适应英语加勒比地区的 INTERGROWTH-21 神经发育评估（INTER-NDA）。
Adaptation of the INTERGROWTH-21st neurodevelopment assessment (INTER-NDA) to the context of the English-speaking Caribbean.
机构信息
School of Medicine, St. George's University, True Blue, Grenada, West Indies.
The Windward Islands Research and Education Foundation, True Blue, Grenada, West Indies.
出版信息
BMC Pediatr. 2022 Jan 4;22(1):21. doi: 10.1186/s12887-021-03039-7.
BACKGROUND
Adaptation of standardized early child development (ECD) assessments to low- and middle-income countries can be challenging because of culture-specific factors relating to language, content, context, and tool administration, and because the reliance of these tests on specialist healthcare professionals limits their scalability in low resource settings.
METHODS
We report the cross-cultural adaptation of an international, standardized ECD instrument, the INTERGROWTH-21st Project Neurodevelopment Assessment (INTER-NDA), measuring cognitive, language, motor and behavioural outcomes in 2-year-olds, from a UK-based English-speaking population to the English-speaking Caribbean. Children aged 22-30 months were recruited from a pre-existing randomized controlled neurodevelopment intervention study in Grenada, West Indies.
RESULTS
Eight of 37 INTER-NDA items (22%) were culturally and linguistically adapted for implementation in the Caribbean context. Protocol adherence across seven newly-trained non-specialist child development assessors was 89.9%; six of the seven assessors scored ≥80%. Agreement between the expert assessor and the non-specialist child development assessors was substantial (κ = 0.89 to 1.00 (95% CI [0.58, 1.00]). The inter-rater and test-retest reliability for non-specialist child development assessors was between κ = 0.99 -1.00 (95% CI [0.98, 0.99]) and κ = 0.76 - 1.00 (95% CI [0.33, 1.00]) across all INTER-NDA domains.
CONCLUSIONS
The current study provides evidence to support the use of the adapted INTER-NDA by trained, non-specialist assessors to measure ECD prevalence in the English-speaking Caribbean. It also provides a methodological template for the adaptation of child developmental measures to cultural and linguistic contexts that conform to the cultural standards of the countries in which they are utilized to aid in the measurement of neurodevelopmental impairments (NDIs) in a variety of global clinical settings.
背景
由于与语言、内容、背景和工具管理相关的特定文化因素，以及这些测试对专业医疗保健专业人员的依赖限制了它们在资源匮乏环境中的可扩展性，因此对来自中低收入国家的标准化早期儿童发展（ECD）评估进行调整可能具有挑战性。
方法
我们报告了一项国际标准化 ECD 工具——INTERGROWTH-21st 项目神经发育评估（INTER-NDA）的跨文化适应，该工具用于测量 2 岁儿童的认知、语言、运动和行为结果，该工具源自英国讲英语的人群，适用于英语加勒比地区。在西印度群岛的格林纳达，从一项现有的随机对照神经发育干预研究中招募了 22-30 个月大的儿童。
结果
在加勒比地区实施的 37 项 INTER-NDA 项目中，有 8 项（22%）进行了文化和语言方面的调整。经过培训的 7 名非专业儿童发育评估员中有 89.9%的人遵守了协议；7 名评估员中有 6 名得分≥80%。专家评估员与非专业儿童发育评估员之间的一致性很高（κ=0.89 至 1.00（95%CI[0.58,1.00]）。非专业儿童发育评估员的组内和重测信度在所有 INTER-NDA 领域分别为 κ=0.99-1.00（95%CI[0.98,0.99]）和 κ=0.76-1.00（95%CI[0.33,1.00]）。
结论
本研究为受过培训的非专业评估员使用改编后的 INTER-NDA 来衡量英语加勒比地区 ECD 的流行率提供了证据。它还为儿童发育评估工具适应文化和语言环境提供了一种方法模板，该模板符合其使用国家的文化标准，以帮助在各种全球临床环境中测量神经发育障碍（NDIs）。
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