Translation, Adaptation, and Validation of the French Version of the Low Literacy Decisional Conflict Scale in Adolescents

Purpose. We aimed 1) to translate and adapt the English version of Low Literacy Decisional Conflict Scale (LL-DCS) into French and 2) to assess its psychometric properties in adolescents. Methods. The original LL-DCS was translated into French by 2 independent translators, with discrepancies resolved by a multidisciplinary team. The reconciled version was back-translated into English by 2 other translators to ensure accuracy. We tested the prefinal version among 14 adolescents, who evaluated the clarity of the items. Second, we conducted psychometric testing of the final version among 85 adolescents participating in a pilot study evaluating a decision aid for contraception and menstrual management. Participants completed the French version of LL-DCS before (T0) and after (T1) their clinical encounter. We assessed internal consistency with Cronbach’s alphas and model fit with confirmatory factorial analyses. We evaluated discriminant validity by comparing scores at T0 and T1 based on participants’ responses regarding treatment preference. Results. Internal consistency of the French LL-DCS was acceptable, with a Cronbach’s alpha of 0.72 at both T0 and T1, although there was variability in reliability at the subscale level. Model fit was adequate at T0, indicating good factor validity. There was evidence for the original 4-factor model at T0, but exploratory analysis suggested a 3-factor solution with Informed and Values Clarity as one factor. Discriminant validity was strong, as the scale distinguished between adolescents who had decided on treatment and those who remained undecided. Conclusion. The French version of the LL-DCS demonstrates satisfactory psychometric properties, including internal consistency, factor validity, and discriminant validity. However, caution should be exercised when interpreting individual subscales, as their internal consistency is somewhat lower than the original English version of LL-DCS. Highlights We translated, adapted, and tested the French version of Low Literacy Decisional Conflict Scale in adolescents. The French version of the Low Literacy Decisional Conflict Scale is adapted to people with limited literacy skills. We hope that it might facilitate the participation of vulnerable populations in clinical research projects.