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Cross-cultural adaptation of the Parcours Amoureux des Jeunes - PAJ inventory of Canadian origin to the Brazilian context

Abstracts

Analyzing violent events in the amorous trajectory of young people mobilizes researchers worldwide. The scope of this study is to perform the cross-cultural adaptation and content validation of the Canadian Parcours Amoureux des Jeunes (PAJ) inventory in the Brazilian context. It is a methodological study with the following steps: (a) translation and back-translation; (b) committee of experts (10) for analysis of equivalence, clarity and matching percentages; (c) calculation of the Content Validity Index / CVI. This analysis generated Pilot version III (d) submitted to a pre-test group of 36 adolescents aged 14 to 24 of both sexes to obtain cultural, conceptual, semantic and idiomatic equivalence. The PAJ showed adequate content validity (CVI 0.97). In section 1 (sociodemographic aspects of youths and families inherent to the Canadian context), the questions were appropriate to the Brazilian context shown by the low value of the CVI. Cross-cultural adaptation and content validation processes showed that the PAJ had adequate clarity and equivalence properties. This step makes it viable to conduct psychometric analysis to assess the replicability and reliability of the instrument to be applied in the Brazilian context.

Cross-cultural comparison; PAJ; Validation studies; Adolescence


Analisar eventos violentos no percurso amoroso de jovens mobiliza estudiosos em nível mundial. O objetivo deste estudo é realizar a adaptação transcultural e validação de conteúdo do inventário PAJ Parcours Amourex des Jeunes, do Canadá, para o contexto brasileiro. Estudo metodológico envolvendo etapas: (a) Tradução e Retrotradução; (b) Comitê de Especialistas (10) – análise da equivalência, clareza e porcentagens de concordância; (c) Cálculo do Índice de Validade de Conteúdo/IVC. Esta análise originou a versão Piloto III: (d) Submissão ao Pré-teste com grupo de 36 jovens, de 14 a 24 anos, ambos os sexos, visando obter equivalências cultural, conceitual, semântica, idiomática. O PAJ apresentou adequada validade de conteúdo (IVC 0,97). Na seção 1 (aspectos sociodemográficos de jovens e famílias, inerentes ao contexto canadense), as questões foram adequadas ao contexto brasileiro pelo baixo valor do IVC. Os processos de adaptação transcultural e validação de conteúdo apontaram que o PAJ apresentou adequação nas propriedades de clareza e equivalência. Esta etapa viabiliza as análises psicométricas visando à reprodutibilidade e confiabilidade do instrumento a ser aplicado no contexto brasileiro.

Comparação transcultural; PAJ; Estudos de validação; Adolescência


Introduction

The cultural diversity of a continental country like Brazil requires the understanding of the dynamics of social and affective relations of young people with their families and partners, making violence a complex topic by integrating multiple factors related to young people’s relationships. Under this perspective, it is necessary to study the course of adolescent’s love life to understand how they establish and maintain their connections under multiple possibilities and interferences for the consolidation of these bonds.

Various forms of relationships and socially imposed standards can intervene in the construction of affectivity among young people, which may have an impact on the quality of life, social skills, health, and survival of these groups. In childhood, children who live and participate in appropriate socialization environments participate in group activities creating permanent bonds of friendship, vital factors for the collaborative and solidary learning to make choices. In adolescence, relationships between friends support the process of psychosocial development, stimulating information exchange, social support, as well as the interaction with people living in the same transformation context. At this stage, one can observe that these connections provide social protection against adversities and conflicts that are common in this period of life, helping the personality development in a more stable and safe way11. De Souza DA, Cerqueira-Santos E. Relacionamentos de amizade e coping entre jovens adultos. Psicologia: Teoria e Pesquisa2012; 28(3):345-356..

The current literature on the subject has pointed out that love relationships have less durable bonds, little or no tolerance to conflict, minimal patience and constant demands for immediate results22. Zordan EP, Strey MN. A separação conjugal na contemporaneidade: motivos, circunstâncias e contextos [tese]. Porto Alegre: Pontifícia Universidade Católica do Rio Grande do Sul; 2010.. With population growth and media modernization, the number of links between people who do not know each other expanded, creating other forms of interaction and, consequently, greater opportunities for the manifestation of violent acts, although most crimes are committed by people who have close relationships. In the United States, between 1998 and 2002, a study conducted by the Bureau of Justice Statistics (2006) showed that about 54% of all violent crimes occurred between acquaintances33. United States. US Departament of Justice. Office of Justice Programs. Bureau of Justice Statistics (BJS). National Crime Victmization Survey:Criminal Victimization, 2005. Washington: BJS; 2006.. In a study performed in Brazil, in 2013, in 10 capital cities, 60 adolescents (19.9%) claimed to physical violence on their partners, being 37 female (21.8%) and 23 male (17.4%). Regarding psychological violence, the prevalence was 82.8% (80.6% female and 85.6% male44. Wolfe DA, Scott K, Wekerle C, Pittman AL. Child maltreatment: risk of adjustment problems and dating violence in adolescence. J Am Acad Child Adolesc Psychiatry 2001; 40(3):282-289.,55. Barreira AK, Lima MLC, Avanci JQ. Coocorrência de violência física e psicológica entre adolescentes namorados do Recife, Brasil: prevalência e fatores associados. Cien Saude Colet 2013; 18(1):233-243.).

Considering the current panorama of relationships, violence in the love and friendly life among young people has been calling attention of researchers, mainly due to its cumulative effects of abuses that may bring problematic and negative consequences during the formation of links and intimate relations66. Straus MA. Measuring intrafamily conflict and violence: the Conflict Tatics (CT) scales. Journal of Marriage and the family1997; 41(1):75-88..

Different research instruments are used to study violence, analyzing the phenomenon under other perspectives, such as the Conflict in Adolescent Dating Relationships Inventory (CADRI)66. Straus MA. Measuring intrafamily conflict and violence: the Conflict Tatics (CT) scales. Journal of Marriage and the family1997; 41(1):75-88., which evaluates the violence between adolescent intimate partners, based on the Conflict Tatics Scale (CTS)77. Tolman RM. The development of a measure of psychological maltreatment of women by their male partners. Violence Vict1989; 4(3):173-189. and the Psychological Maltreatment of Women Inventory (PMWI)88. Koss MP, Oros CJ. Sexual experiences survey: a research instrument investigating sexual aggression and victimization. J Consult Clin Psychol 1982; 50(3):455-457.; the Sexual Experiences Survey, which identifies different degrees of sexual assault and victimization99. Koss MP, Gidyez CA. Sexual experiences survey: reability and validity. J Consult Clin Psychol 1985; 53(3):422-423.; the Early Trauma Inventory-Self Report (ETI)1010. Bremner JD, Bolus R, Mayer EA. Psychometric properties of the Early Trauma Inventory – Self Report. J Nerv Ment Dis 2007; 195(3):211-218., clinical instrument to assess the emotional aspects of physical and sexual abuse and negligence in childhood1111. Wong T, Hisashima J. Domestic violence Exploratory Study on DVSI and SARA. Hawaii State Departament of Health. [acessado 2013 mar 10]. Disponível em: http://hawaii.gov/icis/documents/SARA-DVSI%20Exploratory%20Study%20(Oct%202008).pdf.
http://hawaii.gov/icis/documents/SARA-DV...
; and the Domestic Violence Screening Instrument (DVSI), which tracks the criminal behavior, separating offenders by rates of possible risk1212. Rud JD, Skiling N, Nonemaker D. DOCCR validation of two domestic violence risk instruments: Domestic Violence Screening Instrument (DVSI) e Spousal Abuse Risk Assessment (SARA). [S.L.]: Hennepin Organizational Change Management; 2011.,1313. Hébert M, Blais M, Lavoie F, Fernet M, Frappier JY, Karelis A, Boucher S. Équipe des IRSC sur les traumas interpersonnels – Programme de recherche. Montréal; Université du Québec à Montréal; 2010., among them the Enquete sur les Parcours Amoureux des Jeunes (PAJ).

We chose transcultural adaptation and validation of the Enquete sur les Parcours Amoureux des Jeunes (PAJ), a inventory structured by Montreal universities (Université du Québec à Montréal – UQAM, Université de Montréal – UM, and Université de Laval – UL), to expand the knowledge on this area, considering that this inventory analyzes different aspects related to violent events in the relationship of young couples and the possible connections with everyday situations of their family, friends and love relationships. The instrument is structured in sections, whose domains and items are presented in the form of questions with their respective scales. For the elaboration of PAJ questions, the team of researchers from Canada used specific instruments of different contexts validated worldwide, as well as population surveys, which comprise, individually, different topics related to the insertion of violence in the young love life. It also contemplates a wide investigation about interpersonal violence involving young couples, causes, consequences and influence of their relationships55. Barreira AK, Lima MLC, Avanci JQ. Coocorrência de violência física e psicológica entre adolescentes namorados do Recife, Brasil: prevalência e fatores associados. Cien Saude Colet 2013; 18(1):233-243.,66. Straus MA. Measuring intrafamily conflict and violence: the Conflict Tatics (CT) scales. Journal of Marriage and the family1997; 41(1):75-88.,1313. Hébert M, Blais M, Lavoie F, Fernet M, Frappier JY, Karelis A, Boucher S. Équipe des IRSC sur les traumas interpersonnels – Programme de recherche. Montréal; Université du Québec à Montréal; 2010.,1414. Reichenheim ME, Moraes CL. Operacionalização de adaptação transcultural de instrumentos de aferição usados em epidemiologia. Rev Saude Publica 2007; 41(4):665-73..

Thus, the objective of this study is based on the transcultural adaptation of PAJ, through recommended methodological protocol steps, seeking validation and suitability for application in the Brazilian context.

Methodology

It is a methodological study that uses systematic procedures for transcultural adaptation of the PAJ inventory, held in the city of Feira de Santana, second largest city in the state of Bahia (about 600 thousand inhabitants), situated in the center of an important road junction that links the North, Northeast and Southeast regions1515. Instituto Brasileiro de Geografia e Estatística (IBGE).Censo demográfico. Rio de Janeiro: IBGE; 2010.. The Universidade Estadual de Feira de Santana (UEFS) has interchange with the UQAM since 2010, through the Center of Studies and Research in Childhood and Adolescence (NNEPA).

Inventory Description

The PAJ has 64 questions distributed in seven sections: 1. Sociodemographic data of adolescents and their parents or guardians; 2. Affective and love relationships – addressing anti-social behavior of friends; past and current love situation (romance), partner’s behavior, psychological, physical and sexual violence, gender issues, homosexuality; 3. Difficult Experiences – addressing moral, psychological and sexual violence, post-traumatic stress disorder, suicidal ideation; 4. Sexual behaviors – the inventory comprises sexual performance and sexual practices, relationship between genders, sexual partners, vulnerability in sexual relations, prostitution; 5. Family section – evaluation of relationships and events in the family context, the parental support network; 6. Behaviors and Life habits – transgression, and obedience to parents; consumption of psychoactive substances; 7. Feelings and Emotions – comprehend consequences of violence, post-traumatic stress, self-esteem, friendships and trust relationships, participation in recreational and sports activities involving collective performance.

Transcultural Adaptation of the Inventory

a) Phase I – Translation

Conducted individually by two Brazilian researchers qualified in French language proficiency. After the two translations, we obtained T1 and T2 and Portuguese versions. This process originated the first consensus version of the PAJ, called Pilot I.

b) Phase II – Back-Translation

Two Canadian researchers, qualified in Portuguese language proficiency, analyzed the Pilot I version, and thus we had two new versions in French, designated B1 and B2. These versions were evaluated by two Canadian researchers of the area of violence, adolescence, and youth, resulting in the synthetic version B12 back-translation.

Later, the B12 version was back-translated to Portuguese, being compared to version T12. After consensus between Brazilian researchers, we made the necessary adaptations and concluded the synthetic version in Portuguese, establishing thus the consensus version, Pilot II, which was used in the analysis of equivalence of clarity properties by the committee of experts.

c) Phase III – Evaluation by the Committee of Experts

Ten experts who had specific knowledge about the evaluated construct analyzed the Pilot II version of PAJ; in this case, involving the areas of violence, adolescence and youth, validation and psychometrics, with the purpose to perform validation of its content (clarity and equivalences – conceptual, cultural, idiomatic and semantics).

The experts who participated in the evaluation consulted a manual of procedures, whose content provided guidelines on aspects of structure and content of sections, questions, items, domains and their scales. In each PAJ question, we analyzed the degree of clarity with the scale: “(1) It is not clear”; “(2) It is little clear”; “(3) Almost clear”; “(4) It is clear and I do not have any doubts”. Concerning the degree of equivalence: “(1) not equivalent”; “(2) a little bit equivalent”; “(3) equivalent.” The experts could give their opinion and suggest changes, and the team analyzed the relevance of these changes.

To assess the proportion of agreement among evaluators, for each PAJ question, for clarity and equivalence, we considered appropriate those whose score reached levels 3 and 4 (almost everything is clear, it is clear and I do not have any doubts), whose agreement parameter pointed to a value greater than or equal to 80%.

We calculated the Content Validity Index (CVI) of each question by dividing the sum of questions graded 3 and 4 by the total number of experts (10). The general CVI of the instrument was calculated by dividing the sum of questions graded 3 and 4 by the total of questions, considering the CVI suitable when the values were higher than 0.78, according to the literature for studies with more than six experts1616. Alexandre NMC, Coluci MZO. Validade de conteúdo nos processos de construção e adaptação de instrumentos de medidas. Cien Saude Colet2011; 16(7):3061-3068.. The items listed in the categories “1” and “2” were revised or deleted1616. Alexandre NMC, Coluci MZO. Validade de conteúdo nos processos de construção e adaptação de instrumentos de medidas. Cien Saude Colet2011; 16(7):3061-3068.. The propositions suggested by the experts were added and inserted to adjust the content, language and interpretation of PAJ questions to Portuguese1717. Beauford JE, Nagashima Y, Wu MH. Using translated instruments in research. Journal of College Teaching & Learning 2009; 6(5):77-81. (Chart 1). This process generated the Pilot III version.

d) Phase IV – Pre-Test

During the pre-test, the Pilot III version was applied to 40 students from a large public high school of Feira de Santana (BA).

We explained to the adolescents the purpose of the survey and told them to critically answer each question. In case of doubts and difficulties about unfamiliar terms, concepts, format of scales, little understanding of the items, they were instructed to request clarification from the researchers responsible for the application process. In this situation, the researchers reported in the control inventories the items and questions that had more problems regarding comprehension, marking them for later changes.

The objective of this phase was to identify interpretative problems, regarding operational, conceptual, semantics and idiomatic equivalences of the items, aiming to enhance the inventory, reviewing and modifying its problematic questions.

Figure 1
Stages of the PAJ’s Cross-Cultural Adaptation.

e) Phase V – Formulating the final version

From the experts’ evaluation and adjustments, proposed by the adolescents in the pre-test, we elaborated the PAJ final version, named Pilot IV, which will be used in the empirical stage of the psychometric analysis.

Ethical aspects

The project was submitted to the Committee of Ethics in Research at Universidade Estadual de Feira de Santana.

Results

Phase I – PAJ Translation and Back-translation

The Portuguese version, named Pilot I, resulted from consensual adaptations and modifications, considering the divergent items between languages, in regard to semantic, cultural and conceptual aspects. The questions from theGeneral Information section were adjusted to the Brazilian context. Questions 2 and 3 were grouped into When is your birth date? We removed the items “Japanese” and “Chinese” from the item “language spoken by the family” to maintain the appropriate context. The education level was modified to primary, junior high and high school, according to the Brazilian Ministry of Education. We also modified African, American and Caribbean ethnicities, among others. Considering the race/skin color of the Brazilian population, the items Mixed/Brown, Black, Indigenous and Other were added. In section 2, Affective and LoveRelationships (question 20), which address delinquent behaviors of friends, the items How many of your good friends (a) dropout school, smoke or smoked cigarettes, drink or drank alcohol beverages, smoked or smoke marijuana were adapted and the termsused or use crack and/or cocaine were added. After these modifications, we submitted Pilot I version to back-translation, which had no significant changes, and submitted Pilot II version of the PAJ to evaluation by the committee of experts and by the group of young people who participated in the pre-test.

Chart 1.
Presentation of the PAJ, for Cross-Cultural Adaptation according to sections, questions and areas studied in the item set. Feira de Santana/Bahia/Brazil, 2014.

Phase II – Evaluation by the Committee of Experts

The experts were selected according to experience in the area of the object of study. They analyzed the clarity and equivalence levels of each question of the inventory. In Table 1, we present these indexes for the questions that had consensus between the experts, being considered appropriate when the proportion exceeded 80%, and inadequate when below this percentage (case in which the indexes need changes or to be removed).

Table 1
Content Validity Indicators (proportion of agreement for clarity and equivalence below 80%) and calculation of the Content Validity Index/CVI, according to the analysis of the Pilot III version of the PAJ by the experts committee, Feira de Santana/Bahia/Brazil, 2014.

Generally, with the exception of section 1, in all the other PAJ sections most questions and items showed levels of agreement above 80% (for the attributes “clarity” and “equivalence”).

In section 1, certain questions had low level of agreement for clarity; in question 4, the item Do you have same-sex parents (Yes and no) was replaced by Man/man,woman/woman; in questions 5 and 6, the itemlevel of education of parents was modified toeducation. These same questions showed equivalence of 70%, among the experts. The item Attended only primary school, only high school was changed to Illiterate,Studied from 1stto 4thgrade, from 5thto 8thgrade.Question 18 (In this year you will conclude) was deleted, considering that question 16 demanded an identical answer toAtwhat level of studies are you?

In section 2, Affective and LoveRelationships, question 21, which investigates the current love relationship status of the juveniles, had consensus of 30% for clarity, and thus suffered modifications: the term now was replaced by at the moment. In question 22, which analyzes the juvenile as a victim or an aggressor, and whose items are shown in table format and answers in graduated columns in frequency scales, the analysis of the experts pointed out a consensus of 50% for clarity. Thus, we changed the item Provoked with rude words to Said things that provoked anger, and the terms without your permission, against your will were modified to without consent. Question 26, which address the juvenile’s opinions on aggression among same-sex couples, presented a consensus of 55.6% for clarity and 77.8% for equivalence. The focus of the problem pointed out by experts was the Likert-type scale, considered confusing, thus being modified without causing changes in the values. The items Do not agree, Do not always agree, Sometimes I agree and I always agree were modified toI totally disagree, Sometimes I disagree, Sometimes I agree, Totally agree. The low clarity identified in this question was related to the difficulty for young people to opine on homosexual relationships or to identify themselves as one of the partners.

In section 3, Difficult experiences, we modified question 38 (consensus of 60% for clarity) in the item Have you been touched, sexually fondled without consent (blackmail or physical strength)? in which the G option (A Family Member) was subdivided into G1 (A close family member – father/stepfather, mother/stepmother, siblings) and G2 (otherrelatives – uncle/aunt, grandfather and grandmother).

Regarding the analyses of equivalences, a good level of consensus among the experts was observed for each question, according to the definitions proposed by the literature1616. Alexandre NMC, Coluci MZO. Validade de conteúdo nos processos de construção e adaptação de instrumentos de medidas. Cien Saude Colet2011; 16(7):3061-3068.. It is important to emphasize that Section 1 of PAJ (sociodemographic information) was considered to have low equivalence (≤ 80%), as well as in the analysis of clarity, therefore, the section had suggested and relevant modifications: in question 11, about religion (consensus of 60% for equivalence), the options Muslim, Buddhist, Hindu or Sikh were replaced byCatholic, Protestant,Spiritualist, Candomblé,Umbanda, atheist (does not believe in God), other (specify), none.In all the questions addressing relationships among adolescents, we added the category casual date, due to cultural aspects and wide use of the term by young people in Brazil.

The calculation of the general Content Validity Index (CVI) of the PAJ inventory (after the analysis of the experts and the pre-test) had a result of 0.97, considered appropriate and relevant1616. Alexandre NMC, Coluci MZO. Validade de conteúdo nos processos de construção e adaptação de instrumentos de medidas. Cien Saude Colet2011; 16(7):3061-3068.. The individual evaluation of the CVI showed that only questions 4 and 20 had a CVI lower than 0.80.

Phase III – Pre-test – Pilot III

The adolescents, students at a large school of Feira de Santana, were randomly selected, composing a convenience sampling of 36 students, whose group distribution of gender and age was: about 72% from 14 to 18 years old, and 28% from 19 to 24 years old. When it comes to gender, about 55.5% were women and 44.5% men.

The main difficulties pointed out by the adolescents had to do with questions 20, 23, 26, 27, 29, 48 and 58. In question 20, item H proved to be confuse, with more than one action for the same question. Thus, the itemBreaks or have broken traffic laws causing accidents or practicing vandalism was subdivided into H1 (Have broken traffic law), H2 (Caused accidents) and H3 (Practiced vandalism). Regarding situations with boyfriend/girlfriend, partner and casual date, in question 23, item D (Do you feel distant from other people and lost interest in things) was subdivided into D1 (Do you feel distant from other people) and D2 (Did you lose interest in things). In question 26, the scale was revised again, being suggested Stronglydisagree; Disagreesometimes; Iagreesometimes; Totallyagree. On the approach of living with, support, resilience (question 27), item C (This person encouraged you to seek new things you would have liked to do, but that made you nervous), was replaced by This person encouraged you to do things you would like to do, but that you felt afraid to try. We divided question 29, free answer, which requests a reporting of a difficult life event, into sub-questions, to help subsequent categorization, and changed question 48 (about sexual behavior suffered) in the item that addresses sexual relationship we added, as an answer option, the categoryreligious advisor. The juveniles considered question 58 (about alcoholic beverages consumption) ambiguous, and we then subdivided into: 58a) amount of alcoholic beverage, and 58b)frequency of 5 doses or more in the same occasion.

Discussion

In the context of a continental country, such as Brazil, the methodological approach that comprehends the transcultural adaptation and psychometric analysis of an instrument for measurement of a phenomenon should contemplate particularities related to cultural diversity. Values, morals, personal opinion, life habits, as well as some practices and attitudes can be considered inherent to the daily life of a population group. However they may be unknown and uncommon in another context. When it comes to measuring instruments, these differences may compromise the research applicability, since they can interfere in the understanding and standard of the individuals’ answers, consequently with biased results1818. Pasquali L. Psicometria: teoria dos testes na Psicologia e na Educação. 5ª ed. Petrópolis: Ed Vozes; 2013..

The transcultural adaptation of PAJ represented an important step in several areas of knowledge, since this instrument expanded the analysis of violent events involving adolescents and young people in their familial, emotional and love relationships, analyzed under multiple dimensions, and therefore classified as a multidimensional inventory.

The methodological proposals that converge to the transcultural adaptation process of instruments follow systematic criteria, based on a global experience1919. Erthal TC. Manual de psicometria. 7ª ed. Rio de Janeiro: Jorge Zahar; 2012.

20. Guillemin F, Bombardier C, Beaton D. Cross-Cultural Adaptation of Health-Related Quality of Life Measures: Literature Review and Proposed Guidelines. J Clin Epidemiol 1993; 46(12):1417-1432.
-2121. Mota DDCF, Pimenta CAM. Avaliação e mensuração de variáveis psicossociais: desafio para pesquisa e clínica de enfermagem. Revista Gaúcha de Enfermagem 2007; 28(3):309-314.. In this perspective, the PAJ content validation used procedures whose goal was to verify if the various items had, in fact, representativeness in relation to the content to be measured, since, in addition to the appropriate translation, the items reached the conceptual adjustment for clarity and equivalence, as well as cultural proximity with the context and target audience to be applied1919. Erthal TC. Manual de psicometria. 7ª ed. Rio de Janeiro: Jorge Zahar; 2012.

20. Guillemin F, Bombardier C, Beaton D. Cross-Cultural Adaptation of Health-Related Quality of Life Measures: Literature Review and Proposed Guidelines. J Clin Epidemiol 1993; 46(12):1417-1432.
-2121. Mota DDCF, Pimenta CAM. Avaliação e mensuração de variáveis psicossociais: desafio para pesquisa e clínica de enfermagem. Revista Gaúcha de Enfermagem 2007; 28(3):309-314..

In the translation and back-translation phases, complex tasks, we may observe changes in the format of the original instrument, such as the inclusion or exclusion of items, as well as to make changes in the scoring criteria of the questions. However, these modifications must be implemented with caution, since they can undermine the equivalence between the original instrument and the translated version, with consequent impact on their characteristics as well as on the results of applications1616. Alexandre NMC, Coluci MZO. Validade de conteúdo nos processos de construção e adaptação de instrumentos de medidas. Cien Saude Colet2011; 16(7):3061-3068..

For the PAJ translation and back-translation, the evaluation of contextual adjustments and modifications was of utmost importance. We needed to replace and delete some specific Canadian terminologies, seeking to adapt the text to the Brazilian reality. As a result of this approach, we made some adjustments, such as the addition of the items “crack and cocaine” in the question about drug use, due to the growing consumption of these substances in our country, especially because our study focused on young men and women in the 14-24 age group.

We must highlight that the participation of different translators and back-translators, at the early stages of PAJ transcultural adaptation, was an important strategy for blind translation to decrease the possibility of biases regarding domains and items studied. PAJ is an extensive inventory that comprises various aspects of adolescents’ relationships with family, friends and partners. The aspects that did not fit in the Brazilian culture underwent all the relevant considerations pointed out by the professionals who made translations and back-translations, in the first version of the consensus of PAJ, Pilot I version.

When it comes to the methodological study, the literature of the area emphasizes the importance of considering aspects that may influence the analysis of the psychometric properties of the instrument, such as number of questions, time required to answer all the questions and language used, which can interfere in the quality of the answers and in the precision of the adaptation process, compromising the later steps of validation2222. Beaton D, Bombardier C, Guillemin F, Ferraz MB.Recommendations for the Cross-Cultural Adaptation of the DASH e QuickDASH outcome measures. Toronto: Institute for Work & Health; 2007.. The consensus of these thematic studies confirmed the importance of rigorous methodological processes used in the PAJ transcultural adaptation, whose criteria and changes aimed at preserving the characteristics of the original instrument, in relation to equivalence and clarity, seeking, through the content validation, to adjust the translated version to the Brazilian context.

Considering the multiplicity of areas and all the PAJ questions, the participation of ten experts with different experiences was necessary, expanding the universe of suggestions and criticism to reach the content validity, through the analysis of equivalence and clarity. The accumulated experience showed that the participation of a team of experts in such studies was decisive to obtain this in-depth analysis, which resulted in adjustments in some items and in inventory structure (layout).

In terms of validation, we verified that cultural equivalence was present throughout the structuring process of the PAJ Brazilian version, translation, back-translation and pre-test, being the support for the analysis of semantic, idiomatic and conceptual equivalences, without altering the essence of the original instrument. The experts critically examined the questions and items of different sections, based on the theory of equivalences1414. Reichenheim ME, Moraes CL. Operacionalização de adaptação transcultural de instrumentos de aferição usados em epidemiologia. Rev Saude Publica 2007; 41(4):665-73.,1616. Alexandre NMC, Coluci MZO. Validade de conteúdo nos processos de construção e adaptação de instrumentos de medidas. Cien Saude Colet2011; 16(7):3061-3068.,1818. Pasquali L. Psicometria: teoria dos testes na Psicologia e na Educação. 5ª ed. Petrópolis: Ed Vozes; 2013..

It was evident that, in general, PAJ presented adequacy (Pilot III version) and content validity in all sections, except in Section 1, regarding general information of adolescents and their families, being justified by the different forms to classify or categorize sociodemographic characteristics, such as schooling, among others, in the Brazilian and Canadian contexts.

The calculation of the Content Validity Index (CVI), for question 20, Section 2 –Affective and LoveRelationships had a value of 0.70, pointing out the need for adaptations and modifications in Pilot III version. The expertise in this area considers irrelevant CVI values lower than 0.78, and recommends adjustments and changes in questions that are below this score1616. Alexandre NMC, Coluci MZO. Validade de conteúdo nos processos de construção e adaptação de instrumentos de medidas. Cien Saude Colet2011; 16(7):3061-3068..

Thirty-six adolescents – with the same characteristics of the target population –participated in the pre-test and were part of the sample used for the subsequent psychometric analysis. This strategy favored the analysis adequacy of content validity, considering multiple possibilities of questions and contributions in the process.

The adolescents who took part in this step detailed the items through critical reading, analyzing the questions that were in accordance with their cultural and social reality, as well as properly understood by them. The main definitions proposed for the PAJ were the expressions: a little bit long; well elaborated;interesting; easy and simple to answer;long. Thus, this approach shows how wide is the PAJ proposal .

Final Considerations

The methodological procedures involving transcultural adaptation and validation of content were a challenge, considering the complexity that involves the validation process of an extensive and complex inventory, such as PAJ. The main challenges were the multiplicity of questions and scales, as well as the need to meet the strict criteria and procedures recommended, especially concerning an original instrument of distinct sociocultural context.

The pioneering experience of transcultural adaptation and validation of PAJ for application in another country was necessary and important for the dissemination of knowledge in this area. It is important to mention that the EVISSA team, formed by researchers from several Canadian contributed to this research, providing documents that authorized the use of PAJ, and to the literature review of each question of the instrument, which served as the basis for the conclusion of the transcultural adaptation, essential to the validation and subsequent application at national level. Methodological studies like this helps to apply the original knowledge of a specific context in other contexts, such as the Brazilian one.

The PAJ content validation, obtained from the analysis of the experts and from a group of young people, which allowed to evaluate clarity and equivalence attributes, and calculation of CVI, pointed out that the inventory is adapted, once the methodological procedures and careful evaluation of their structures certified that the domains and respective items contemplate the theoretical framework of the study.

In this perspective, the study helped to give the scientific community possibilities of replicating a comprehensive instrument that assesses various manifestations of a multifaceted event (such as a violent one), especially among vulnerable population groups in their love relationships. Thus, the strengthening of research in this area may promote greater attention to several factors involved in relationships, supporting psychometric analysis, subsequent assessment of the phenomenon in the national context and, consequently, justify policies, protection programs of different forms of violence included in the love life of adolescents.

Referências

  • 1
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Publication Dates

  • Publication in this collection
    Nov 2015

History

  • Received
    11 Mar 2015
  • Reviewed
    18 May 2015
  • Accepted
    20 May 2015
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