Cross-cultural adaptation of the NoMAD questionnaire to Brazilian Portuguese.

BACKGROUND: The Normalization Measure Development (NoMAD) tool is used to determine the contextual determinants in the process of implementing complex health interventions. The aim of this study is to translate and culturally adapt NoMAD to Brazilian Portuguese. METHODS: The cross-cultural adaptation was performed in five steps: 1) translation of the questionnaire into Portuguese; 2) synthesis and creation of the first version; 3) back-translation of the instrument into the source language; 4) review of the instrument by a group of experts and target professionals; and 5) pretesting. A final version of the questionnaire was answered by users of a clinical monitoring system in specialist care services for people living with HIV/AIDS, and the internal consistency of the questionnaire was assessed using Cronbach's alpha. RESULTS: The questionnaire was answered by 188 health professionals, of which 87.7% were female, and the average age was 45.2 years. For the final version of the questionnaire, Cronbach's alpha was over 0.70 for the construct's coherence (0.74), collective action (0.70), cognitive participation (0.71), and reflexive monitoring (0.81). CONCLUSION: The NoMAD questionnaire was cross-culturally adapted and can be used to evaluate the implementation of complex health care interventions.

Cross-cultural adaptation of the NoMAD questionnaire to Brazilian Portuguese

SUMMARY BACKGROUND: The Normalization Measure Development (NoMAD) tool is used to determine the contextual determinants in the process of implementing complex health interventions. The aim of this study is to translate and culturally adapt NoMAD to Brazilian Portuguese. METHODS: The cross-cultural adaptation was performed in five steps: 1) translation of the questionnaire into Portuguese; 2) synthesis and creation of the first version; 3) back-translation of the instrument into the source language; 4) review of the instrument by a group of experts and target professionals; and 5) pretesting. A final version of the questionnaire was answered by users of a clinical monitoring system in specialist care services for people living with HIV/AIDS, and the internal consistency of the questionnaire was assessed using Cronbach's alpha. RESULTS: The questionnaire was answered by 188 health professionals, of which 87.7% were female, and the average age was 45.2 years. For the final version of the questionnaire, Cronbach's alpha was over 0.70 for the construct's coherence (0.74), collective action (0.70), cognitive participation (0.71), and reflexive monitoring (0.81). CONCLUSION: The NoMAD questionnaire was cross-culturally adapted and can be used to evaluate the implementation of complex health care interventions.

RESUMO INTRODUÇÃO: O questionário Normalisation Measure Development (NoMAD) tool busca identificar os fatores contextuais determinantes no processo de implementação de intervenções complexas em saúde. Este artigo tem por objetivo traduzir e adaptar culturalmente o NoMAD para o português do Brasil. MÉTODOS: A adaptação transcultural foi realizada em cinco etapas: 1-Tradução do questionário para o português; 2-Síntese e criação da primeira versão; 3-Retro-tradução do instrumento para a língua de origem; 4-Revisão por grupo de especialista e profissionais-alvo do instrumento; e 5-Pré-teste. A versão final do questionário foi respondida por usuários do sistema de monitoramento clínico em serviços de assistência especializada às pessoas vivendo com HIV/AIDS e sua consistência interna foi avaliada por meio de alpha de Cronbach. RESULTADOS: O questionário foi respondido por 188 profissionais, 87,7% eram do sexo feminino e média de idade de 45,2 anos. A versão final do questionário apresentou α de Cronbach superiores a 0.70 nos construtos coerência (0.74), ação coletiva (0.70), participação cognitiva (0,71) e monitoramento reflexivo (0.81). CONCLUSÃO: O questionário NoMAD foi adaptado transculturalmente e pode ser utilizado para avaliar a implementação de intervenções complexas no cuidado em saúde.