title: Chinese version of the Global Youth Tobacco Survey: cross-cultural instrument adaptation.
abstract: BACKGROUND
  Tobacco smoking poses public health concerns because of its high risk for many chronic diseases. Most smokers begin using tobacco in their teens and recent reports indicate that smoking prevalence is climbing among youth. The Global Youth Tobacco Survey (GYTS) is a worldwide, school-based, tobacco-specific survey, but cross-cultural differences limit its effectiveness in international studies. Specifically, the GYTS assesses not only the prevalence of smoking, but also tobacco-related attitudes, school curricula, and advertisements, which are culturally influenced. Therefore, we conducted this study to develop a Chinese version of the GYTS for both national surveillance and international comparison.
  
  
  METHODS
  The original English GYTS was translated and back translated using a cross-cultural adaptation process. The comprehensiveness and feasibility of using the Chinese-version GYTS were reviewed by a panel of 6 tobacco-control experts. The understandability and cultural relevance of the Chinese-version GYTS were discussed in a focus group of 5 schoolteachers and 8 students. The expert and focus group feedback was incorporated into a final Chinese version of the GYTS, which was administered to 382 students throughout Taiwan by multi-stage sampling from 10 randomly selected schools.
  
  
  RESULTS
  The internal consistency (Cronbach's alpha) for the GYTS subscales (smoking susceptibility, attitude toward smoking, and media messages about smoking) ranged from 0.70 to 0.94. The internal logical agreement of responses ranged from 85.3 to 99.2%.
  
  
  CONCLUSIONS
  The Chinese version of the GYTS has good reliability and validity and can serve as the foundation for international comparison and tobacco control in Chinese-speaking communities.
authors.affiliation: School of Nursing, Taipei Medical University, Taipei, Taiwan. plchen@tmu.edu.tw
authors.forename: Ping-Ling
authors.initials: PL
authors.lastname: Chen
authors.forename: Hung-Yi
authors.initials: HY
authors.lastname: Chiou
authors.forename: Yi-Hua
authors.initials: YH
authors.lastname: Chen
mesh_terms: D000293:Adolescent; D002648:Child; D005260:Female; D017144:Focus Groups; D006306:Health Surveys; D006801:Humans; D007802:Language; D008297:Male; D011159:Population Surveillance / Q000379:methods; D015203:Reproducibility of Results; D012907:Smoking / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D013624:Taiwan / Q000453:epidemiology; D014177:Translations