Adaptation and psychometric assessment of a sexual and reproductive empowerment scale in Arabic among refugee and non-refugee adolescent girls.

Abstract

Abstract Background Sexual and reproductive empowerment (SRE) is an important determinant of women’s and girls’ health yet measuring it is complex due to cultural and domain-specific variations. This study describes the process of adapting an SRE sale and testing its psychometric properties among Arabic speaking adolescent girls in Lebanon. Methods An SRE scale developed in a Western context was adapted in four steps: 1) reviewing the scale and selecting culturally appropriate domains for translation to standard Arabic; 2) conducting cognitive interviews with 30 11-17-year-old adolescent girls in Lebanon; 3) administering the scale to 339 refugee adolescent girls who participated in an early marriage intervention; and 4) conducting confirmatory factor analysis (CFA) on the data to assess the scale’s psychometric properties. Results The original model for the 13-item adapted scale demonstrated poor fit in CFA. After iteratively removing two items, scale properties were improved, albeit not optimal. The best validity and reliability results were obtained for the self-efficacy domain. Qualitative data revealed that Arab adolescent girls understood self-efficacy in relational terms, recognizing that autonomous decision-making is not necessarily favored but is influenced by parents and family. Conclusions This study presents an effort to customize an SRE scale to use in studies on the health of adolescent girls in an Arab cultural context. Qualitative findings highlight the importance of taking into consideration relationality in adolescent sexual and reproductive decision-making. The self-efficacy domain in the adapted scale demonstrates good psychometric properties and is recommended for use in health studies to capture SRE.