• Ana Paula Loch, Tracy Finch, Mylva Fonsi, and Soárez Patrícia Coelho de PC http://orcid.org/0000-0001-8383-0728 Professora no Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Univ.
• Pesquisadora no Centro de Referência e Treinamento em DST/Aids, São Paulo, SP, Brasil.
• Rev Assoc Med Bras (1992). 2020 Oct 1; 66 (10): 1383-1390.

BackgroundThe 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.MethodsThe 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.ResultsThe 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).ConclusionThe NoMAD questionnaire was cross-culturally adapted and can be used to evaluate the implementation of complex health care interventions.

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