Joyal Miranda

Cultural adaptation and translation of measures: An integrated method

Differences in the conceptualization and operationalization of health-related concepts may exist across cultures. Such differences underscore the importance of examining conceptual equivalence when adapting and translating instruments. In this article, we describe an integrated method for exploring conceptual equivalence within the process of adapting and translating measures. The integrated method involves five phases including selection of instruments for cultural adaptation and translation; assessment of conceptual equivalence, leading to the generation of a set of items deemed to be culturally and linguistically appropriate to assess the concept of interest in the target community; forward translation; back translation (optional); and pre-testing of the set of items. Strengths and limitations of the proposed integrated method are discussed.

Relationships between personal beliefs and treatment acceptability, and preferences for behavioral treatments

BACKGROUND The literature on preferences for behavioral interventions is limited in terms of understanding treatment-related factors that underlie treatment choice. The objectives of this study were to examine the direct relationships between personal beliefs about clinical condition, perception of treatment acceptability, and preferences for behavioral interventions for insomnia. METHODS The data set used in this study was obtained from 431 persons with insomnia who participated in a partially randomized clinical trial and expressed preferences for treatment options. The data were collected at baseline. Logistic regression was used to examine the relationships between personal beliefs and treatment acceptability, and preferences. The relationships between personal beliefs and perception of treatment acceptability were explored with correlational analysis. RESULTS Perception of treatment acceptability was associated with preferences. Persons viewing the option as convenient tended to choose that option for managing insomnia. Personal beliefs were not related to preferences. However, beliefs about sleep promoting behaviors were correlated with perceived treatment effectiveness. CONCLUSIONS Perception of treatment acceptability underlies expressed preferences for behavioral interventions. Personal beliefs about insomnia are not directly associated with preferences. Importance is highlighted for providing information about treatment options and exploring perception of each options acceptability during the process of treatment selection.

Exploring the Contribution of Treatment Factors to Preferences for Smoking Cessation Interventions

Background: Preferences for treatment affect the poor uptake, adherence, and outcomes of smoking cessation interventions. This study addressed the need to examine what smokers like and dislike about smoking cessation interventions. The study aimed to describe adult smokers’ preferences for three interventions: nicotine replacement therapy, brief individual advice and group behavioral therapy, and to identify treatment-related factors underlying treatment preferences. Methods: A cross-sectional design was used. Eligible participants were given information about each smoking cessation intervention, completed items to rate it relative to four attributes (appropriateness, effectiveness, severity of side effects and convenience of use), and asked to indicate what made the preferred intervention appealing. Logistic regression was used to examine the treatment attributes that were related to preferences. Content analysis was applied to identify additional factors that contribute to preferences. Results: The majority of participants had a preference, with the nicotine gum (45.6%) and group behavioral (54.4%) therapy most frequently selected. Only the attribute of appropriateness (OR > 2.0) was significantly associated with preferences for nicotine gum and group behavioral therapy. The perceived effectiveness, convenience of use and format in which it is delivered (e.g. group dynamics) were additional factors underlying preferences. Conclusions: The findings highlight the importance of assessing the smokers’ perception and preferences when selecting cessation treatment. Future research should examine the impact of providing the preferred intervention on abstinence.

Attrition in Randomized and Preference Trials of Behavioural Treatments for Insomnia

Preferences for treatment contribute to attrition. Providing participants with their preferred treatment, as done in a partially randomized clinical or preference trial (PRCT), is a means to mitigate the influence of treatment preferences on attrition. This study examined attrition in an RCT and a PRCT. Persons with insomnia were randomly assigned (n = 150) or allocated (n = 198) to the preferred treatment. The number of dropouts at different time points in the study arms was documented and the influence of participant characteristics and treatment-related factors on attrition was examined. The overall attrition rate was higher in the RCT arm (46%) than in the PRCT arm (33%). In both arms, differences in sociodemographic and clinical characteristics were found between dropouts and completers. The type of treatment significantly predicted attrition (all p ≤ .05). The results provide some evidence of a lower attrition rate in the PRCT arm, supporting the benefit of accounting for preferences as a method of treatment allocation.