Challenges of measuring self-reported exposure to occupational biomechanical risk factors amongst people with low literacy engaged in manual labour: Findings from a cross-cultural adaptation and psychometric investigation in an African population with chronic low back pain

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Abstract

Purpose
Occupational biomechanical factors are implicated in the aetiology and progression of low back pain (LBP). This study cross-culturally adapted and psychometrically investigated the occupational risk factor questionnaire (ORFQ) in a low literate Nigerian Igbo population with chronic LBP.
Methods
Forward and back translation of the original ORFQ by clinical and non-clinical translators was followed by an expert committee review. The adapted ORFQ was pre-tested amongst rural Nigerian adults with chronic LBP using cognitive think-aloud interviewing. Internal consistency (Cronbach’s alpha) and test–retest reliability (unweighted and linear weighted k statistic for item-by-item agreement, and intra-class correlation coefficient—ICC) were investigated amongst 50 rural and urban Nigerian dwellers with chronic LBP. Spearman’s correlation and regression analyses were conducted with the Igbo-ORFQ, and measures of disability [World Health Organisation Disability Assessment Schedule (WHODAS 2.0), Roland Morris Disability Questionnaire (RMDQ), Back performance scale (BPS)], pain intensity [Eleven-point box scale (BS-11)] and social support [Multidimensional Scale of Perceived Social Support (MSPSS)], to test construct validity with 200 rural Nigerian dwellers with chronic LBP.
Results
Cross-cultural adaptation highlighted difficulty conceptualising and concretising exposure to biomechanical risk factors. Item-by-item agreement, internal consistency (α = 0.84) and intraclass correlation coefficient (ICC = 0.83) were good. Some unexpected direction of associations between the biomechanical components of the Igbo-ORFQ, and disability, pain intensity, and social support prohibits establishment of construct validity.
Conclusions
Prospective studies comparing the Igbo-ORFQ to other measures of exposure to occupational biomechanical risk factors are required to establish the construct validity of the Igbo-ORFQ.

















Original languageEnglish
JournalJOURNAL OF OCCUPATIONAL REHABILITATION
Publication statusAccepted/In press - 7 Jan 2024

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