Cross-cultural adaptation of the CDC Worksite Health ScoreCard
questionnaire into Portuguese
PhD – Professor at the Department of Preventive Medicine, Faculdade de Medicina, Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil
PhD – MD, Escola Paulista de Medicina da Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brazil
MSc – Researcher at the Laboratório de Inovações Assistenciais em Promoção da Saúde e Prevenção de Riscos e Doenças na Saúde Suplementar, Agência Nacional de Saúde Suplementar (ANS), São Paulo, SP, Brazil
MSc – Coordinator at the Laboratório de Inovações Assistenciais em Promoção da Saúde e Prevenção de Riscos e Doenças na Saúde Suplementar, ANS, São Paulo, SP, Brazil
Study conducted at Departamento de
Medicina Preventiva, Faculdade de
Medicina da Universidade de São Paulo
(FMUSP), São Paulo, SP, Brazil
Accepted for publication:
Address: Av. Dr. Arnaldo, 55, 2
São Paulo, SP – Brazil
Postal code: firstname.lastname@example.org http://dx.doi.org/10.1590/1806-9282.62.03.236
Pan American Health
Despite the progress in the implementation of health promotion
programs in the workplace, there are no questionnaires in Brazil to assess the
scope of health promotion interventions adopted and their scientific basis. This
study aimed to translate into Brazilian Portuguese and culturally adapt the CDC
Worksite Health ScoreCard (HSC) questionnaire.
The HSC has 100 questions grouped into twelve domains. The steps
are as follows: translation, reconciliation, back-translation, review by expert
panel, pretesting, and final revision. The convenience sample included 27 indi-
viduals from health insurance providers and companies of various sizes, types
and industries in São Paulo. Data were analyzed using descriptive statistics.
The average age of the sample was 38 years, most of the subjects were
female (21 of 27), and were responsible for programs to promote health in these
workplaces. Most questions were above the minimum value of understanding
set at 90%. The participants found the questionnaire very useful to determine
the extent of existing health promotion programs and to pinpoint areas that
could be developed.
: The Brazilian Portuguese version of the HSC questionnaire may
be a valid measure and useful to assess the degree of implementation of health
promotion interventions based on evidence in local health organizations.
health promotion, occupational health, occupational health servic-
es, surveillance in occupational health.
Chronic non-communicable diseases (CNCD) are the
leading cause of mortality and burden of disease in most
countries in the world.
In the United States of America,
estimates of the total cost of cardiovascular diseases, in-
cluding heart disease and strokes, totaled US$ 444 bil-
lion in 2010.
For medium/high income countries such
as Brazil, the estimated annual cost is 4% of the GDP, i.e.
approximately US$ 139
Brazil suggest that the loss of productivity at work and
decreased family income resulting from merely three
CNCD (diabetes, heart disease and stroke) will lead to a
loss in the Brazilian economy of US$ 4.18 billion between
2006 and 2015.
Faced with the exponential growth of health costs,
many employers are implementing evidence-based health
promotion programs, including individual risk reduc-
tion programs, connected to environmental support for
healthy behaviors, coordinated and integrated into oth-
er activities related to wellbeing, which has been shown
to be the most efficient strategy to reduce the risk of de-
veloping chronic diseases.
Several studies have concluded that health promo-
tion programs in the workplace can improve employee
health and reduce the health expenditure of employers.
In North America, 76% of companies have some kind of
health promotion program. In Latin America, this figure