Date Presented 4/19/2018
We performed a cross-cultural comparison of performance on the Weekly Calendar Planning Activity by Israeli and American adolescents to demonstrate its cross-cultural stability. The assessment was not merely translated but also adapted to the cultural context, providing occupational therapists with an ecologically valid measure of performance that can be used to guide culturally sensitive intervention.
Primary Author and Speaker: Meghan Doherty
Contributing Authors: Miri Tal-Saban
PURPOSE: The aims of the study were to describe the process of adapting the Weekly Calendar Planning Activity (WCPA; Toglia, 2015), an occupational performance–based assessment, to meet the cultural context of Israeli adolescents and to explore cross-cultural stability in WCPA performance of typically developing Israeli and American adolescents. Cultural sensitivity is considered a feature of the holistic approach, which is a core concept of occupational therapy (Townsend & Polatajko, 2007). Cultural sensitivity is awareness that cultural differences and similarities exist and influence values, learning, and behavior (Stafford et al., 1997), which are embedded in everyday occupational activities and performance.
The World Health Organization (WHOQOL Group, 1995) recommended the cross-cultural translation of existing instruments because this process can facilitate collaboration, exchange of information, and comparison between international populations. Moreover, rehabilitation researchers and clinicians who want to use instruments that were developed in English-speaking countries must first undertake the work of translating them into their own language and then validating their use in a different cultural context (Coster & Mancini, 2015).
The WCPA is a functional performance assessment that requires executive functions (EF) and provides a broad analysis of how a person manages a complex and cognitively challenging everyday activity. EF and strategy use are crucial to occupational performance and fall within the domain of occupational therapy practice (Toglia et al., 2013).
METHOD: In this experimental cross-cultural comparison study, 170 typically developing Israeli adolescents (M age = 15, SD = 1.7) were matched by age and gender with 30 typically developing American adolescents. The steps involved in translation of the WCPA Middle/High School version followed recommendations for cross-cultural adaptation of instruments in occupational therapy research and practice. The WCPA was adapted for Israeli adolescents by altering some of the original appointments and their time frames to match the cultural demands, habits, and routines of Israelis and by changing an aspect of the scoring criteria after a careful analysis of common error patterns. Normative data were compared across key scores: accuracy, strategy use, efficiency, times, and rules followed. Statistical analysis included the nonparametric Mann–Whitney U test.
RESULTS: A subsample of 30 was extracted from the Israeli sample and compared across WCPA key scores, age, and gender. No significant differences were found. The 30 Israelis were then compared to the 30 Americans. No significant differences were found between the groups, except for the number of rules followed.
CONCLUSION: The cross-cultural comparison of typically developing Israeli and American adolescents revealed no significant differences between the groups, except for the number of rules followed, demonstrating cross-cultural stability of the WCPA. This finding provides a foundation for enhancing occupational therapy practitioners’ ability to identify subtle difficulties in cognitively demanding activities and to screen for risk of occupational performance deficits. The process of adapting the WCPA included not merely translating it, but also maintaining its fidelity to the original purpose, providing an ecologically valid measure of performance that can be used to guide culturally sensitive intervention.
References
Coster, W. J., & Mancini, M. C. (2015). Recommendations for translation and cross-cultural adaptation of instruments for occupational therapy research and practice. Journal of Occupational Therapy of University of São Paulo, 26(1). https://doi.org/10.11606/issn.2238-6149.v26i1p50-57
Stafford, J. R., Bowman, R., Ewing, T., Hanna, J., & Lopez-De Fede, A. (1997). Building culture bridges. Bloomington, IN: National Educational Service.
Toglia, J. (2015). Weekly Calendar Planning Activity: A performance test of executive function. Bethesda, MD: AOTA Press.
Townsend, E. A., & Polatajko, H. J. (2007). Enabling occupation II: Advancing an occupational therapy vision for health, wellbeing and justice through occupation. Ottawa: CAOT Publications.
