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Table 3 Synthesis of needed equivalence changes to develop the PEM-CY (German)

From: Cross-cultural adaptation of the Participation and Environment Measure for Children and Youth (PEM-CY) into German: a qualitative study in three countries

Equivalent changes Explanation Original PEM-CY Changes made to culturally adapt the PEM-CY (German)
Semantic equivalence A similar semantic expression • “community” • “societal” (G: “gesellschaftlich”)
• “involvement” • “engagement” (G: “Engagement”)
• “participation” • “participation” G: “Teilhabe”
• “children” • “children and adolescents”
• (G: “Kinder und Jugendliche ”)
Idiomatic equivalence Less misleading expression • “the child”- he or she • neutral form (it) (G: “es”)
• “assignment” and “homework” • “homework and assignments” (G: “Hausaufgaben”)
• “climate” • “seasonal conditions” (G: “Jahreszeiten”)
Experiential equivalence Words that represent culturally based experiences • activity examples used in the original PEM-CY that are not common for children in the targeted countries: “Brownies”, “mentoring”, “lunchroom supervisor”, “public speaking”, “working in a store”, “baseball” • removed uncommon examples and added new examples: “playing Lego©”, “showering”, “learning vocabulary”, “going to school”, “bullying and misuse”, “soccer”, “skiing”, “walking”, “salary during apprenticeship and internship”.
• “Video gaming” is the first group of activities in the home setting • “Video gaming” moved and is now the third group of activities in in the home setting
• school participation: response option “daily” • school participation – response option changed to “daily at school days”
• school participation • kindergarten and school participation
• “neighborhood” • “visits in public area”
Conceptual equivalence Covering linguistically the same logic, meaning or mental images   Additional information:
 • enhanced definition of “participation” and “environment”
 • added information about the possible age of children (5–17 years)
 • explained that it is not about independence
 • included the time frame of four months on each page
 • added encouragement to fill in school setting despite little knowledge
 • instructed global thinking in the “environmental sections”
 • provided examples for all environmental items
Structural changes:
 • add headings for all participation aspects (frequency, involvement, desire for change)
 • insert “activity group” as subheading
 • make thicker lines between options for wishes for changes
 • highlight “Skip to C”
 • explain environment and settings on each page
 • repetition of “environmental factor” in possible answers
 • present all questions with the same answer format in the environment part on the same page.
 • added line for possible comments for desired changes in participation