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Cross-Cultural Adaptation and Validation of Voice Handicap Index in Tulu Language
Deepali Devadiga1, Riya Mariam Thomson1, Rohit Ravi1
1Department of Audiology and Speech Language Pathology, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Manipal, India.
Objectives:
To translate, cross-culturally adapt, and validate the Voice Handicap Index into the Tulu language and to compare outcomes between individuals with and without voice problems.
Study Design:
Cross-sectional study METHODS: The study included 156 participants: 78 individuals without voice problems (Group I) and 78 with voice problems (Group II). The Voice Handicap Index was translated into Tulu following standard cross-cultural adaptation procedures, including forward translation, backward translation, expert review, and pilot testing. The adapted Voice Handicap Index-Tulu was administered to all participants. Internal consistency was assessed using Cronbach's α, test-retest reliability using the intraclass correlation coefficient, and construct validity using independent-samples t tests.
Results:
Participants with voice problems reported significantly higher Voice Handicap Index-Tulu scores across all domains compared to those without voice problems (P < 0.001), with large to very large effect sizes. VHI-Tulu demonstrated good to excellent internal consistency (Cronbach's α = 0.82 in Group I; Cronbach's α = 0.94 in Group II). Test-retest reliability was excellent (intraclass correlation coefficient = 0.97). Subscale reliability ranged from acceptable to excellent in Group II.
Conclusions:
The Voice Handicap Index-Tulu is a reliable and valid tool for assessing the voice-related quality of life in the Tulu-speaking community and can be used in clinical practice and research.