ArticleChild: care, health and development2026
Translation and Cross-Cultural Adaptation of the Family Nutrition and Physical Activity Screening Tool for Portuguese Well-Child Visits.
Article in Child: care, health and development, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundFamily environments play a critical role in shaping children's lifestyle behaviours that influence obesity risk. However, culturally validated instruments to assess these behaviours are lacking in Portuguese primary care.
aimThis study aims to translate and culturally adapt the Family Nutrition and Physical Activity (FNPA) screening tool for use in Portugal (FNPA-PT) and to evaluate its face and content validity through cognitive interviews with parents attending well-child visits. DESIGN AND
methodsAn exploratory, descriptive study followed internationally endorsed guidelines (Beaton; MAPI) for translation and cross-cultural adaptation. The process comprised seven stages: forward translations, synthesis, back translations, comparisons of back translations, expert committee review, cognitive debriefing and final proofreading. Ten parents of five-year-old children attending a public primary care centre in Lisbon completed the FNPA-PT while participating in individual cognitive interviews. Data were analysed using Content Analysis, guided by Tourangeau's four-stage response model.
resultsSemantic equivalence between forward and back translations was high (85% of items with satisfactory or perfect equivalence). Minor linguistic and cultural adaptations were introduced to improve clarity and contextual relevance. Cognitive interviews indicated that the FNPA-PT was well understood, acceptable to parents, and feasible to complete during well-child visits. Parents valued the questionnaire's comprehensiveness and its potential to enhance awareness and stimulate discussion about family health behaviours. Minor revisions addressed comprehension issues in three items related to milk consumption, screen time and sleep.
conclusionsThe FNPA-PT demonstrated strong face and content validity and high acceptability among Portuguese parents. It provides a culturally appropriate, family-centred tool for health professionals to support early identification of obesogenic environments and to guide preventive counselling in primary care. The study also offers a transparent methodological pathway for translating and adapting behavioural measures across languages and settings.
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