Cultural adaptation of Kiswahili version of PedsQL 4.0 Generic Core Scales for Kenyan infants up to 24 months of age

Abstract

Abstract Background Quality of life measures are important for understanding child well-being, particularly in low- and middle-income countries where linguistic and cultural differences can limit the use of standardized tools. Although the PedsQL 4.0 Generic Core Scales (GCS) for Infants is widely used, no Kiswahili translation exists for infants in Kenya. This study aimed to culturally adapt the PedsQL 4.0 GCS for use in western Kenya. Methods Cultural adaptation followed Mapi Research Institute guidelines. Two bilingual translators independently completed forward translations, which were reconciled into a Kiswahili version. A third translator conducted backward translation, with discrepancies resolved by a multidisciplinary committee. Cognitive interviews were conducted with nine bilingual caregivers using the adapted 13–24 month scale to assess comprehension and cultural relevance. Feedback was used to revise wording and ensure conceptual equivalence. Identical changes were applied to the 1–12 month scale. Results Nine caregivers (89% female; mean age 32.5 years) participated in cognitive interviews. Findings resulted in 15 revisions to the Kiswahili translation, addressing literal translations that were uncommon in local usage, cultural incongruities, such as the absence of a direct Kiswahili term for “tickle”, and grammatical structures that hindered clarity. Revised versions were reviewed and approved by the Mapi Research Institute. Conclusion Using systematic translation and cognitive interviewing, we produced a culturally relevant Kiswahili version of the PedsQL 4.0 GCS. This tool fills an important gap in measuring infant quality of life in western Kenya and is now used in ongoing research. Additional psychometric validation is needed to assess reliability, validity, and applicability across diverse caregivers.