Cross-cultural adaptation of the NoMAD questionnaire to Brazilian Portuguese

Ana Paula Loch, Tracy Finch, Mylva Fonsi, Patrícia Coelho de Soárez

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)
14 Downloads (Pure)


The Normalization Measure Development (NoMAD) tool is used to determine the contextual determinants in the process of implementing complex health interventions. The aim of this study is to translate and culturally adapt NoMAD to Brazilian Portuguese.

The cross-cultural adaptation was performed in five steps: 1) translation of the questionnaire into Portuguese; 2) synthesis and creation of the first version; 3) back-translation of the instrument into the source language; 4) review of the instrument by a group of experts and target professionals; and 5) pretesting. A final version of the questionnaire was answered by users of a clinical monitoring system in specialist care services for people living with HIV/AIDS, and the internal consistency of the questionnaire was assessed using Cronbach's alpha.

The questionnaire was answered by 188 health professionals, of which 87.7% were female, and the average age was 45.2 years. For the final version of the questionnaire, Cronbach's alpha was over 0.70 for the construct's coherence (0.74), collective action (0.70), cognitive participation (0.71), and reflexive monitoring (0.81).

The NoMAD questionnaire was cross-culturally adapted and can be used to evaluate the implementation of complex health care interventions.
Original languageEnglish
Pages (from-to)1383-1390
Number of pages7
JournalRevista da Associacao Medica Brasileira (1992)
Issue number10
Publication statusPublished - Oct 2020


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