Harrington Elizabeth K, Congo Ouma, Kimanthi Syovata, Dollah Annabell, Onono Maricianah, Mugo Nelly, Barnabas Ruanne V, Bukusi Elizabeth A, Upadhyay Ushma D
Department of Obstetrics & Gynecology, University of Washington, Seattle, Washington, United States of America.
Department of Global Health, University of Washington, Seattle, Washington, United States of America.
PLOS Glob Public Health. 2023 Oct 26;3(10):e0001978. doi: 10.1371/journal.pgph.0001978. eCollection 2023.
Measuring empowerment is critical to understanding the level of control adolescents and young adults (AYA) have over their sexual and reproductive health (SRH) behaviors, and could provide a key window into addressing their unique SRH needs. We adapted the Sexual and Reproductive Empowerment (SRE) scale for AYA for use in an East African context. This multi-method qualitative study sampled 15-23 year-old female adolescents and young adults in Kisumu, Kenya. We conducted in-depth interviews (n = 30) and analyzed transcripts with an inductive, constant comparison approach. Empowerment domains were integrated with Kabeer's (1999) framework in a conceptual model, which we referenced to revise the original and develop new scale items. Items underwent expert review, and were condensed and translated through team-based consensus-building. We evaluated content validity in cognitive interviews (n = 25), during which item phrasing and word choice were revised to generate an adapted SRE scale. Participants (n = 55) had a median age of 18 (range 16-23), and 75% were under 19 years. We categorize three types of adaptations to the SRE scale: new item generation, item revision, and translation/linguistic considerations. We developed nine new items reflecting AYA's experiences and new domains of empowerment that emerged from the data; new domains relate to self-efficacy in accessing sexual and reproductive health care, and how material needs are met. All items were revised and translated to echo concepts and language relevant to participants, navigating the multilingualism common in many African countries. Centering the voices of female Kenyan AYA, this study provides insight into measuring the latent construct of adolescent sexual and reproductive empowerment in an East African setting, and supports the adapted SRE scale's content validity for Kenya. We detail our multi-method, theory-driven approach, contributing to limited methods guidance for measure adaptation across contexts and among diverse adolescent populations.
衡量赋权对于了解青少年和青年（AYA）对其性健康和生殖健康（SRH）行为的控制程度至关重要，并且可以为满足他们独特的性健康和生殖健康需求提供关键窗口。我们对AYA的性与生殖赋权（SRE）量表进行了改编，以用于东非背景。这项多方法定性研究在肯尼亚基苏木对15至23岁的女性青少年和青年进行了抽样。我们进行了深入访谈（n = 30），并采用归纳式、持续比较法分析了访谈记录。赋权领域在一个概念模型中与卡比尔（1999年）的框架相结合，我们以此为参考来修订原始量表并开发新的量表项目。项目经过专家评审，并通过基于团队的共识构建进行浓缩和翻译。我们在认知访谈（n = 25）中评估了内容效度，在此期间对项目措辞和用词进行了修订，以生成一个改编后的SRE量表。参与者（n = 55）的年龄中位数为18岁（范围为16 - 23岁），75%的人年龄在19岁以下。我们将对SRE量表的改编分为三种类型：新项目生成、项目修订以及翻译/语言考量。我们开发了九个反映AYA经历和从数据中浮现的新赋权领域的新项目；新领域涉及获得性健康和生殖健康护理的自我效能感，以及物质需求如何得到满足。所有项目都经过修订和翻译，以呼应与参与者相关的概念和语言，应对许多非洲国家常见的多语言情况。以肯尼亚女性AYA的声音为中心，本研究深入探讨了在东非背景下衡量青少年性与生殖赋权这一潜在结构的方法，并支持改编后的SRE量表在肯尼亚的内容效度。我们详细阐述了我们的多方法、理论驱动的方法，为跨背景和不同青少年群体的测量改编提供了有限的方法指导。
