JMIR Publications

ABSTRACT

Background:

The world as we know it changed during the Covid-19 pandemic. Hope has emerged with the development of new vaccines against the disease. However, many factors hinder vaccine uptake and lead to vaccine hesitancy. Understanding the factors affecting vaccine hesitancy and how to assess its prevalence has become an imperative amidst the Covid-19 pandemic. The vaccine hesitancy scale (VHS), developed by the WHO Strategic Advisory Group of Experts on Immunization (SAGE), has been modified to the adult VHS (aVHS) and validated in English and Chinese. To our knowledge, no available aVHS have been designed or validated in Arabic or French.

Objective:

This research aim is to translate the aVHS from its original English language to Arabic and French and validate the translations in the WHO Eastern Mediterranean region.

Methods:

The study will follow a cross-sectional design divided into five phases inspired by the methodology proposed in the “Guidelines for developing, translating, and validating a questionnaire in perioperative and pain medicine.” By Tsang et al. Phase 1-The original aVHS will be forward translated to Arabic and French followed by backward translation to English. An expert committee will review and rate all versions of the translations. Expert agreement will then be measured using Cohen’s coefficient Kappa(K). Phase 2-The translated aVHS will be pilot tested on two samples of participants; a group that speaks both Arabic and English and another that speaks French and English, N=100. Participants’ responses to the English version will also be collected. Phase 3-Responses will then be compared. Descriptive statistics and paired t-test or one-way ANOVA and Pearson’s correlation coefficient (Rho) will be used in preliminary validation. Phase 4-Pre-final versions (Arabic and French) will be tested on a larger sample size, N=1000 for Arabic speakers and N=1000 for French speakers. Socio-demographic information and vaccination status will be collected and used for further analysis. Phase 5-The scale's statistical reliability and internal consistency will be measured using Cronbach’s alpha. An Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) will be used to examine model fit resulting from EFA. ANOVA analyses and/or regression models will be constructed to control for confounders. All data will be electronically collected.

Results:

As of January 2022, the scale has been translated to Arabic and French and is undergoing the process of back translation. All data collection tools have been prepared (i.e., Socio-demographics, vaccination status and open-ended questions) and are ready to go into their electronic formats. We expect to reach the desired sample size in this phase by June 2022.

Conclusions:

This study will provide researchers with a validated tool to assess adult vaccine hesitancy within populations that speak Arabic and/or French and provide a roadmap to scale translation and ensure cross-cultural adaptation.