Cross-cultural adaptation and validation of a Sinhalese version of the Sense of Coherence 13-item scale among adolescents in Sri Lanka

Sense of Coherence (SOC) is the central construct of the health model of Salutogenesis, which has been identified as an effective approach for health promotion in adolescence as it focuses on pathways and mechanisms leading to health rather than disease and addresses the “upstream” social determinants of health. Antonovsky developed the SOC-13 item questionnaire to assess sense of coherence with the three dimensions, comprehensibility, manageability and meaningfulness in English-speaking populations. This study was conducted to assess the validity and reliability of Antonovsky’s SOC-13 item questionnaire for use among Sinhala-speaking adolescents in Sri Lanka. The cultural adaptation process included the establishment of item, conceptual, operational, and semantic equivalence of the questionnaire. Principal component analysis (PCA) and confirmatory factor analysis (CFA) were used to determine construct validity. Data from a sample of 400, Sinhala speaking 15-year-old students attending Sinhala medium government schools in Kandy district were used for this purpose. The reliability was assessed using internal consistency and testretest reliability. The culturally adapted ‘Sinhala version of the Adolescence Sense of Coherence questionnaire produced a single-factor solution with 5- items that accounted for 40.8% of the total variance of the scale. These 5 items included at least one item from the three different dimensions of the original questionnaire namely comprehensibility, manageability, and meaningfulness. The model fitted adequately with a single factor solution (c2 = 5.65; p=0.32, CFI=0.99, RMSEA=0.026) when assessed with CFA. The reliability of the questionnaire assessed through internal consistency (Cronbach alpha=0.63) and test-retest reliability (Spearman r correlation coefficient=0.65) were moderate. The Sinhala version of the adolescents’ sense of coherence questionnaire is a valid and reliable instrument to measure the construct sense of coherence in 15-year-old Sinhalaspeaking students in Sri Lanka.