# Translation and cross-cultural adaptation of Adolescent Asthma Self-Efficacy Questionnaire to Brazilian Portuguese and analysis of its measurement properties

## TL;DR

This paper translates and validates a self-efficacy questionnaire for asthmatic adolescents in Brazil, showing it is reliable and fills a gap in this population.

## Contribution

The paper provides a cross-culturally adapted and validated version of the AASEQ for Brazilian Portuguese.

## Key findings

- The AASEQ showed good internal consistency and test-retest reliability in Brazilian adolescents.
- The translated AASEQ has acceptable measurement properties for use in asthma self-efficacy assessment.
- The questionnaire has minimal floor and ceiling effects, indicating good range of scores.

## Abstract

•AASEQ is a self-efficacy tool with rigorous validation procedures.•AASEQ was translated and cross-culturally adapted to Brazilian Portuguese.•AASEQ shows good internal consistency and substantial test-retest reliability.•AASEQ fills a gap in assessing self-efficacy in Brazilian asthmatic adolescents.

AASEQ is a self-efficacy tool with rigorous validation procedures.

AASEQ was translated and cross-culturally adapted to Brazilian Portuguese.

AASEQ shows good internal consistency and substantial test-retest reliability.

AASEQ fills a gap in assessing self-efficacy in Brazilian asthmatic adolescents.

Some scales evaluate the self-efficacy of asthmatic adolescents, but do not consider issues related to age and the correct use of medication.

To translate to cross-culturally adapt to Portuguese and to test the psychometric properties of the Adolescent Asthma Self-Efficacy Questionnaire (AASEQ).

The questionnaire was translated and adapted to Portuguese. The final version was applied in two moments with an interval between seven and fourteen days. Asthma-related Quality of Life Questionnaires (PedsQL and PAQLQA) were also applied. Reliability, agreement, construct validity, ceiling and floor effect, and confirmatory factor analysis were evaluated.

A total of 135 adolescents (median age 14 (interquartile range 12‒16) were evaluated, and the severity of asthma was mild in 63 (47 %), with controlled symptoms in 90 (67 %). The internal consistency of the AASEQ was adequate (Cronbach's alpha 0.70). The standard error of measurement was very good (SEM = 5.82 points and MDC90 % = 6.68), with moderate reliability (ICC3,1: 0.68 [95 % CI: 0.55–0.77], p < 0.0001. The validity of the AASEQ construct was poor with PedsQL (r = 0.28 and p < 0.05) and PAQLQA (r = 0.27 and p > 0.05). The floor and ceiling effects were adequate.

AASEQ is a reliable tool to assess self-efficacy in Brazilian adolescents with asthma.