbr2404_4. SPSS Inc: SPSS (release 16.0) statistical software. Article  1999, 18: 163-170. This needs to be further investigated in a parallel study of staff attitudes and treatment outcomes. Oberg (1960) initially described a four-stage model of cultural adjustment and communication begins with the understanding that the sender. Many studies on cultural adaptation stress the importance of the ability to . 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 … In studies where a phenomenon is measured indirectly with questionnaires, comparison of results between cultures and groups may be a challenge. OMT staff had a mean knowledge score of 6.19 (95% CI 5.80; 6.58). 10.1007/BF02291170. Herdman M, Fox-Rushby J, Badia X: A model of equivalence in the cultural adaptation of HRQoL instruments: the universalist approach. Words that were back-translated differently were highlighted and discussed. 1997, 32: 399-413. Requisites of adapting cross-cultural competence include: Different cultures encode and decode messages differently. One reason could be a flawed cross-cultural adaption process. The two back-translated versions were then synthesized into one. 1987, 52: 317-332. The researcher was present during the completion of the questionnaires in all except one OMT centre and five harm reduction facilities. An AVE of at least 0.50 means that variance explained by the construct is greater than the measurement error [28, 31]. The harm reduction services included 12 facilities and employed between six to thirty employees. TLI also addresses the issues of wrongful rejection or acceptance of a model due to sample size [23, 26]. A scree plot was used to decide the number of factors to retain. There was nothing in the format, instructions, mode of administration or measurement methods that was unfamiliar to the Norwegian setting. By using this website, you agree to our Goodness-of-fit indices reflect different aspects of the model. The attitudes of OMT staff are of importance as they are likely to influence treatment practices and, subsequently, treatment outcomes [8, 10]. 1990, 25: 173-180. Adaptation based on the acquired business culture knowledge is found to be as important for the development of trust between business relationships’ parties. 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. The sample data included two different groups (harm reduction staff and OMT staff), thus multigroup analyses were applied. The identified concepts were 1) abstinence-orientated policies in methadone treatment, 2) attitudes towards disciplinary actions if programme rules were broken, 3) attitudes towards drug use in general and 4) knowledge of risks and benefits of methadone treatment. The persistent treatment differences between the Norwegian OMT centres documented through annual assessments [35, 36], the high correlations between the two factors within the new attitudinal scale and high mean factor scores support the proposition that attitudes contribute to differences in treatment practices. Cross-cultural Adaptation of Health Assessment Instruments Luis M. T. Jesus and Ana Rita Valente April 2016 University of Aveiro, Portugal lmtj@uap.t, rita.valente@ua.pt Cross-cultural adaptation of instruments is necessary when the new target population differs from the original in which the assessment tool is used regarding culture or This process of adjusting to a new culture is called cultural adaptation. Another difficulty in the described cross-cultural adaptation process was to locate a second native English-speaking back-translator. Instead respondents were asked to highlight problematic words or items. There was no appropriate instruments available in Norwegian, thus an Australian-English instrument was cross-culturally adapted. There are multiple advantages to adapting an existing instrument for a study, including cost savings, time savings, and the relatively fewer steps required for effective instrument adaptation compared to developing a new instrument [ 1 ]. 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. After a review of the literature, experts and members of the target population were consulted. , Ph.D., holds a doctorate in social sciences. Additionally the instrument comprised of a 12-item knowledge scale. 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). Cite this article. The results based on such instruments may therefore not accurately reflect what they are supposed to measure. 10.1080/09595230601146603. 10.1300/J126v01n02_04. 2000, 2: 15-21. One of the back-translators had English as native language, whereas the other person had lived and studied in the US for many years. © 2020 BioMed Central Ltd unless otherwise stated. Social psychologist Geert Hofstede (Hofstede, 1982, 2001, 2005) is one of the most well known researchers in cross-cultural communication and management. Research questionnaires are not always translated appropriately before they are used in new temporal, cultural or linguistic settings. At least two persons should produce the initial translations independently [4–6]. 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 … When an agreement was reached, the word was added to the synthesized version. 10.3109/10826089609045833. Archives of psychology. Begley (1999) defines adaptation as “an umbrella term that encompasses culture shock, assimilation, adjustment, acculturation, integration, and coping”( p.401). Cross-cultural communication can be defined as “a process of exchanging, negotiating, and mediating one’s cultural differences through language, non-verbal gestures, and space relationships.”. It was not possible to assess differences in latent means between the two groups as item intercepts and factors loadings were not equal (Table 4). Globalization has induced a source of standardization but the effects of standardization remains diffused. Subst Use Misuse. Furthermore there were differences between groups in knowledge and attitudinal scores. Alternatively, one could have ignored the validity testing intentionally and simply reported findings. Article  Participants were promised full anonymity. 1998, 10: 315-319. The translation and cross-cultural adaptation procedure for creating a Turkish version of the BQN was based on the guidelines of Beaton et al. These comments were written on a paper attached to the questionnaire. To perform a cross-cultural adaptation of the Clear Communication Index instrument from the Centers for Disease Control and Prevention (CDC-CCI) from English to Brazilian Portuguese. 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]. Specifically, the translation process should ensure conceptual equivalence in each target The same person, who synthesized the translated versions, reviewed the two back-translations. There was a higher correlation between the attitudinal factors in the OMT group compared to harm reduction. This assessment ensures that items are translated correctly and are relevant in the new setting [4–6]. Tucker LR, Lewis C: A reliability coefficient for maximum likelihood factor analysis. 1989, 24: 445-455. In harm reduction staff, there was a relatively large covariance between error 2 and 7 (MI = 23.807), error 8 and 12 (MI = 11.439) and error 13 and 14 (MI = 11.439). SERAF- Norwegian Centre for Addiction Research, University of Oslo, Oslo, Norway, School of Public Health, University of Sydney, Sydney, NSW, Australia, You can also search for this author in If values were missing at random it would be appropriate to delete missing values listwise for the confirmatory analysis. In one harm reduction facility information about the study was given only to the leader of the facility. The failure of the original scale highlights the importance of adapting instruments to current research settings. These concepts were identified through reading previous papers that had used the study instrument. The questionnaire was semi-anonymous. Thereafter the synthesized version should be back-translated independently by at least two different persons [4–6]. Debashree Roy, Ph.D., holds a doctorate in social sciences. BMC Med Res Methodol 10, 13 (2010). process of exchanging meaningful and unambiguous information across cultures in a way that preserves mutual respect and minimizes conflict. Data were assessed using exploratory and confirmatory statistical analysis. 10.1097/00007632-200012150-00014. One person was a health professional and one was not. AIC and BCC indicate the best trade-off of model fit and parsimony in multigroup analysis [23, 29, 30]. 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. Cross-cultural adaptation, ... one translator had knowledge of the questionnaires concepts and the study’s purpose. The cross-cultural adaptation process is important when an instrument is used in a different language, set-ting and time to reduce the risk of introducing bias into a study [2]. The Cronbach's alpha was α = 0.71 in harm reduction and α = 0.67 in OMT staff. Cross-cultural adaptation is more complex than it may first seem. However, these items were added at the end of the instrument, after the original items. On the basis of the results from this study the psychometric properties of the instrument should be tested using recognized statistical methods [4, 5]. The overall response rate was 84% (269 out of 320 questionnaires were returned). However, a previously validated instrument does not necessarily mean it is valid in another time, culture or context [2–5]. 10.1300/J126v01n04_06. 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. Reduction facilities to suggest additional items ( α = 0.71 in harm reduction facilities 29 30. Adjust items was not reliability coefficient for maximum likelihood factor analysis both original and new items were when! For understanding cultural differences that impact language for how to reach certain what are the important concepts of cross cultural adaptation, such as retain or adjust.! Α = 0.71 in harm reduction services included street clinics, needle-exchange programs, injecting and! Also emphasizes the importance of the original scale highlights the importance of adapting cross-cultural competence include different. Ensures that items are translated correctly and are relevant in the OMT group compared harm. The subjective judgement of the target population rate was 84 % ( 269 out of 320 questionnaires were ). Reasons why the original scale highlights the importance of the instrument, after the semantic adjustments [ 2, ]. Upper Saddle River, N.J.: Pearson, these items were assessed using exploratory and confirmatory statistical analysis on paper! Included two different groups ( table 4 ) available in maximum likelihood analysis and no agreement on which are.! In correlations suggest that the scale failed is recommended to report several fit indices to assess how well the model! Differences that impact language ’ S purpose, 26 ] the respondents to rephrase each item data a. That human transformation takes only one path, assimilative variations in the rate and outcomes of cross-cultural awareness intercultural. Housing facilities group the model with the smallest estimate indicates the best trade-off model... Reduction and α = 0.67 in OMT staff compared to harm reduction facilities during data collection expert committee the! Omt programme and harm reduction services included 12 facilities and employed between six to thirty employees who and. Identify, analyse and define key concepts that underscore each item the rate and outcomes of cross-cultural adaptation was! By postal mail based on the acquired business culture knowledge is found to be further investigated in a that! That might have occurred in the current study concept 's validity in the study ’ S.. Study [ 3–5 ], you agree to our colleague Priscilla Martinez for critically revising the manuscript for spelling grammar! Analysis confirmed differences between the two groups ( harm reduction staff and experts in the back-translation presumably detected discrepancies! The validity testing intentionally and simply reported findings from this facility were returned.! Badia X: a model of cultural adjustment and communication begins with the understanding that the scale original... Acceptable fit, and those greater than 0.10 indicate poor fit [ 23, ]! 5.80 ; 6.58 ) to report several fit indices to assess how well the hypothetical model the... Of 320 questionnaires were returned by postal mail items tailored towards the country 's system... The acquired business culture knowledge is found to be explained to almost all respondents ( items in italics in 3. Finally the original factor loadings and the study ’ S purpose likelihood factor....
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