Multiple instrument translation for use with South Asian Indian immigrants

Physical Activity Behavior and Measurement in Arab American Women: An Integrative Review

Physical activity (PA) is associated with cardiovascular health; however, in the U.S., only 20% of women are physically active, compared to 28% of men. Arab American women (AAW) experience unique barriers to engaging in the recommended PA. This review examines quantitative PA studies conducted with AAW with a specific focus on how PA outcomes were assessed. Studies were analyzed to explore: (a) types of PA behavior, (b) components of PA interventions/interest (if conducted), (c) PA measurement, and (d) translation of PA tools. After screening titles, abstracts, and a full-text review of articles from five different databases, 12 studies met the inclusion criteria. Leisure-time PA was the most readily used PA measure. Only two out of the 12 studies included women-only participants. There was a total of 10 cross-sectional studies and two quasi-experimental studies. All the studies used a self-report PA questionnaire; one study used a pedometer to measure PA. Six PA questionnaires were translated into Arabic. Future studies must explore the use of reliable and valid translated instruments, objective PA measures, and randomized controlled trial designs.

Ethical climate and moral distress in paediatric oncology nursing

BACKGROUND

Ethical climate and moral distress have been shown to affect nurses' ethical behaviour. Despite the many ethical issues in paediatric oncology nursing, research is still lacking in the field.

RESEARCH AIM

To investigate paediatric oncology nurses' perceptions of ethical climate and moral distress.

RESEARCH DESIGN

In this cross-sectional study, data were collected using Finnish translations of the Swedish Hospital Ethical Climate Survey-Shortened and the Swedish Moral Distress Scale-Revised. Data analysis includes descriptive statistics and non-parametric analyses.

RESPONDENTS AND RESEARCH CONTEXT

Ninety-three nurses, working at paediatric oncology centres in Finland, completed the survey.

ETHICAL CONSIDERATIONS

According to Finnish legislation, no ethical review was needed for this type of questionnaire study. Formal research approvals were obtained from all five hospitals. Return of the questionnaire was interpreted as consent to participate.

RESULTS

Ethical climate was perceived as positive. Although morally distressing situations were assessed as highly disturbing, in general they occurred quite rarely. The situations that did appear often reflected performing procedures on school-aged children who resist such treatment, inadequate staffing and lack of time. Perceptions of ethical climate and frequencies of morally distressing situations were inversely correlated.

DISCUSSION

Although the results echo the recurrent testimonies of busy work shifts, nurses could most often practise nursing the way they perceived as right. One possible explanation could be the competent and supportive co-workers, as peer support has been described as helpful in mitigating moral distress.

CONCLUSION

Nurturing good collegial relationships and developing manageable workloads could reduce moral distress among nurses.

Ensuring Cultural and Cognitive Integrity in Instrument Translation: Quality of Life Index for Japanese Cancer Patients

Objective

The objective of this paper is to provide a practical illustration of methods useful for translating and testing questionnaire instruments for nursing and healthcare to ensure reliability, validity, and appropriateness for the target culture.

Methods

We present the process used to create the Japanese version of a well-established quality of life (QOL) instrument, originally developed in American English. The Ferrans and Powers Quality of Life Index (QLI)-Cancer Version III was translated into Japanese by a team of bilingual translators and tested using an iterative process involving cognitive interviewing with monolingual Japanese cancer patients.

Results

Discussions among the translation team made it possible to find and resolve linguistic, cultural, and practical issues regarding the translation. Problems stemming from question interpretation and information retrieval were resolved through the cognitive interviewing process. One problem related to response editing could not be remedied with altered phrasing, namely a question referring to the respondents' sex lives. This item was retained in the Japanese version of the QLI as an indispensable component of QOL, particularly in a healthcare context.

Conclusions

The final Japanese version captured the intended meaning of the original, and also was culturally appropriate and clearly understood by Japanese cancer patients.

Barriers and Motives to PA in South Asian Indian Immigrant Women

The high prevalence of chronic illnesses in South Asian Indian immigrant women underscores the need for identifying factors that could influence their PA. The purpose of this qualitative study was to examine the perspectives of South Asian Indian immigrant women related to barriers to and motives for lifestyle PA within the PA Framework for South Asian Indian Immigrants. Forty women participated in focus groups that were conducted in English and Hindi. Focus group questions were open-ended and semistructured. Transcribed and de-identified audiotaped sessions were coded and analyzed using Atlas.ti software. Role expectation was a core theme for barriers with four subthemes: lack of time, loss of interest, diminished social support, and environmental constraints. Self-motivation was a core theme for motives with three subthemes: optimal physical and psychological health, emphasis on external beauty, and strong social support. Future PA interventions need to target these culturally sensitive factors.

Factors Affecting Korean Neonatal Infant Pain Care: Translation and Validation of Three Instruments

This study aimed to translate three English-language instruments-Pain Knowledge and Use (PKU), Collaboration and Satisfaction About Care Decisions (CSACD), and Environmental Complexity Scale (ECS)-into Korean and evaluate the equivalence of the instrument versions. Three Korean translators and two senior reviewers translated the instruments' 56 items using a committee approach. Eight Korean experts evaluated the cultural relevance of the translated instruments using a content validity index (CVI), and 12 Korean neonatal nurses were interviewed to assess their understanding of items. In an expert panel review, the item-CVI was less than 0.78 for 14 items. Based on cognitive interviews, four items were found to be unsuitable in Korea. Based on expert panel review and cognitive interviews, unsuitable items were modified or deleted. In another expert panel review, the scale-CVI was 1.00 for the final instruments. The findings support the validity of the Korean-language PKU, CSACD, and ECS for research application.

Development of macaronic Hindi-English 'Hinglish' text message content for a coronary heart disease secondary prevention programme

BACKGROUND

Coronary heart disease (CHD) is a leading cause of morbidity and mortality in India. Text message based prevention programs have demonstrated reduction in cardiovascular risk factors among patients with CHD in selected populations. Customisation is important as behaviour change is influenced by culture and linguistic context.

OBJECTIVES

To customise a mobile phone text message program supporting behaviour and treatment adherence in CHD for delivery in North India.

METHODS

We used an iterative process with mixed methods involving three phases: (1) Initial translation, (2) Review and incorporation of feedback including review by cardiologists in India to assess alignment with local guidelines and by consumers on perceived utility and clarity and (3) Pilot testing of message management software.

RESULTS

Messages were translated in three ways: symmetrical translation, asymmetrical translation and substitution. Feedback from cardiologists and 25 patients was incorporated to develop the final bank. Patients reported Hinglish messages were easy to understand (93%) and useful (78%). The software located in Australia successfully delivered messages to participants based in Delhi-surrounds (India).

CONCLUSIONS

Our process for customisation of a text message program considered cultural, linguistic and the medical context of potential participants. This is important in optimising intervention fidelity across populations enabling examination of the generalisability of text message programs across populations. We also demonstrated the customised program was acceptable to patients in India and that a centralised cross-country delivery model was feasible. This process could be used as a guide for other groups seeking to customise their programs.

TRIAL REGISTRATION NUMBER

TEXTMEDS Australia (Parent study)-ACTRN 12613000793718.

Asian Indians in America: The influence of values and culture on mental health

Asian Indians represent a significant portion of the largest growing race of Asians in the past decade in the United States. This selective review examines major cultural themes related to first- and second-generation Asian Indians living in the United States as they impact psychological and psychiatric dysfunction in this population. Specifically, we review the impact of Asian Indian culture on mental health, discuss the impact of acculturation and ethnic identity development on the mental health of Indian-Americans, and focus on typical mental health problems of Asian Indian adolescents, women and elderly in America. Finally, we provide a brief overview of empirically-supported treatment approaches and cultural considerations for additional treatments relevant to this population. This review is intended to provide an important foundation for more systematic empirically-driven investigation into better understanding how Asian Indian cultural themes impact mental health for Indian-Americans, and how to develop effective treatments for these issues in this cultural group.

Bilingual Text Messaging Translation: Translating Text Messages From English Into Spanish for the Text4Walking Program

BACKGROUND

Hispanic adults in the United States are at particular risk for diabetes and inadequate blood pressure control. Physical activity improves these health problems; however Hispanic adults also have a low rate of recommended aerobic physical activity. To address improving physical inactivity, one area of rapidly growing technology that can be utilized is text messaging (short message service, SMS). A physical activity research team, Text4Walking, had previously developed an initial database of motivational physical activity text messages in English that could be used for physical activity text messaging interventions. However, the team needed to translate these existing English physical activity text messages into Spanish in order to have culturally meaningful and useful text messages for those adults within the Hispanic population who would prefer to receive text messages in Spanish.

OBJECTIVE

The aim of this study was to translate a database of English motivational physical activity messages into Spanish and review these text messages with a group of Spanish speaking adults to inform the use of these text messages in an intervention study.

METHODS

The consent form and study documents, including the existing English physical activity text messages, were translated from English into Spanish, and received translation certification as well as Institutional Review Board approval. The translated text messages were placed into PowerPoint, accompanied by a set of culturally appropriate photos depicting barriers to walking, as well as walking scenarios. At the focus group, eligibility criteria for this study included being an adult between 30 to 65 years old who spoke Spanish as their primary language. After a general group introduction, participants were placed into smaller groups of two or three. Each small group was asked to review a segment of the translated text messages for accuracy and meaningfulness. After the break out, the group was brought back together to review the text messages.

RESULTS

A translation confirmation group met at a church site in an urban community with a large population of Hispanics. Spanish speaking adults (N=8), with a mean age of 40 (SD 6.3), participated in the study. Participants were engaged in the group and viewed the text messages as culturally appropriate. They also thought that text messages could motivate them to walk more. Twenty-two new text messages were added to the original database of 246 translated text messages. While the text messages were generally understood, specific word preferences were seen related to personal preference, dialect, and level of formality which resulted in minor revisions to four text messages.

CONCLUSIONS

The English text messages were successfully translated into Spanish by a bilingual research staff and reviewed by Hispanic participants in order to inform the use of these text messages for future intervention studies. These Spanish text messages were recently used in a Text4Walking intervention study.

Correlates of lifestyle: physical activity among South Asian Indian immigrants

South Asian immigrants are at increased risk for cardiovascular disease and diabetes, but little is known about their physical activity patterns. In this cross-sectional study, 110 participants were recruited to describe lifestyle physical activity behavior of this at-risk population. Education (p = .042), global health (p = .045), and self-efficacy (p = .000) had significant positive independent effects on leisure-time physical activity. Depression (p = .035) and waist circumference (p = .012) had significant negative independent effects, and frequency of experiencing discrimination a significant positive independent effect (p = .007) on daily step counts. Culture-sensitive physical activity interventions need to target South Asian Indian immigrants who are less educated, in poor health, concerned about racial discrimination, and have low self-efficacy.

Lifestyle physical activity behavior among South Asian Indian immigrants

Little is known of the physical activity behavior of South Asian Indian immigrants (SAIs), though they have more than twice the risk for cardiovascular disease and diabetes than Whites. This was a cross-sectional descriptive face-to-face survey design, comparing between men and women in leisure time (LTPA), household (HPA), and occupational physical activity (OPA). Participants also wore a Lifecorder EX (NL2200) accelerometer for 7 days. Just over half (51.8 %) of the participants met the recommended PA guidelines (≥150 min moderate-intensity or ≥75 min vigorous-intensity) through LTPA. The average number of daily steps was 6,904.3, which is in the "low active" classification. Increasing lifestyle PA among SAIs is important; PA interventions appealing to gender and culture and with an aerobic component are needed.