title: Transcultural Adaptation of Questionnaire to Evaluate Drug Use Among Students: The Use of the EU-Dap European Questionnaire in Brazil.
abstract: BACKGROUND
  Social and cultural differences between countries stress the need for adapting existent instruments for adequately comparing epidemiological results. However, there are controversies in literature on how to carry out this process.
  
  
  OBJECTIVE
  This study aimed to describe the process of cultural adaptation and evaluation of the Brazilian Portuguese language of the European Drug Addiction Prevention Trial (EU-Dap) questionnaire to identify alcohol, tobacco, and other drug use among adolescents.
  
  
  METHODS
  The cross-sectional study took place in 16 public schools in three Brazilian cities during the year 2013 in a sample of 2,969 adolescents between the ages of 11 and 16. Operating steps involved analysis of qualitative data collected through student's focus group and field notes by interviewers and quantitative data from test-retest evaluation and nonresponse to item.
  
  
  RESULTS
  The results revealed moderate reliability for the primary outcomes and high levels of nonresponse, mainly in the 2/3 final questions. Focus group provided high-quality information about misconception for the semantic and structure of the questionnaire. Participatory observation helped researchers to tap into the main difficulties of the application context.
  
  
  CONCLUSIONS
  Sociocultural issues related to Brazilian students, the application context, and the structure of the original questionnaire contributed to the unsatisfactory results of the transcultural adaptation process. The results further highlighted the challenge of adapt questionnaires investigating sensitive issues in an age group particularly influenced by educational factors, especially when the countries have different standards of achievement in education.
authors.affiliation: a Preventive Medicine Department , Universidade Federal de São Paulo (UNIFESP) , São Paulo , Brazil.
authors.forename: Mariangela Cainelli de Oliveira
authors.initials: MC
authors.lastname: Prado
authors.affiliation: b Department of Psychology , Universidade Federal de Santa Catarina (UFSC) , Florianópolis , Brazil.
authors.forename: Daniela Ribeiro
authors.initials: DR
authors.lastname: Schneider
authors.affiliation: a Preventive Medicine Department , Universidade Federal de São Paulo (UNIFESP) , São Paulo , Brazil.
authors.forename: Adriana
authors.initials: A
authors.lastname: Sañudo
authors.affiliation: a Preventive Medicine Department , Universidade Federal de São Paulo (UNIFESP) , São Paulo , Brazil.
authors.forename: Ana Paula Dias
authors.initials: AP
authors.lastname: Pereira
authors.affiliation: b Department of Psychology , Universidade Federal de Santa Catarina (UFSC) , Florianópolis , Brazil.
authors.forename: João Felipe
authors.initials: JF
authors.lastname: Horr
authors.affiliation: a Preventive Medicine Department , Universidade Federal de São Paulo (UNIFESP) , São Paulo , Brazil.|c Centro Brasileiro de Informações sobre Drogas Psicotrópicas (CEBRID) , São Paulo , Brazil.
authors.forename: Zila M
authors.initials: ZM
authors.lastname: Sanchez
mesh_terms: D000293:Adolescent; D001938:Brazil / Q000453:epidemiology; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D011594:Psychometrics; D013334:Students / Q000706:statistics & numerical data; D019966:Substance-Related Disorders / Q000453:epidemiology*; D011795:Surveys and Questionnaires / Q000592:standards; D014177:Translations
keywords: Brazil; Latin culture; Transcultural adaptation; adolescents; drug use; mixed methods research; questionnaire reliability