Department of Health Promotion and Community Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon.
Center for Research on Population and Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon.
BMC Med Res Methodol. 2024 Sep 12;24(1):202. doi: 10.1186/s12874-024-02300-8.
Sexual and reproductive empowerment (SRE) is an important determinant of women's and girls' health yet measuring it is complex due to cultural and domain-specific variations. This study describes the process of adapting an SRE scale consisting of four domains (self-efficacy; future orientation; social support; and safety) and testing its psychometric properties among Arabic speaking adolescent girls in Lebanon.
An SRE scale developed in a Western context was adapted in four steps: (1) reviewing the scale and selecting culturally appropriate domains for translation to standard Arabic; (2) conducting cognitive interviews with 30 11-17-year-old adolescent girls in Lebanon; (3) administering the scale to 339 refugee adolescent girls who participated in an early marriage intervention; and (4) conducting confirmatory factor analysis (CFA) on the data to assess the scale's psychometric properties.
The original model for the 13-item, four-domain adapted scale demonstrated poor fit in CFA. After iteratively removing two items, scale properties were improved, albeit were not optimal. The validity and reliability results for the self-efficacy domain were acceptable. Cognitive interview data revealed that Arab adolescent girls understood self-efficacy in relational terms, recognizing that autonomous decision-making is not necessarily favored but is influenced by parents and family.
This study presents an effort to customize an SRE scale for use in studies on the health of adolescent girls in an Arab cultural context. Findings from cognitive interviews highlight the importance of taking into consideration relationality in adolescent sexual and reproductive decision-making. The self-efficacy domain in the adapted scale demonstrates acceptable psychometric properties and is recommended for use in health studies to capture SRE.
性与生殖赋权（SRE）是女性和女孩健康的重要决定因素，但由于文化和领域的差异，衡量其水平非常复杂。本研究描述了将一个包含四个领域（自我效能；未来取向；社会支持；和安全）的 SRE 量表进行改编，并在黎巴嫩讲阿拉伯语的青春期少女中测试其心理测量特性的过程。
在西方背景下开发的 SRE 量表通过四个步骤进行改编：（1）审查量表并选择适合翻译成标准阿拉伯语的文化适当领域；（2）对 30 名 11-17 岁的黎巴嫩青春期少女进行认知访谈；（3）对 339 名参加早婚干预的难民青春期少女进行量表施测；（4）对数据进行验证性因子分析（CFA），以评估量表的心理测量特性。
原始的 13 项、四项改编量表模型在 CFA 中拟合不佳。经过反复删除两个项目，量表特性得到了改善，但并非最佳。自我效能领域的效度和信度结果可接受。认知访谈数据显示，阿拉伯裔青春期少女以关系术语理解自我效能，认识到自主决策不一定受到青睐，但会受到父母和家庭的影响。
本研究努力为在阿拉伯文化背景下研究青春期少女健康状况定制 SRE 量表。认知访谈的结果强调了在青少年性与生殖决策中考虑关系的重要性。改编后的量表的自我效能领域具有可接受的心理测量特性，建议在健康研究中用于捕捉 SRE。
