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Adaptation of the barriers to help-seeking for trauma (BHS-TR) scale : a cross-cultural cognitive interview study with female intimate partner violence survivors in Iceland

Adaptation of the barriers to help-seeking for trauma (BHS-TR) scale : a cross-cultural cognitive interview study with female intimate partner violence survivors in Iceland


Title: Adaptation of the barriers to help-seeking for trauma (BHS-TR) scale : a cross-cultural cognitive interview study with female intimate partner violence survivors in Iceland
Author: Thorvaldsdottir, Karen Birna
Halldorsdottir, Sigridur   orcid.org/0000-0003-0629-4428
Johnson, Rhonda M.
Sigurdardottir, Sigrun   orcid.org/0000-0003-2898-3240
Saint Arnault, Denise
Date: 2021-12
Language: English
Scope:
School: School of Health Sciences
Series: Journal of Patient-Reported Outcomes; 5(1)
ISSN: 2509-8020
DOI: https://doi.org/10.1186/s41687-021-00295-0
Subject: Cognitive interviews; Cross-cultural adaptation; Health-related quality of life; Help-seeking; Interpersonal violence; Self-reported measures; Translation; Trauma; Áfallastreita; Heimilisofbeldi; Hjúkrun; Health Informatics; Health Information Management
URI: https://hdl.handle.net/20.500.11815/2565

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Citation:

Thorvaldsdottir , K B , Halldorsdottir , S , Johnson , R M , Sigurdardottir , S & Saint Arnault , D 2021 , ' Adaptation of the barriers to help-seeking for trauma (BHS-TR) scale : a cross-cultural cognitive interview study with female intimate partner violence survivors in Iceland ' , Journal of Patient-Reported Outcomes , vol. 5 , no. 1 , 22 . https://doi.org/10.1186/s41687-021-00295-0

Abstract:

 
Background Even though traumatization is linked to substantially reduced health-related quality of life, help-seeking and service utilization among trauma survivors are very low. To date, there has not been available in Iceland a culturally attuned, self-reported measure on help-seeking barriers after trauma. This study aimed to translate and cross-culturally adapt the English version of Barriers to Help-Seeking for Trauma (BHS-TR) scale into the Icelandic language and context. Methods The BHS-TR was culturally adapted following well-established and rigorous guidelines, including forward-backward translation, expert committee review, and pretesting through cognitive interviews. Two rounds of interviews with 17 female survivors of intimate partner violence were conducted using a think-aloud technique and verbal probing. Data were analyzed using qualitative content analysis, a combination of deductive and inductive approaches. Results Issues with the BHS-TR that were uncovered in the study were classified into four categories related to general design, translation, cultural aspects, and post-trauma context. The trauma-specific issues emerged as a new category identified in this study and included concepts specific to trauma experiences. Therefore, modifications were of great importance—resulting in the scale becoming more trauma-informed. Revisions made to address identified issues improved the scale, and the process led to an Icelandic version, which appears to be semantically and conceptually equivalent to the original version; additionally, the results provided evidence of content validity. Conclusions As a cognitive interview study, it adds to the growing cognitive interviewing methodology literature. Furthermore, the results provide essential insights into the self-report response process of trauma survivors, highlighting the significance of making health-related research instruments trauma-informed.
 
Background: Even though traumatization is linked to substantially reduced health-related quality of life, help-seeking and service utilization among trauma survivors are very low. To date, there has not been available in Iceland a culturally attuned, self-reported measure on help-seeking barriers after trauma. This study aimed to translate and cross-culturally adapt the English version of Barriers to Help-Seeking for Trauma (BHS-TR) scale into the Icelandic language and context. Methods: The BHS-TR was culturally adapted following well-established and rigorous guidelines, including forward-backward translation, expert committee review, and pretesting through cognitive interviews. Two rounds of interviews with 17 female survivors of intimate partner violence were conducted using a think-aloud technique and verbal probing. Data were analyzed using qualitative content analysis, a combination of deductive and inductive approaches. Results: Issues with the BHS-TR that were uncovered in the study were classified into four categories related to general design, translation, cultural aspects, and post-trauma context. The trauma-specific issues emerged as a new category identified in this study and included concepts specific to trauma experiences. Therefore, modifications were of great importance—resulting in the scale becoming more trauma-informed. Revisions made to address identified issues improved the scale, and the process led to an Icelandic version, which appears to be semantically and conceptually equivalent to the original version; additionally, the results provided evidence of content validity. Conclusions: As a cognitive interview study, it adds to the growing cognitive interviewing methodology literature. Furthermore, the results provide essential insights into the self-report response process of trauma survivors, highlighting the significance of making health-related research instruments trauma-informed.
 

Description:

Funding Information: This study was supported by the Icelandic Gender Equality Fund, grants no. 190036–0551 and no. 200197–5501. The funding body had no role in the design of the study, collection, analysis, and interpretation of data, nor in writing the manuscript. Publisher Copyright: © 2021, The Author(s).

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