A pilot feasibility study of a questionnaire to determine European Union-wide CAM use.
BACKGROUND
No questionnaire specifically measuring the core components of complementary and alternative medicine (CAM) use has been validated for use across European Union (EU) countries. We aimed to determine the face validity, acceptability and the participants' comprehension of a pre-existing questionnaire designed to measure 'CAM use', to provide a comparative, standardised questionnaire for use by health care providers, policy makers and purchasers throughout Europe.


METHODS
Established procedures were employed to translate the questionnaire into 4 EU languages. The translated questionnaires were piloted on 50 healthy adults from each country who may never have used CAM. 10 participants per country also took part in audio-recorded think aloud interviews about the questionnaire. The interviews were transcribed and analysed in the language in which they were conducted; findings were summarised in English. Questionnaire data were pooled across countries, and patterns of completion and missing data were analysed.


RESULTS
The questionnaire was translated into Italian, Spanish, Dutch and Romanian. The mean age of the participants was 43.6 years. 34% were male, 87.4% were either light or heavy CAM users, and 12.6% were non-users. Qualitative analysis identified common problems across countries including a 'hard-to-read' layout, misunderstood terminology and uncertainty in choosing response options. Quantitative analysis confirmed that a substantial minority of respondents failed to follow questionnaire instructions and that some questions had substantial rates of missing data.


CONCLUSIONS
The I-CAM-Q has low face validity and low acceptability, and is likely to produce biased estimates of CAM use if applied in England, Romania, Italy, The Netherlands or Spain. Further work is required to develop the layout, terms, some response options and instructions for completion before it can be used across the EU.
Complementary and Integrative Medicine Research, University of Southampton, UK.
Susan
S
Eardley
Felicity L
FL
Bishop
Francesco
F
Cardini
Koldo
K
Santos-Rey
Miek C
MC
Jong
Sorin
S
Ursoniu
Simona
S
Dragan
Gabriella
G
Hegyi
Bernhard
B
Uehleke
Jorge
J
Vas
Ovidiu
O
Jupaneant
Maria Caterina
MC
Citro
Vinjar
V
Fønnebø
Sara A
SA
Quandt
George
G
Lewith
D000328:Adult; D000529:Complementary Therapies / Q000706:statistics & numerical data*; D003431:Cross-Cultural Comparison; D005060:Europe; D005062:European Union; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires; D014175:Translating; D014600:Utilization Review