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oárez
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2016; 62(3):236-242
The translation and cultural adaptation of the instru-
ment followed the guidelines,
14-16
which recommend trans-
lation, reconciliation of translations, back-translation, re-
vision by the Expert Committee, evaluation of cultural
adaptation (pretesting) and final revision (Figure 1)
Before the start of this process, the authors of the orig-
inal instrument were contacted by the ANS and sent an
authorization request in writing for conducting this study.
Through collaboration with the ANS and the Labo-
ratory of Care Innovations in Health Promotion and Pre-
vention of Risks and Diseases in Supplementary Health,
40 individuals working in the health promotion programs
of health insurance operators or companies were invited
to participate.
The data were collected in person at two different
times: Pretesting 1 at the ANS head office in São Paulo
and Pretesting 2 at the head office of the Brazilian Qual-
ity of Life Association (ABQV). The questionnaires were
self-administered.
R
esults
The convenience sample included 27 individuals from
health insurance providers and companies of various siz-
es, types and industries in São Paulo. The average age of
the sample was 38 years, and most of the individuals who
answered the questionnaire were female (21 out of 27)
and responsible for health promotion programs at these
workplaces. Table 1 provides a summarized description
of the sample studied.
TABLE 1
Characteristics of the participants. São Paulo,
SP, Brazil, 2013.
(n=27)
%
Average age (years)
38
Gender
Male
22.2
Female
77.8
Formal education
Undergraduate level
32.0
Graduate level
68.0
Respondent’s position
Wellness and quality of life programs team
7.7
Human resources team
3.8
Management
34.6
Medical area team
53.8
Size of the organization
Very small
7.4
Small
25.9
Mid-sized
22.2
Large
44.4
Type of organization
For profit
55.6
Non profit
44.4
Economic activity*
Extractive industry
3.7
International organizations and other institutions
3.7
Transport, storage and courier
3.7
Information and communication
7.4
Public administration, defense and social security
7.4
Manufacturing industries
14.8
Financial activities, insurance and related services
59.3
For this study, the following definitions for organizational size according to the CDC were used:
Very small (10 to 99 employees); small (100 to 249); mid-sized (250 to 749); and large (+750).
*Defined according to the Brazilian National Classification of Economic Activities (CNAE).
Translation
Initial translation
The items in the original version of the HSC were trans-
lated initially by two independent professionals with pre-
vious experience in translation of patient reported out-
comes (PRO) measurements, Brazilian nationals, resident
in Brazil, with extensive knowledge of the English lan-
guage and who were aware of the research goals. The im-
portance of a conceptual translation rather than a strict-
FIGURE 1
Stages in the translation and cultural adaptation
process.
Initial translation
Reconciliation
Back-translation
Revision by the expert committee
Pretesting
Final revision