Journal of Excellence in Nursing and Healthcare Practice


Background: As the focus of healthcare shifts toward the social determinants of health, more information about health disparities between different ethnic communities is needed. The Health Promoting Lifestyle Profile II (HPLP-II) is an instrument that measures health promotion behavior across various cultural lines.

Purpose: This article describes the translation and validation of the HPLP-II from English to Armenian for the purpose of studying health promotion behavior among the hypertensive and normotensive Armenian American population and addressing health disparities among this community.

Methods: Translating this instrument required a multi-step process to capture cultural linguistic adjustment. First the researcher, a local bilingual professor, and a professional translation company each created a forward translation. These three translations were combined by an editor to create one translation with the highest clarity. The researcher then submitted this translation to two bilingual community members for back translation. A committee comprised of the researcher, the community members, and a bilingual healthcare worker reviewed each back translated item and adjusted those that lost their meaning. Another committee reviewed each item for clarity and consistency. The instrument was then given to five native speakers who were asked to read each question and then verbally express what they understood it to be asking. After the researcher made adjustments based on this feedback, the instrument was given to a committee of nine bilingual experts who reviewed each item and scored it.

Results & Discussion: This multi-step, iterative process resulted in an instrument with an item content validity index score of 0.90 (>0.78) and a scale content validity index of 0.96 (>0.90), and a Chronbach’s alpha of 0.936, suggesting a high level of reliability. This instrument can now be used in future studies regarding health promotion behavior among Armenian Americans.