Translation and Adaptation of the Brief Negotiation Interview Adherence Scale for the Tanzanian Culture

Abstract

Background: Harmful or hazardous alcohol use is a grave public health problem, causing over 3.3 million deaths annually worldwide. A large number of patients who seek medical care at Emergency Department (ED) present alcohol-related injuries. The use of the Brief Negotiation Interview (BNI) by healthcare providers can help reduce alcohol use and modify drinking patterns of patients in this condition. Considering this, the present study’s objectives were to 1) develop a Swahili version of the Brief Negotiation Interview (BNI) Adherence Scale (BAS) adapted to the Tanzanian culture; 2) support the previously published culturally adapted BNI “Reduce Alcohol for Your Health” a nurse-delivered intervention (PPKAY); and, 3) analyze the psychometric properties of the BAS scale such as internal consistency and factor structure. Methods: This study is a cross-sectional evaluation of the adherence of ED health care practitioners to the BNI components among patients with harmful alcohol use presenting for care at the Kilimanjaro Christian Medical Centre (KCMC) in Moshi, Tanzania. The translation and cross-cultural adaptation involved the ‘back-translation’ method. Sample consisted of five research nurses, which evaluated up to twelve BNI sessions, completing 108 individual assessments. To assess the validity related to internal structure of the different models, a Confirmatory Factor Analysis (CFA) was performed. The internal consistency was measured by the Cronbach’s alpha, McDonald’s Omega coefficient and Composite Reliability. Results: Both 2-factor and 3-factor models presented good internal consistency and factor loadings. High values were found for TLI, CFI and NNFI (>0.90). Both RMSEA values were smaller than 0.08. Average extracted variance showed that the 3-factor model could explain 77%, 65% and 65% variables’ variance while the 2-factor model could explain 76% and 53% variables’ variance of each dimension. Conclusions: This is the first study to translate and adapt the BNI Adherence Scale to Tanzanian culture. The 3-factor model performed better with good fit indices. The adapted scale showed to be a reliable instrument to assess healthcare providers’ adherence to BNI and is a supportive tool and important component of the previously culturally adapted BNI “Reduce Alcohol for Your Health” (PPKAY).