Cross-cultural adaptation, content validity, and feasibility of the school physical activity and nutrition environment tool

Abstract

Objective: To perform a cross-cultural adaptation, content validity and feasibility of The School Physical Activity and Nutrition Environment Tool (SPAN-ET) for the Spanish context. It is a valuable tool for making comprehensive assessments of school environments in three environmental categories: policy, situation/social, and physical. Method: We followed the cross-cultural adaptation guidelines which consist of a five-stage methodological approach: 1) forward translation, 2) synthesis, 3) back translation, 4) adaptation to the Spanish context, and 5) pilot testing. In addition, an expert panel performed a content validity analysis to assess the level of comprehensibility, applicability, and cultural appropriateness of the SPAN-ET for its use in Spain. The pilot test was carried out in five schools to assess the feasibility of the tool in the Spanish context. Results: After applying the guidelines for the translation and cultural adaptation of the SPAN-ET into the Spanish context, the new tool (SPAN-ET-ES) preserves the main dimensions of the original document to evaluate school environments in Spain. The evaluation of the SPAN-ET-ES, done by an expert panel, concluded that items included in the revised version of the SPAN-ET-ES were relevant (S-CVI/Ave = 0.96), clear (S-CVI/Ave = 0.96), simple (S-CVI/Ave = 0.98), and non-ambiguous (S-CVI/Ave = 0.98) for the Spanish context. Finally, the pilot test offered empirical evidence for the feasibility and content validity of the SPAN-ET-ES at assessing school environments in Spain. Conclusions: SPAN-ET-ES is a feasible tool for assessing nutrition and physical activity environments at schools in Spain.