Translation, Cross-Cultural Adaptation and Pilot Testing of the Young Children’s Participation and Environment Measure (YC-PEM) in the Dutch Culture

Abstract

Concepts such as participation and environment may differ across cultures. Consequently, to use a measure like the Young Children's Participation and Environment Measure (YC-PEM) in other than the original English-speaking contexts, cultural adaptation needs to be assured. The objective is to cross-culturally translate, adapt, and pilot test the YC-PEM into the Dutch language and culture. In total 3 cognitive interviews with caregivers and one focus group with Occupational Therapists (N = 5) working in early intervention were conducted to evaluate the cultural relevance of the YC-PEM content for use in a Dutch context. Data was analyzed by content analysis using semantic, idiomatic, content, and conceptual equivalence. The YC-PEM was pilot tested with 31 caregivers of children with and without disabilities. Setting specific estimates of internal consistency and test-retest reliability were obtained. Results show adaptations mainly focused on content and conceptual equivalence, with conceptual equivalence being the most challenging to reach. Internal consistency estimates varied from .42 to .93 for the participation scales and from .74 to .83 for the environmental scale. This study gives preliminary evidence for the use of a culturally adapted YC-PEM in Belgium and the Netherlands. Further validation in a larger sample is indicated to evaluate its psychometric properties.

Translation and cross-cultural adaptation of the young children participation and environment measure for its use in Austria, Germany, and Switzerland

“…How the YC-PEM was constructed (the exemplary naming of the most frequently typical activities of a cultural community) increased the number of changes to reach item equivalence additionally. Sometimes also defined as content equivalence ( 39 ), it was reported to be also high in similar research ( 30 , 33 , 34 , 50 ). We also agree with Arestad et al ( 34 ) that some items of YC-PEM were less relevant to children of a younger age, and this became obvious in think-aloud interviews of caregivers with infants.…”

“…However, others describe a similar approach to visualizations after the caregivers’ feedback in their first round of cognitive interviews with the PEM-CY ( 51 ). With this adapted introduction and the use of colors as guiding means ( 52 ), changes in the display, which are reported frequently elsewhere ( 33 , 34 ), are less needed. These adaptations also increase the self-explanatory nature of the YC-PEM and support the concept of self-report assessments.…”

“…By referring to experiences of the cultural adaptation of PEM-CY for the German-speaking countries ( 43 ) and thus integrating the primary conceptual phrasing from PEM-CY (G) into YC-PEM (G), we decided that sufficient information in an early stage of the project would prevent problems later on ( 41 ). This was definitely the case considering the wording of “participation”, “environment”, and “community”, which in the Dutch cultural adaptation posed some difficulties ( 33 ). Similar to findings by others ( 31 , 34 , 51 ), expert consultation in an earlier stage led to even more conceptual equivalence changes.…”

“…Criteria for inclusion were: (a) caring for a child between 0 and 5 years of age, (b) living in Germany, Austria, or Switzerland in the last five years, and (c) being able to read and speak German. As reported in similar work ( 31 , 33 , 34 ), convenience sampling was used to recruit caregivers. This was combined with a purposeful sampling technique to reach diversity.…”

“…Therefore, equivalence, specifically conceptual equivalence, is essential because concepts such as participation and disability may differ across cultures ( 29 ). Based on experiences of translation and cultural adaptation of YC-PEM to the context of Singapore ( 30 ), Sweden ( 31 ), China ( 32 ), Dutch-speaking countries ( 33 ), and Hispanic US population ( 34 ), a guiding process to culturally adapt participation-focused pediatric practice was recently published ( 35 ). According to these authors, some of which are the developers of the YC-PEM, cross-cultural research advances the delivery of culturally responsive pediatric rehabilitation and translates knowledge on a global scale.…”