title: Cultural adaptation of a survey to assess medical providers' knowledge of and attitudes towards HIV/AIDS in Albania.
abstract: Though the HIV/AIDS epidemic in Southeastern Europe is one of low reported prevalence, numerous studies have described the pervasiveness of medical providers' lack of knowledge of HIV/AIDS in the Balkans. This study sought to culturally adapt an instrument to assess medical providers' knowledge of and attitudes towards HIV/AIDS in Albania. Cultural adaptation was completed through development of a survey from previously validated instruments, translation of the survey into Albanian, blinded back translation, expert committee review of the draft instrument, focus group pre-testing with community- and University Hospital Center of Tirana-based physicians and nurses, and test-retest reliability testing. Blinded back translation of the instrument supported the initial translation with slight changes to the idiomatic and conceptual equivalences. Focus group pre-testing generally supported the instrument, yet some experiential and idiomatic changes were implemented. Based on unweighted kappa and/or prevalence adjusted bias adjusted kappa (PABAK), 20 of the 43 questions were deemed statistically significant at kappa and/or PABAK ≥0.5, while 12 others did not cross zero on the 95% confidence interval for kappa, indicating their probable significance. Subsequently, an instrument to assess medical providers' knowledge of and attitudes toward HIV/AIDS for an Albanian population was developed which can be expanded within Albania and potentially to other countries within the Balkans, which have an Albanian-speaking population.
authors.affiliation: Department of Pediatrics, Stanford University School of Medicine, Stanford, California, United States of America. shanem@stanford.edu
authors.forename: Shane D
authors.initials: SD
authors.lastname: Morrison
authors.forename: Vania
authors.initials: V
authors.lastname: Rashidi
authors.forename: Vilson H
authors.initials: VH
authors.lastname: Banushi
authors.forename: Namrata J
authors.initials: NJ
authors.lastname: Barbhaiya
authors.forename: Valbona H
authors.initials: VH
authors.lastname: Gashi
authors.forename: Clea
authors.initials: C
authors.lastname: Sarnquist
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Maldonado
authors.forename: Arjan
authors.initials: A
authors.lastname: Harxhi
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000453:epidemiology*; D000223:Adaptation, Psychological; D000415:Albania / Q000453:epidemiology; D001291:Attitude of Health Personnel; D003469:Culture; D017144:Focus Groups; D019538:Health Care Surveys / Q000706:statistics & numerical data*; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel / Q000706:statistics & numerical data*; D006801:Humans; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires
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