Translation, cultural adaptation, and evidence of content and face validity of a questionnaire to assess REDs knowledge in Brazil: a cross-cultural validation study
Keywords:
Validation study, Athletes, Female athlete triad syndrome, Validation studies, Translating, Cross-cultural adaptation, Athlete, Relative energy deficiency in sport, KnowledgeAbstract
BACKGROUND: Relative energy deficiency in sport (REDs) is a syndrome that impairs physiological function because of low energy availability. Awareness and knowledge of REDs among athletes and health professionals are essential for early identification and prevention.
OBJECTIVE: To translate into Brazilian Portuguese and culturally adapt a questionnaire that assesses knowledge of the signs, symptoms, and consequences of REDs, originally created by Pai et al., and to obtain evidence of content and face validity.
Design and setting: Translation, cultural adaptation, and validation study conducted remotely using online tools and digital data collection.
METHODS: The translation and cultural adaptation consisted of the following steps: two independent translations, synthesis of the translations by a committee of health professionals, two back-translations, and review by a committee of experts to determine the best version for testing. For content validity, the content validity coefficient (CVC) was calculated based on the evaluation of the experts committee on the practical pertinence, theoretical relevance, and linguistic clarity of the items of the pretest version. For face validity, the pretest version was applied to 30 individuals who assessed the items for linguistic clarity, adequacy, and comprehensibility.
RESULTS: The CVC for the scale was 0.97. The CVC values for clarity, pertinence, and relevance were 0.97, 1 and 0.99, respectively. All items had a CVC > 0.8, confirming acceptable content validity. The pretest version was tested on 12 female runners, eight coaches, and 10 dietitians. Items were clear and comprehensible to 93% and adequate to 96% of respondents. No changes were needed, and the pretest version was defined as the Brazilian version of the questionnaire to assess REDs knowledge (QC-REDs).
CONCLUSION: The QC-REDs obtained strong content and face validity. It provides a rigorously adapted tool for Brazil, supported by positive feedback from the target population, demonstrating its applicability and usability. This instrument fills a crucial gap and offers a valuable resource for researchers and professionals working with athletes at risk of REDs. Future research should focus on psychometric validation to further solidify its effectiveness in the Brazilian context.
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