The Simplified Chinese Version of the Suitability Assessment of Materials for the Evaluation of Health-Related Information for Adults: Translation and Validation Study

Abstract

Background Suitable health education materials can educate people about the potential harms of high-risk factors, leading to expected behavior changes and improved health outcomes. However, most patient education materials were not suitable in terms of content, structure, design, composition, and language, as stated in the literature. There is a pressing need to use well-designed scales to assess the suitability of health education materials. Although such assessment is a common practice in English-speaking communities, few assessment tools are available in mainland China. Objective This study aimed to translate the Suitability Assessment of Materials (SAM) for the evaluation of health-related information for adults into a simplified Chinese version (S-C-SAM) and validate its reliability for evaluating the suitability of health education materials written in simplified Chinese in mainland China. Methods The SAM was translated into an S-C-SAM in three steps: (1) translating the SAM into an S-C-SAM, (2) translating the S-C-SAM back into an English version, and (3) testing the translation equivalence between the 2 English versions (original and back-translated) of the SAM linguistically and culturally. Any differences between these 2 English versions were resolved through a panel discussion. The validity of the S-C-SAM was determined by measuring its content validity index. The final version of the S-C-SAM was used by 3 native Chinese-speaking health educators to assess 15 air pollution–related health education materials. The Cohen κ coefficient and Cronbach α were calculated to determine the interrater agreement and internal consistency of the S-C-SAM. Results We agreed on the final version of the S-C-SAM after settling the discrepancies between the 2 English versions (original and back-translated) and revising 2 items (sentences) rated negatively in content validation. The S-C-SAM was proven valid and reliable: the content validity index was 0.95 both in clarity and in relevance, the Cohen κ coefficient for the interrater agreement was 0.61 (P<.05), and Cronbach α for the internal consistency of the whole scale was .71. Conclusions The S-C-SAM is the first simplified Chinese version of the SAM. It has been proven valid and reliable for evaluating the suitability of air pollution–related health education materials written in simplified Chinese in mainland China. It has the potential to be used for assessing the suitability of health education materials specifically selected for other health education purposes.