Open Access Original article BMJ Open Sport Exerc Med: first published as 10.1136/bmjsem-2017-000289 on 22 February 2018. Downloaded from Adaptation, translation and reliability of the Australian ‘Juniors Enjoying Cricket Safely’ injury risk perception questionnaire for Sri Lanka Prasanna J Gamage,1,2 Lauren V Fortington,1 Caroline F Finch1 To cite: Gamage PJ, ABSTRACT What are the new findings? Fortington LV, Finch CF. Objectives Cricket is a very popular sport in Sri Lanka. Adaptation, translation In this setting there has been limited research; specifically, and reliability of the ► This study successfully produced reliable Sinhala there is little knowledge of cricket injuries. To support Australian ‘Juniors Enjoying and Tamil versions of the Juniors Enjoying Cricket future research possibilities, the aim of this study was to Cricket Safely’ injury risk Safely injury risk perception questionnaires that can cross-culturally adapt, translate and test the reliability of perception questionnaire be administered to Sri Lankan junior cricketers. for Sri Lanka. BMJ Open an Australian-developed questionnaire for the Sri Lankan ► In reliability assessment, the questions relating to Sport & Exercise Medicine context. injury risk perceptions in specific cricket-playing 2018;4:e000289. doi:10.1136/ Methods The Australian ‘Juniors Enjoying Cricket Safely’ tasks required the most modifications due to low bmjsem-2017-000289 (JECS-Aus) injury risk perception questionnaire was agreement. cross-culturally adapted to suit the Sri Lankan context ► Additional material is ► This study provides a successful process for the and subsequently translated into the two main languages published online only. To view, adaptation, translation and testing of an English- (Sinhala and Tamil) based on standard forward-back Protected by copyright. please visit the journal online language outcome measure in sports injury for use (http:// dx. doi. org/ 10. 1136/ translation. The translated questionnaires were examined in different contexts. bmjsem- 2017- 000289). for content validity by two language schoolteachers. The questionnaires were completed twice, 2 weeks apart, by two groups of school cricketers (males) aged 11–15 Accepted 27 November 2017 years (Sinhala (n=24), Tamil (n=30)) to assess reliability. preventing injures has become a priority.3 4 Test–retest scores were evaluated for agreement. Where One strategy is injury risk perceptions recog- responses were <100% agreement, Cohen’s kappa ( ) κ nition and subsequent implementation of statistics were calculated. Questions with moderate-to- poor test–retest reliability ( <0.6) were reconsidered for measures that serve to moderate negative κ 4 modification. perceptions or promote positive perceptions. Results Both the Sinhala and Tamil questionnaires had The Juniors Enjoying Cricket Safely (JECS) 100% agreement for questions on demographic data, study was an Australian project developed to and 88%–100% agreement for questions on participation identify injuries and injury risk perceptions in cricket and injury history. Of the injury risk perception associated with playing cricket at a junior http://bmjopensem.bmj.com/ questions, 72% (Sinhala) and 90% (Tamil) questions level.5 6 The main objective of that project was showed a substantial ( =0.61–0.8) and almost perfect κ to collect information to inform the devel- (κ=0.81–1.0) test–retest agreement. Conclusion The adapted and translated JECS-SL opment of injury prevention strategies and questionnaire demonstrated strong reliability. This is the encourage safe sports participation. In order first study to adapt the JECS-Aus questionnaire for use to achieve this objective, the JECS partici- in a different population, providing an outcome measure pant baseline questionnaire (JECS-Aus) was for assessing injury risk perceptions in Sri Lankan junior developed as the study instrument to collect 1Australian Centre for Research cricketers. information about injuries and injury risk into Injury in Sport and its perceptions in junior cricketers. The JECS-Aus Prevention (ACRISP), Federation on September 27, 2021 by guest. University Australia, Ballarat, questionnaire was validated and subsequently Victoria, Australia INTRODUCTION used among Australian junior cricketers, 2 School of Health Science and Preventing sports-related injuries among aged 8–16 years, to examine their injury risk 7 8 Psychology, Faculty of Health, athletes is important to the health and safety perceptions in playing cricket. The find- Federation University Australia, Ballarat, Victoria, Australia of participants. Consequently, sporting ings of the JECS-Aus study highlighted the governing bodies have focused research on importance of recognising the risk percep- better understanding injury and injury risk tion behaviours and attitudes among junior Correspondence to Dr Prasanna J Gamage; among those who partake in their respective cricketers, providing an incentive to evaluate 1 2 janakagamage@ students. sports. Injuries among junior athletes are a injury risk perceptions among junior crick- federation. edu. au major public health burden and consequently, eters in other cricket-playing nations. Gamage PJ, et al. BMJ Open Sport Exerc Med 2018;4:e000289. doi:10.1136/bmjsem-2017-000289 1 Open Access BMJ Open Sport Exerc Med: first published as 10.1136/bmjsem-2017-000289 on 22 February 2018. Downloaded from Cricket is a field-based team sport, played mainly by to evaluate injury risk perceptions among Sri Lankan the member countries of the Commonwealth.9 It is a junior cricketers. Once adapted to the Sri Lankan very popular sport among juniors, especially among the context and translated into two main languages (Sinhala Indian subcontinent cricket-playing nations of Bangla- and Tamil), this could gather injury risk perception desh, India, Pakistan and Sri Lanka. Cricket is, without data from a socioeconomically and culturally different doubt, the most popular sport in Sri Lanka.10 More cricket population. Therefore, the primary objective than 15 000 school players take part in school cricket at of this study was to cross-culturally adapt, translate and competitive level, approximately competing over 3000 test content validity and reliability of an existing ques- matches in each cricket season annually.11 12 Despite tionnaire (JECS-Aus) for use among Sri Lankan junior the high participation by juniors, knowledge about cricketers. cricket injuries, injury mechanisms and participants’ risks perceptions is lacking. To date, neither injuries nor injury risk perceptions have been investigated METHODS among Sri Lankan junior cricketers. Consequently, The original English version of the JECS-Aus ques- there is now a recognised need to conduct research tionnaire consisted of several domains: participation among junior cricketers in these subcontinent coun- in cricket, training and competition workload, other tries including Sri Lanka. sports participation, sports injury history, safety in At present, JECS-Aus is the only tool available to eval- cricket with injury risk perception.7 In the present uate injury risk perceptions in junior cricket. It was study, the JECS-Aus questionnaire was cross-cultur- developed in English and is yet to be translated into ally adapted, translated and evaluated for content other languages common to other cricketing nations. validity and reliability in a stepwise manner, following There is strong potential for the JECS-Aus injury risk guidelines used commonly within the health science perception questionnaire to serve as a validated tool literature as explained in figure 1.13 Protected by copyright. http://bmjopensem.bmj.com/ on September 27, 2021 by guest. Figure 1 Stepwise process of developing Juniors Enjoying Cricket Safely (JECS)-SL Sinhala and Tamil versions of the injury risk perception questionnaire. 2 Gamage PJ, et al. BMJ Open Sport Exerc Med 2018;4:e000289. doi:10.1136/bmjsem-2017-000289 Open Access BMJ Open Sport Exerc Med: first published as 10.1136/bmjsem-2017-000289 on 22 February 2018. Downloaded from Step 1: cross-cultural adaptation and reformation Step 4: testing for reliability The JECS-Aus questionnaire was first adapted to suit The JECS-SL questionnaires were then tested among the Sri Lankan context and conditions. The objec- a group of junior cricketers (males) to examine reli- tive of cross-cultural adaptation was to ensure that the ability using the test–retest method. Two junior cricket content of the questionnaire is relevant to the social, teams representing the under-13 age group from a cultural and environmental settings in Sri Lanka. For Sinhala language-based (n=24) and a Tamil language- example, some of the sports and recreational activities based school (n=30) were selected from Western and stated in the JECS-Aus questionnaire are not commonly Northern provinces, respectively. The questionnaire seen in the Sri Lanka society and sports culture (eg, was administered twice among the players during the skateboarding, playing on the trampoline, Austra- 2016 school cricket season. Test 1 was carried out in lian rules football). Therefore, these sports had to be the presence of the lead author (PJG), to clarify any removed and replaced with the local sports (eg, elle), questions with understanding during the test. Test 2 in order to make the content comprehensible to the was conducted after 2 weeks by the schoolteachers in Sri Lankan junior cricketers. These modifications were charge of the teams, with completed questionnaires made following discussion,