Cultural Adaptation of Health Literacy Measures: Translation Validation of the Newest Vital Sign in Arabic-speaking Parents of Children with Type 1 Diabetes in Kuwait.

Abstract

BackgroundLow level of health literacy (HL) has been linked to several adverse health outcomes independently from education, ethnicity and socio-economic status. There is a dire need for a reliable tool to assess HL of patients and general public in Arab countries. This study aimed to assess the feasibility of use and reliability of the Arabic version of the Newest Vital Sign (NVS) in parents of children with type 1 diabetes (T1D). MethodsTranslation and cross-cultural adaptation of the Arabic version of the NVS (NVS-Ar) was conducted according to established guidelines. In order to investigate the functionality of NVS, the nal version of NVS-Ar was administered to 175 adult caregivers of children with T1D, who are native Arabic speakers. We assessed the association between NVS-Ar score for the parents and HbA1C for their children. The internal consistency was evaluated by Cronbach's Alpha (CA) and reliability was assessed by test retest method. ResultsThe median (interquartile rang IQR) score was 4.0 (3-5). The internal consistency of the NVS-Ar was moderate (CA= 0.58). While the intraclass correlation coe cient (ICC) was 0.61. There was no correlation between NVS-Ar score and HbA1C (Spearman's rho = 0.055; p=0.62). Furthermore, there was signi cant inverse association between adequate HL and optimal glycemic control among children, which remained evident even after adjusting for the duration of T1D, age or education of the parents/child guardian.However, it lost statistical signi cance when we adjust for treatment regimen. ConclusionOur ndings demonstrate that NVS is unlikely to be a predictive tool for functional HL in Arabic settings and that there is a need to properly translate and validate other tools such as TOFLA or alternatively develop a reliable tool de novo.

The Newest Vital Sign: Frequently Asked Questions

“…The original version of the NVS was developed in English and Spanish and validated in the United States for identifying people with limited health literacy skills (Weiss et al, 2005). Since then, the NVS has been adapted and validated for use in other languages and countries, including the United Kingdom (Rowlands et al, 2013), the Netherlands (Fransen et al, 2014), Japan (Kogure et al, 2014), Italy (Capecchi, Guazzini, Lorini, Santomauro, & Bonaccorsi, 2015), Kuwait (Al-Abdulrazzaqa, Al-Haddadb, AbdulRasoula, Al-Basarib, & Al-Taiara, 2015), Brazil (Rodrigues, de Andrade, González, Birolim & Mesas, 2017), China (Xue et al, 2018), and Canada (Mansfield, Wahba, Gillis, & Weiss, 2018). It has also been adapted for administration in American Sign Language (McKee et al, 2015).…”