title: Validation of a French-language version of the health education impact Questionnaire (heiQ) among chronic disease patients seen in primary care: a cross-sectional study.
abstract: BACKGROUND
  The Health Education Impact Questionnaire (heiQ) allows for the evaluation of the effects of education interventions provided to patients with chronic diseases. This study describes the process for the cross-cultural adaptation and validation of the heiQ into French (heiQ-Fv).
  
  
  METHODS
  We undertook a systematic translation process followed by a validation study based on the secondary analysis of cross-sectional data from a longitudinal study. Participants in the validation study were adult patients from primary care clinics in Quebec, Canada, with one or more of the following diseases: diabetes, asthma, chronic obstructive pulmonary disease, cardiovascular disease; or one or more risk factors for these diseases. Main outcomes of the study were the French version of the heiQ-Fv and the validation analyses that included internal consistency, test-retest reliability, confirmatory factor analysis (CFA) and concomitant validity.
  
  
  RESULTS
  The validation analysis was conducted on results from 332 participants. Cronbach's alphas (internal consistency) for seven domains of the heiQ-Fv varied from 0.80 to 0.89; one domain scored 0.69. The test-retest analysis (n = 50) yielded intra-class correlation coefficients from 0.66 to 0.86. The CFA of the eight heiQ domains with the hypothesis of no correlation between the domains yielded a model that did not exhibit acceptable fit values. A model with the hypothesis of all domains correlated exhibited acceptable fit values (scaled chi-square = 1210.15, degrees of freedom = 712, p < 0.001; CFI = 0.98; RMSEA = 0.06; SRMR = 0.065). Results show a moderate correlation (concomitant validity) between five domains of the heiQ-Fv and the Self-Efficacy for Managing Chronic Diseases. We also found a moderate to strong correlation between the Emotional Wellbeing domain of the heiQ and the Kessler Psychological Distress Scale (K6) (r = 0.61; 95 % CI: 0.52 -0.69, p < 0.01).
  
  
  CONCLUSIONS
  The heiQ was translated into French using a rigorous translation process; the French-language version showed good psychometric properties. Health professionals and researchers in primary care settings may use the heiQ-FV to evaluate the impact of educational programs on patients with chronic diseases.
authors: Registered nurse and graduate student, Department of health sciences, Université du Québec à Chicoutimi (UQAC), Quebec, Canada. Anne.Belanger@uqac.ca.
authors: Anne
authors: A
authors: Bélanger
authors: Family physician and professor, Department of family medicine and emergency medicine, Université de Sherbrooke, Quebec, Canada. Catherine.Hudon@Usherbrooke.ca.
authors: Catherine
authors: C
authors: Hudon
authors: Family physician and professor, Department of family medicine and emergency medicine, Université de Sherbrooke, Quebec, Canada. Martin.Fortin@Usherbrooke.ca.
authors: Martin
authors: M
authors: Fortin
authors: Adjunct professor, Department of family medicine and emergency medicine, Université de Sherbrooke, Quebec, Canada. Jose.Amirall@Usherbrooke.ca.
authors: José
authors: J
authors: Amirall
authors: Adjunct professor, Department of family medicine and emergency medicine, Université de Sherbrooke, Quebec, Canada. Tarek.Bouhali@Usherbrooke.ca.
authors: Tarek
authors: T
authors: Bouhali
authors: Registered nurse and professor, Department of health sciences, Université du Québec à Chicoutimi (UQAC), Québec, Canada. Maud-Christine_Chouinard@uqac.ca.
authors: Maud-Christine
authors: MC
authors: Chouinard
mesh_terms: D000328:Adult; D000368:Aged; D002170:Canada / Q000453:epidemiology; D002908:Chronic Disease / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005163:Factor Analysis, Statistical; D005260:Female; D015438:Health Behavior; D006266:Health Education / Q000379:methods*; D006801:Humans; D007802:Language; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care / Q000706:statistics & numerical data*; D011594:Psychometrics / Q000706:statistics & numerical data; D011788:Quality of Life; D015203:Reproducibility of Results; D020377:Self Efficacy; D011795:Surveys and Questionnaires / Q000592:standards*; D014175:Translating