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P.-A. Schmidt1, V. Naidoo1,1
1University of the Witwatersrand, Physiotherapy, Johannesburg, South Africa
Background: Non-specific low back pain (NSLBP) is one of the most prevalent conditions in the world and identifying patients at risk for developing chronic NSLBP is key to effective treatment. The STarT back screening tool is a validated, prognostic screening tool that identifies subgroups of patients with NSLBP, and the risk factors associated with each subgroup, which can guide the treatment decision-making process. The objective of this study was to translate and validate the English version of the STarT back screening tool into isiZulu.
Purpose: Make the STarT back screening tool useful and accessible to the isiZulu population of South Africa, and clinicians working with this population.
Methods: Translation was done in 4 phases, which included forward translation, forward translation synthesis, backward translation and expert review. Validation included expert review for content validity and testing and retesting of the preliminary translated tool on a sample of 30 participants.
Results: Minor linguistic differences occurred with the translating process. The expert committee came to agreement around the challenging translation of the terms “more slowly” in question 4, “physically active” in question 5, “terrible” in question 7 and “bothersome” in question 9. A total of 30 patients were recruited, with 77% female and 23% male. Item content validity for relevance was excellent (I-CVI = 1.00), and satisfactory (I-CVI = 0.94) for clarity, simplicity and ambiguity. Scale content validity was acceptable at 0.955. Spearman’s CC for test-retest reliability was acceptable at 0.73. Cronbach’s Alpha for internal consistency for the total score for test one was 0.68 and 0.77 for test two, whilst the psychosocial scale for test one was 0.62 and test two was 0.77. Thirty three percent reported the translated tool very easy to understand and 40% reported it very easy to complete.
Conclusion(s): The isiZulu STarT back screening tool showed excellent validity, acceptable reliability and internal consistency and can therefore be used by an isiZulu population of patients with NSLBP. Testing of the clinical and cost-effectiveness of the English and isiZulu STarT back tool in the South African context is necessary.
Implications: Translation and validation of outcome measures is an important part of effective treatment in developing countries.
Funding, acknowledgements: South African Society of Physiotherapy
Keywords: STarT back, Translation, Validation
Topic: Pain & pain management
Did this work require ethics approval? Yes
Institution: University of the Witwatersrand
Committee: Health Research Ethics Committee
Ethics number: M170717
All authors, affiliations and abstracts have been published as submitted.
