“I Can’t Answer What You’re Asking Me. Let Me Go, Please.”

Cognitive interviewing is a method to develop culturally appropriate survey questions and scale items. We conducted two rounds of cognitive interviews with 24 pregnant women in Ethiopia and Kenya to assess the appropriateness, acceptability, and comprehension of general and micronutrient supplement adherence-specific social support scales. We stopped the first round of cognitive interviews after receiving negative feedback from interviewers and participants about their distressing and uncomfortable experiences with cognitive probes and challenges related to cultural perspectives on social support. Through an iterative process, we made substantial changes to the cognitive interview guides and items from both social support scales. In the second round, the revised cognitive interviewing process substantially improved interviewer and participant experiences and increased comprehension and appropriateness of both social support scales. This study confirms the importance of cultural adaptation of the cognitive interviewing process as well as social support scales.

[1]  Murrey G. Olmsted,et al.  Research participant selection in non-English language questionnaire pretesting: findings from Chinese and Korean cognitive interviews , 2016 .

[2]  Kenya,et al.  Kenya Demographic and Health Survey 2014 , 2015 .

[3]  Hyunjoon Park,et al.  Investigating validity and effectiveness of cognitive interviewing as a pretesting method for non-English questionnaires: Findings from Korean cognitive interviews , 2014 .

[4]  Thomas S Inui,et al.  Cognitive Interviewing for Cross-Cultural Adaptation of Pediatric Antiretroviral Therapy Adherence Measurement Items , 2014, International Journal of Behavioral Medicine.

[5]  L. Makewa,et al.  Learner-Centered Teaching: Can It Work in Kenyan Public Primary Schools? , 2014 .

[6]  Jai K. Das,et al.  Evidence-based interventions for improvement of maternal and child nutrition: what can be done and at what cost? , 2013, The Lancet.

[7]  E. Diener,et al.  Social relations, health behaviors, and health outcomes: a survey and synthesis. , 2013, Applied psychology. Health and well-being.

[8]  M. Tesfaye,et al.  Conceptual equivalence of WHOQOL-HIV among people living with HIV in Ethiopia , 2013, Quality of Life Research.

[9]  G. Ice,et al.  Stress associated with caregiving: an examination of the stress process model among Kenyan Luo elders. , 2012, Social science & medicine.

[10]  J. Padilla,et al.  Design and Analysis of Cognitive Interviews for Comparative Multinational Testing , 2011, Field methods.

[11]  Heather E Ridolfo,et al.  Analyzing Cognitive Interview Data Using the Constant Comparative Method of Analysis to Understand Cross-Cultural Patterns in Survey Data , 2011 .

[12]  Yuling Pan,et al.  Cognitive Interviewing in Non‐English Languages: A Cross‐Cultural Perspective , 2010 .

[13]  J. Harkness,et al.  Translation, Adaptation, and Design , 2010 .

[14]  Patricia L. Goerman,et al.  Managing the cognitive pretesting of multilingual survey instruments: A case study of pretesting of the U.S. Census Bureau Bilingual Spanish/English Questionnaire , 2010 .

[15]  T. Christensen,et al.  Qualitative research and content validity: developing best practices based on science and experience , 2009, Quality of Life Research.

[16]  E. Boon,et al.  Improving Access to Productive Resources and Agricultural Services through Gender Empowerment: A Case Study of Three Rural Communities in Ambo District, Ethiopia , 2009 .

[17]  E. Airaksinen,et al.  Adaptation of the multidimensional scale of perceived social support in a Ugandan setting. , 2009, African health sciences.

[18]  T. Johnson.  Methods and Frameworks for Crosscultural Measurement , 2006, Medical care.

[19]  Ethiopia,et al.  Ethiopia demographic and health survey, 2000 , 2006 .

[20]  Derebssa Dufera Serbessa.  Tension between Traditional and Modern Teaching-Learning Approaches in Ethiopian Primary Schools , 2006 .

[21]  E. McColl.  Cognitive Interviewing. A Tool for Improving Questionnaire Design , 2006, Quality of Life Research.

[22]  S. Thomsen,et al.  Thinking Aloud to Create Better Condom Use Questions , 2005 .

[23]  J. W. Hussein,et al.  A CULTURAL REPRESENTATION OF WOMEN IN THE OROMO SOCIETY , 2004 .

[24]  Virginia Schmied,et al.  Defining Social Support in Context: A Necessary Step in Improving Research, Intervention, and Practice , 2004, Qualitative health research.

[25]  L. Kiser,et al.  Social Support Measurement and Intervention: A Guide for Health and Social Scientists. , 2001 .

[26]  W. Fawzi,et al.  Predictors of HIV-1 serostatus disclosure: a prospective study among HIV-infected pregnant women in Dar es Salaam, Tanzania , 2001, AIDS.

[27]  S. Stewart,et al.  Quality of Data in Multiethnic Health Surveys , 2001, Public health reports.

[28]  Gordon B. Willis.  The Practice of Cross-Cultural Cognitive Interviewing , 2015 .

[29]  R. Speare,et al.  Cognitive testing of the WHOQOL-BREF Bangladesh tool in a northern rural Bangladeshi population with lymphatic filariasis , 2012, Quality of Life Research.

[30]  F. Barg,et al.  Social determinants of iron supplementation among women of reproductive age: a systematic review of qualitative data. , 2012, Maternal & child nutrition.

[31]  Peter Prüfer,et al.  Paraphrasing can be dangerous: a little experiment , 2004 .

[32]  Thomas Ashby Wills,et al.  Measuring perceived and received social support. , 2000 .