Transcultural Adaptation of Questionnaire to Evaluate Drug Use Among Students: The Use of the EU-Dap European Questionnaire in Brazil

ABSTRACT

Background: Social and cultural differences between countries stress the need for adapting existent instruments for adequately comparing epidemiological results. However, there are controversies in literature on how to carry out this process. Objectives: This study aimed to describe the process of cultural adaptation and evaluation of the Brazilian Portuguese language of the European Drug Addiction Prevention Trial (EU-Dap) questionnaire to identify alcohol, tobacco, and other drug use among adolescents. Methods: The cross-sectional study took place in 16 public schools in three Brazilian cities during the year 2013 in a sample of 2,969 adolescents between the ages of 11 and 16. Operating steps involved analysis of qualitative data collected through student's focus group and field notes by interviewers and quantitative data from test–retest evaluation and nonresponse to item. Results: The results revealed moderate reliability for the primary outcomes and high levels of nonresponse, mainly in the 2/3 final questions. Focus group provided high-quality information about misconception for the semantic and structure of the questionnaire. Participatory observation helped researchers to tap into the main difficulties of the application context. Conclusions: Sociocultural issues related to Brazilian students, the application context, and the structure of the original questionnaire contributed to the unsatisfactory results of the transcultural adaptation process. The results further highlighted the challenge of adapt questionnaires investigating sensitive issues in an age group particularly influenced by educational factors, especially when the countries have different standards of achievement in education.

KEYWORDS:

• Transcultural adaptation
• drug use
• adolescents
• mixed methods research
• questionnaire reliability
• Latin culture
• Brazil

Additional information

Notes on contributors

Mariangela Cainelli de Oliveira Prado

Mariangela Cainelli de Oliveira Prado, PhD, is a professor of Public Health at the Universidade Federal de São Paulo, Escola Paulista de Medicina. Her research is focused primarily on applying epidemiological methods to analyze and monitoring social inequalities in health. She has been studying these questions in the context of cardiovascular diseases, mental health and preventive drug policy. She is also working to improve medical education introducing different approaches to the learning-teaching process of epidemiology.

Daniela Ribeiro Schneider

Daniela Ribeiro Schneider, PhD, is an associate professor at the Universidade Federal de Santa Catarina, South of Brazil. Her research is focused on evaluating drug abuse prevention programs, mental health services and existentialist psychology. She is the coordinator of the Research Group of CNPq “Clinic Psychosocial Care and Use of Alcohol and Other Drugs and is the author of dozens of articles and book chapters on drug use prevention and mental health.

Adriana Sañudo

Adriana Sañudo, Master in Statistics, is a lecturer in Biostatistics at the Department of Preventive Medicine and a PhD candidate at the Public Health Program at the Universidade Federal de São Paulo. Currently, her main field of research is epidemiology of drug use, with emphasis on factors associated with drug use in specific populations such as adolescents and nightclub patrons.

Ana Paula Dias Pereira

Ana Paula Dias Pereira is a Master of Science, Psychologist and PhD candidate at the Public Health Program at the Preventive Medicine Department at the Universidade Federal de São Paulo – UNIFESP, in Brazil. Currently, her main field of research is drug use prevention in Brazilian schools.

João Felipe Horr

João Felipe Horr is Master in Psychology, and lecturer at the Universidade Regional de Blumenau, South Brazil. Currently, his main field of research is intimate partner violence preventive and clinical interventions, mental health services and evaluation of drug use prevention programs.

Zila M. Sanchez

Zila M. Sanchez, PhD, is a Professor of Epidemiology at the Department of Preventive Medicine at the Universidade Federal de São Paulo. Her main field of research is epidemiology of drug use, with emphasis on factors associated with drug use in specific populations such as adolescents and nightclub patrons. She has more than 50 peer reviewed published articles in the field of drug abuse and is now the principal investigator of research grants focused on the study of drug abuse in nightclubs and drug prevention program evaluation in the school setting.