Danish cross-cultural adaptation of the Theoretical Framework of Acceptability questionnaire

INTRODUCTION: Acceptability of healthcare interventions among patients and healthcare professionals is important for effective and efficient implementation in clinical settings. To standardise the assessment of acceptability of healthcare interventions, the Theoretical Framework of Acceptability (TFA) questionnaire was developed. In this study, we aimed to translate and cross-culturally adapt the TFA questionnaire into Danish.

METHODS: The TFA was forward- and back-translated and pre-tested in accordance with Beaton's guidelines. Following an iterative process, the pre-final questionnaire was field-tested through cognitive interviews using verbal probing and think-aloud techniques to assess relevance, comprehensiveness and comprehensibility.

RESULTS: Following translation, 30 participants (37% female, mean age 61 years) completed cognitive interviews. The population included cardiac arrest survivors and their relatives, patients with hypercholesterolaemia, knee/hip osteoarthritis and patients at risk of heart failure. Five iterative rounds informed adaptations of the Danish version, resolving misinterpretations and improving clarity. Four main issues were identified: 1) structure of the questionnaire, 2) translation of the terms "acceptability" and "intervention", 3) wording of the Likert scale and 4) item-specific interpretation problems.

CONCLUSIONS: Following international guidelines, the TFA questionnaire was successfully translated and cross-culturally adapted into Danish, addressing key linguistic and conceptual challenges.

FUNDING: We acknowledge the University of Southern Denmark and the BOX-trial for supporting this project.

TRIAL REGISTRATION: Not relevant.