1. Introduction

The purpose of this protocol is to outline the steps involved in the cross-cultural adaptation, translation, and psychometric analysis of the Foot Function Index (FFI) in Telugu, India. The FFI is a validated tool used to assess foot function and related disability. Adapting and translating the FFI into Telugu will enable its use in Telugu-speaking populations, ensuring cultural appropriateness and validity.

2. Cross-Cultural Adaptation Process

The cross-cultural adaptation process involves the following steps:

Step 1: Permission and Collaboration

Obtain permission from the MAPI trust to proceed with the adaptation process. Seek collaboration from experts in foot and ankle research and Telugu language specialists.

Step 2: Translation

Engage bilingual translators proficient in English and Telugu to independently translate the original FFI into Telugu. Aim for two or more independent translations to ensure multiple perspectives.

Step 3: Synthesis

Form a committee consisting of translators, experts, and a methodologist. Review the independent translations and compare them to identify discrepancies and areas of disagreement. Develop a consensus version of the translated FFI through discussion and consensus among the committee members.

Step 4: Back-Translation

Engage bilingual translators who are native English speakers and fluent in Telugu. Provide them with the consensus version of the translated FFI and instruct them to independently back-translate it into English.

Step 5: Expert Committee Review

Convene the expert committee to review the back-translated English version in comparison to the original FFI. Identify any discrepancies and discuss potential cultural and linguistic differences.

Step 6: Pretesting

Administer the pre-final version of the translated FFI to a sample of 30 target population (Telugu-speaking individuals). Collect feedback on comprehension, cultural relevance, and clarity of the items. Modify the translated FFI based on the feedback received.