Development of the Chinese, Malay and Tamil translations of the Positive Mental Health Instrument: Cross-cultural adaptation, validity and internal consistency

This study describes the development and validation of Chinese, Malay and Tamil translations of the Positive Mental Health Instrument (PMHI) in a general population sample in Singapore. Translations were performed using two independent forward translations followed by expert panel discussions and tested for content, construct and language appropriateness using focus group discussions. The final translated tools were field-tested among 220 residents per language using self-administered questionnaires comprising the translated PMHI and other validity measures. Missing data, floor and ceiling effects, confirmatory factor analysis (CFA), internal consistency, item response theory differential item functioning (IRT-DIF) and criterion validity were assessed. A total of 10 PMHI-Chinese items, 26 PMHI-Malay items and six response categories and six PMHI-Tamil items were modified based on expert panel and focus group discussions. PMHI had low missing data and showed negative but acceptable skewness (