doVE

Domestic Violence against Women/Men in Europe:

Prevalence, determinants, effects and policies/practices

REPORT:

Validation of

Assessment Tool

(Piloting)

2

INDEX OF CONTENTS

Page

Introduction 4

1. Piloting the Main Instrument 9

2. Results 11

3. Conclusive Remarks 15

4. References 16

3

The present report corresponds to Deliverable 3 of DOVE Project.

4

INTRODUCTION

This Report contains a description of the results obtained from the Pilot process of DOVE’s

instrument in the participating countries.

The difficulties faced in every country are discussed, after summarizing individual reports

provided by each participating centre (conf. ANNEX 6, from Interim Report – Deliverable 4).

In the pilot study the instrument was translated and tested. The aims of the translation were

to translate the instrument in a linguistically and culturally appropriate way. The aims of the pilot

test were to investigate

- practicability of the compiled instrument in diverse cultural contexts;

- feasibility of the compiled instrument and the

- feasibility of the study organization in terms of input, data handling and cross-national

transfer of data.

Figure 1 shows the time sequence for work package 5.

Figure 1: chart of work package 5

Procedures

February 2010

15.

March 2010

April 2010

15.

Translation and adaptation processes

(until February 22.)

Interviewer training and sampling for the

pilot study

Piloting main instrument during field

work

Transfer of reports and data

Reports on piloting

Final evaluation

5

The main underlying question of the pilot study was whether the assessment instrument is

appropriate for investigating the prevalence rates and the factors associated with domestic violence

in the 8 participating countries.

The main instrument was designed by the Swedish and the Portuguese partners and it was

circulated on February 2nd, 2010. The final draft version of this instrument was translated in the

specific languages of the partner countries (German, Portuguese, Hungarian, Spanish, Greek, Belgian

and Swedish). Appropriate translations implied:

- semantic equivalence,

- idiomatic equivalence,

- experiential equivalence and

- conceptual equivalence of the words, items, the parts and the whole instrument.

The translation and adaptation process itself includes 5 steps (WHO, 2010; Sperber, 1994;

Byrne & Campbell, 1999, Hilton and Skrutkowski, 2002), which are described in detail (see also figure

1).

Step 1: Forward translation

A health professional, who was familiar with domestic violence and respective instruments

in this area, translated the forward translation. He was aware of the concepts being examined in the

instrument to provide an equivalent and reliable translation in terms of specific constructs and

domestic violence related processes.

In case it was possible a second bilingual forward translator with a different background with

respect to the research area and the instrument under consideration additionally translated the

instrument (The second translator detected meanings of expressions and phrases from a perspective

unrelated to the scientific concepts of domestic violence Byrne & Campbell, 1999, Hilton and

Skrutkowski, 2002). He tried to find discrepancies looking to the wording and expressions that was

used in the general population. Both translators wrote a report with comments on difficult

expressions and phrases that had to be translated and suggestions of or comments on alternative

words and phrases.

Aims of the forward translation were(e.g. WHO, 2010):

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- To perform a conceptual translation rather than a word-to-word translation;

- To provide simple and not complicated sentences;

- To target the translation for respondents from the general population;

- To avoid the use of jargon, technical terms or other specific expressions that are not

clearly to understand for respondents from the general population and

- to correspond the translation to the DOVE age-groups between 18 and 64 years.

Step 2: First expert panel

After the forward translation an expert panel of the country-specific DOVE group identified and

resolved inadequate translations. Some authors (e.g. Beaton et al., 2000) suggest this step during a

later final stage before pre-testing; however, it is preferable that the expert panel is involved during

all stages. Together with the two translators the expert panel synthesized the two versions of the

questionnaire that had to be translated or the main instrument, respectively. The expert panel used

the reports of the interpreters and discuss cultural appropriate versions of expressions and phrases.

It was important to reach consensus as far as possible if different expressions were suggested.

Previous translations of the questionnaires could be used for the discussion of specific issues.

Otherwise the concerns from one part of the expert panel had to be discussed again after the pre-

testing. This step resulted in a final version for back-translation and a report on how problems have

been resolved as well as on still existing concerns.

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Figure 2: Five steps of translation and cultural validation of the DOVE instrument

Step 3: Back-translation

The instrument was back-translated to English again by two independent translators with different

professional backgrounds that were blind to the original version. The two translators had no

practical or research related background within the area of domestic violence. Recommended were

translators whose mother tongue is English. This step assured that the translated questionnaires

reflected the same contents as the original versions. A report of inconsistencies together with the

back-translated versions was prepared.

Step 4: New expert panel synthesizing the pre-final version

The new bilingual expert team ideally comprised of each partners work group including the country-

specific principal investigator, independent researchers from other fields that were however related

to the domestic violence area and all (back-) translators of the instrument. This new expert panel

reviewed the back-translated version with respect to discrepancies. The reports that have been

generated during translations can help to find alternative expressions.

Forward-

translation

Back-

translation

Expert

panel

Pre-

testing during

piloting

Expert

panel

Step 1:Two translations

by two different

translators

One scientist from

the area/ one from

the Population

Step 2:Expert panel of the

member state work

group with both

translators synthesizing

a new version for back-

translation by

consensus

Step 4:All persons related to the

translation process and

members of the DOVE

work group including the PI

will generate a pre-final

version together with other

interdisciplinary experts

Step 5:Pre-test in the

target sample

probing for

language problems

Eventually new

Pre-testing

Expert

panel

and eventually

revision

Step 6 :Final evaluation by

the expert panel

Step 3:Two back-

translations

by two different

“blind” translators

with no background

of DV research

and DOVE

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In case of concerns about different interpretations and meanings of expressions it can be

also useful to present unclear items to children or adolescents. However, if no consensus is reached

on specific expressions interviewers had to be instructed to probe respondents for appropriate

understanding. The aim of this expert panel is to generate a pre-final version for pre-testing.

Equivalence of this version with the original version and cross cultural adaptation includes:

- Semantic equivalence (same meaning of the words with respect to the vocabulary and

grammar);

- Idiomatic equivalence (same meaning with respect to the intention of the word or

phrase)

- Experiential equivalence (same meaning with respect to corresponding experiences and

framework of violent situations)

- Conceptual equivalence (same meaning e.g. of behaviours with respect to the concept of

domestic violence in different cultures).

Step 5: Pre-testing the translated instrument

The pre-testing of the translated instrument was done during the pilot study. For this purpose it was

suggested to edit and print the complete instrument together with the instructions. Furthermore

forms to fill in with comments from the interviewers were prepared. Interviews were instructed to

control the application of the instrument with respect to its cultural adaptability. After the

assessment, the practicability and feasibility of the instrument was discussed in the expert panel

together with the interviewers.

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1. PILOTING THE MAIN INSTRUMENT

Main question to be answered: Are the questionnaires appropriately adapted and feasible? Do the

respondents understand and accept all items of the main instrument?

In the Ludwigsburg meeting on December 3.-4., 2009 the partners agreed that the pilot study should

be conducted with 5 female and 5 male respondents aged 18-60 years in each participating country.

Snowball-sampling was suggested for recruitment. Snowball sampling means that persons in the

network of the researches are contacted and asked whether they agree in participating on the pilot

study (Patton, 1990).

INTERVIEWERS OF THE PILOT STUDY

At least 1 female and 1 male interviewee was recruited for the pilot study. Because gender might

play a role for the data assessment and the response behaviour the organizational staff allocated

both interviewers and interviewees according to the wishes of the interviewees.

FIELD WORK OF THE PILOT STUDY

The field work of the pilot study consisted of training of interviewers for the pilot study, assessment

of interviewees and of testing the organization of data management for the main study.

Interviewer training for the pilot study

Training of interviewers for the pilot study was done in 11 steps:

Step 1: General information about DOVE

Step 2: Functions and responsibilities of the interviewers

Step 3: Rights of the interviewees

Step 4: Data safety

Step 5: Handling of addresses

Step 6: First phone contact

Step 7: First personal contact

Step 8: Instructions for the administration of the instrument

Step 9: Instructions and practice of problematic situations during assessment

Step 10: Data management together with the study organization

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Step 11: Recording of any problems in the matrix provided by the German team

Assessment of interviewees

Interviewees were assessed with the main instrument. Interviewers recorded length of the interview

and problems during interviewing. The following procedures were recommended with respect to the

cultural adaptation of the instrument:

(1) Interviewees were advised to note any unclear expression or phrase. These expressions and

phrases were recorded.

(2) Interviewees were debriefed after the assessment on further inadequate expressions and

phrases.

(3) Interviewers tried to find alternative words in the above cases together with the Interviewees.

(4) Results of this process of finding solutions for potential problems and any problems with the

instrument were recorded (e.g. appearance and layout of the instrument).

(5) Notes and suggestions for corrections were summarized in a report concerning the main

instrument also included additional information about the respondent.

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2. RESULTS

Table 1. Interviews performed in each country for the pilot study.

Countries

Men

(n)

Women

(n)

Total

(n)

Interview

duration

(minutes)

Age

(mean, range)

Time frame

Belgium 5 5 10 82.6 35.5 Febr. 23th-April 7

Germany 5 5 10 119.4 33.7 Febr. 15th-March 12th

Greece 6 7 13 90 28-57 April 7th-April 14th

Hungary 3 7 10 70 19-57 April 24th-25th

Portugal 5 13 18 69.5 37.7 Febr. 17 th-March 1st

Spain 2 3 5 90 54.0 April 7th-April 12th

Sweden 3 6 9 90 21-53 April

United

Kingdom

6 5 11 76.8 40.9 March 2010

After piloting, all partners put forward several suggestions, and the following paragraph summarizes

those common to all teams:

- Title of the questionnaire should be changed

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- Lenght of the questionnaire (too long)

- Order of scales should be revised

- Transition between scales should be clear

- Introduction of systematic skips are needed

- Numbering of questions is absoluteley necessary

- Coding of missing data should be agreed upon

Additionally, some suggestions came only from one or two centres:

- Health care utilization scale should be simplified

- Smoking , Alcohol use scale needs revision

- Medication scales is too detailed

- Either questions of health or the SF-36

- Before asking for PTSD symptoms :

Type of event, period of life (use of original scale or use of the DSM-events

list)

- „Who did first“ and violence escalation should be omitted in case there was no violence

- „Who did it first“ should be skipped

- PTSD scale needs the full scale

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Overall, 25 interviews were performed in the respondent’s home, 21 in the partners research’s

centers and 16 in other places. 21 weren’t in a relationship, while 52 were currently in a relationship.

No differences were found in terms of duration of interview, by age group, as presented in

graphic 3. The same observation is valid when considering interviewees marital status (graph 4) and

education (graph 5), and profession (graph 6)

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However, when looking at interview duration by country, there were some differences with Spain

having less frequently long-interviews (χ2=49.6; p<0.01).

3. CONCLUSIVE REMARKS

The Pilot process represented an unique opportunity for the first test to what could be

expected, both in terms of feasibility, and in terms of collaboration. A number of decisions and

corrections were put forward in order to achieve a sound and consensual instrument, and the fact

that many actors were consulted (experts, interviewers, participants, researchers), enriched the

overall process.

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4. REFERENCES

1. Byrne BM, Campbell TL. (1999). Cross-cultural comparisons and the presumption of equivalent measurement and theoretical structure: A look beneath the surface. Journal of Cross-Cultural Psychology 30: 555-574.

2. Guillemin F, Bombardier C, Beaton D. (1993). Cross-cultural adaptation of health-related quality of life measures: literature review and proposed guideline. J Clin Epidemiol. 46: 1417-1432.

3. Hilton A, Skrutkowski M. (2002). Translating instruments into other languages: Development and testing processes. Cancer Nursing 25 (1): 1-7.

4. Patton M. (1990). Qualitative evaluation and research methods. Sage:Nebury Park, Calif.

5. Sperber AD, Devellis RF, Boehlecke B. (1994). Cross-cultural translation. Journal of Cross-Cultural Psychology 25: 501-524.