Evaluating Culturally Tailored Strategies for Implementing Cognitive Interviewing on Edinburgh Postnatal Depression Scale Among Chinese Immigrant Women

Abstract

Introduction While the Edinburgh Postnatal Depression Scale (EPDS) is a standard clinical screening tool for postpartum depression, it is unclear whether it is culturally appropriate for Chinese immigrant women in the United States. Cognitive interviewing (CI) is a method for evaluating a scale’s cultural appropriateness. However, CI procedures are problematic with Chinese population. This study assesses three culturally tailored strategies for implementing CI to evaluate the Chinese version of the EPDS (C-EPDS). Methodology CI was conducted with 12 participants in the United States. Three culturally tailored strategies—a CI description, a vignette exercise, and debriefing were used. Directed content analysis was used for data analysis. Results The strategies increased participants’ understanding and ability to perform CI procedures, enabling them to discuss postpartum depression. Participants had difficulty responding to several C-EPDS items. Discussion Findings highlight the importance of using culturally tailored strategies for implementing CI to assess cultural appropriateness of clinical screening tools.