title: A validated translation of a survey for measuring incontinence knowledge in Chinese-speaking American immigrants.
abstract: OBJECTIVE
  Urinary incontinence is common amongst Chinese immigrants. These women are a rapidly growing population in the USA who require unique assessment tools due to language barriers. Presently, there are no Chinese language surveys to assess knowledge of urinary incontinence. Our goal was to translate and validate a urinary incontinence knowledge survey from English into Chinese.
  
  
  METHODS
  The English language Urinary Incontinence Quiz (UIQ) developed and validated by Branch et al. for the Educational Demonstration of Urinary Continence Assessment and Treatment for the Elderly program assesses general knowledge of urinary incontinence as a disease entity. We translated it into Chinese using the forward translation/back translation technique. The Chinese and English versions were then administered to bilingual volunteers in a nonrandomized order during a single encounter. Their responses were analyzed using Cohen's kappa coefficient to establish the validity of the translated knowledge survey.
  
  
  RESULTS
  Minimal reconciliation was needed in construction of the Chinese survey. Minor English grammatical corrections were made to the back-translated English survey. One question testing two knowledge concepts was separated into two questions to allow clear testing of both concepts individually. Twenty-one bilingual participants performed the validity testing. Over 50% (8 out of 15) of the questions showed nearly perfect agreement with a kappa coefficient >0.80, 5 out of the 15 questions showed substantial agreement with kappa coefficients between 0.61 and 0.8 and two questions showed moderate agreement with kappa coefficients between 0.4 and 0.6.
  
  
  CONCLUSIONS
  We validated a translation of the UIQ for assessment of urinary incontinence knowledge in Chinese-speaking immigrants to the USA.
authors.affiliation: Department of Obstetrics and Gynecology, Division of Female Pelvic Medicine and Reconstructive Surgery, Indiana University, 1633 North Capitol Avenue Suite 436, Indianapolis, IN, 46202, USA. rju@iu.edu.
authors.forename: Rujin
authors.identifier: http://orcid.org/0000-0003-2017-1256
authors.initials: R
authors.lastname: Ju
authors.affiliation: Department of Obstetrics and Gynecology, Division of Female Pelvic Medicine and Reconstructive Surgery, Duke University, Durham, NC, USA.
authors.forename: Nazema
authors.initials: N
authors.lastname: Siddiqui
authors.affiliation: Department of Obstetrics and Gynecology, Division of Women's Primary Health, University of North Carolina, Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Joanne
authors.initials: J
authors.lastname: Garrett
authors.affiliation: Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Duke University, Durham, NC, USA.
authors.forename: Liping
authors.initials: L
authors.lastname: Feng
authors.affiliation: Department of Obstetrics and Gynecology, Division of Female Pelvic Medicine and Reconstructive Surgery, Indiana University, 1633 North Capitol Avenue Suite 436, Indianapolis, IN, 46202, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Heit
mesh_terms: D000328:Adult; D044466:Asian People / Q000523:psychology*; D002681:China / Q000208:ethnology; D054242:Emigrants and Immigrants / Q000523:psychology*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology*; D006801:Humans; D007802:Language; D008297:Male; D011594:Psychometrics; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires / Q000592:standards*; D013624:Taiwan / Q000208:ethnology; D014177:Translations; D014481:United States; D014549:Urinary Incontinence / Q000523:psychology*
keywords: Chinese–American; Incontinence; Knowledge; Translation; Urinary; Validation