DOI: 10.6084/m9.figshare.24160737.v1
title: Translation, cross-cultural adaptation and reliability testing of the barriers to physical activity and Disability survey (B-PADS) for Thai people with Spinal Cord injury

description: The objectives of this study were to translate and culturally adapt the Barriers to Physical Activity and Disability Survey (B-PADS) into the Thai context and to assess its inter- and intra-rater reliability. Participants were experts in the field of spinal cord injury (SCI, <i>n</i> = 3), linguistic experts (<i>n</i> = 7), Thai-English bilingual speakers (<i>n</i> = 40), Thai physiotherapists (<i>n</i> = 8), and people with SCI living in Thailand (<i>n</i> = 43). The translation and cross-cultural adaptation of the B-PADS into the Thai context was conducted using a 6-step process; forward translation, reconciliation of the two translated versions, backward-translation, harmonisation, backward-translation of the revised version, and cognitive debriefing with potential users and target population. The reliability of the translated tool was assessed using Cohen’s kappa (K) and McNemar’s test. The inter-rater reliability test demonstrated high-range agreement for the majority of statements (27 out of 38; Cohen’s <i>K</i> &gt; 0.60) in the Thai-B-PADS final version. The intra-rater reliability test revealed that the majority of the statements (29 out of 38) in the Thai-B-PADS final version obtained substantial (Cohen’s <i>K</i> = 0.61–0.80, <i>p</i> &lt; 0.05) to perfect agreement (Cohen’s <i>K</i> = 1.0, <i>p</i> &lt; 0.05). McNemar’s test displayed no statistically significant differences amongst assessors (<i>p</i> &gt; 0.05) for nearly all statements. The Thai-B-PADS final version was successfully translated and culturally adapted for people with SCI. Multi-stakeholders, including academic experts, researchers, translators, clinicians, target users and clients, should be involved in developing health-related questionnaires’ translation and cultural adaptation processes.The Thai version of Barriers to Physical Activity and Disability Survey (B-PADS) possessed high levels of inter- and intra-rater reliability to assess barriers related to undertaking physical activities or exercise in people with spinal cord injury.Interactional biases and perceived social status effects may not be avoided when deploying a face-to-face interview of health-related questionnaires in a culture where social hierarchy is present within the language.The translation and adaptation processes used in this study were thorough, systematic and comprehensive, providing a culturally competent exemplar for translating health-related questionnaires between languages of different root origins. Multi-stakeholders, including academic experts, researchers, translators, clinicians, target users and clients, should be involved in developing health-related questionnaires’ translation and cultural adaptation processes. The Thai version of Barriers to Physical Activity and Disability Survey (B-PADS) possessed high levels of inter- and intra-rater reliability to assess barriers related to undertaking physical activities or exercise in people with spinal cord injury. Interactional biases and perceived social status effects may not be avoided when deploying a face-to-face interview of health-related questionnaires in a culture where social hierarchy is present within the language. The translation and adaptation processes used in this study were thorough, systematic and comprehensive, providing a culturally competent exemplar for translating health-related questionnaires between languages of different root origins.