Cross-cultural adaptation and validation of the STarT Back Tool for Arabic speaking adults with low back pain in Saudi Arabia

Hill, Jonathan C.

Abstract

BACKGROUND:
The STarT Back Tool (Subgrouping for Targeted Treatment; SBT) was developed and validated in the United Kingdom for adults with non-specific low back pain (LBP) to provide risk stratification groups. An Arabic version has not yet been developed. Consequently, our objectives were: First, to cross-culturally adapt the SBT for use in Arabic speaking adults (SBT-Ar) with LBP. Second, to assess the face, content and construct validity of SBT-Ar against relevant reference standards.

METHODS:
This was a prospective, cross-sectional study carried out in the outpatient department in a tertiary care hospital. A total of 59 participants (aged 18-60) with LBP able to read Arabic completed the questionnaire. SBT cross-cultural adaptation was performed according to published guidelines. Face and content validity were explored by individual interviews. Construct validity was assessed using pre-hypothesized correlations with relevant reference standards.

RESULTS:
Following 48 individual interviews the SBT final version was reached and demonstrated face and content validity. The SBT-Ar total score and psychosocial sub-scale had acceptable internal consistency and no redundancy (Cronbach a = 0.7). Moderate Spearman's correlations were found between the SBT-Ar total score and reference standards (Arabic Pain Numeric Rating Scale NRS-Ar r = 0.50 and Arabic Oswestry Disability Index ODI-ar r = 0.51). As expected the SBT-Ar psychosocial subscale had medium to high correlations with the psychosocial reference measures (Arabic Fear-Avoidance Beliefs Questionnaire Physical Activity FABQPA-Ar r = 0.41, Arabic Hospital Anxiety and Depression Scale-Anxiety HADSA-Ar r = 0.58, Arabic Hospital Anxiety and Depression Scale-Depression HADSD-Ar r = 0.45 and Arabic Pain Catastrophizing Scale PCSAr r = 0.69).The SBT-Ar showed no significant floor or ceiling effects.

CONCLUSION:
This study culturally adapted and preliminary validated SBT into Arabic.

STUDY DESIGN:
Prospective, Cross-sectional.

Citation

Elsabbagh, L., Al-Atwi, T., Aldossary, D., Alshami, A. M., Hill, J. C., Abu-Ras, W., Huijer, H. A.-S., & Brooks, D. (2019). Cross-cultural adaptation and validation of the STarT Back Tool for Arabic speaking adults with low back pain in Saudi Arabia. Journal of Orthopaedic Science, 24(2), 200-206. https://doi.org/10.1016/j.jos.2018.09.007

• Journal Article Type: Article
• Acceptance Date: Sep 4, 2018
• Publication Date: 2019-03
• Publicly Available Date: May 26, 2023
• Journal: Journal of Orthopaedic Science
• Print ISSN: 0949-2658
• Electronic ISSN: 1436-2023
• Publisher: Springer Verlag
• Volume: 24
• Issue: 2
• Pages: 200-206
• DOI: https://doi.org/10.1016/j.jos.2018.09.007
• Public URL: https://keele-repository.worktribe.com/output/412738
• Publisher URL: http://doi.org/10.1016/j.jos.2018.09.007