The 10-Step Cross-cultural Equivalence Process for Developing Measures for Culturally Informed Research

We describe a comprehensive ten step process for choosing and adapting existing scales or questionnaires to the Somali language for the Our Body Our Health (OBOH) study. The OBOH study aims to examine sexual pain, coping with pain, sexual health, and decision-making in a sample of Somali women living in the United States and have experienced female genital cutting (FGC). We describe how we used existing guidelines for construct equivalence, semantic equivalence, technical equivalence and translation, while also expanding on these guidelines by engaging community members through a variety of mechanisms. We also used an iterative process where decisions were made, refined, and sometimes overturned as we gathered more community driven feedback. Through this process we adapted 11 scales, created three questionnaires, and translated all. We considered five other scales and describe the reasons we did not use them for the final survey. Finally, we present lessons learned and recommendations for other researchers.