Research Article
Developing a Conceptually Equivalent Type 2 Diabetes Risk
Score for Indian Gujaratis in the UK
Naina Patel,
1
Andrew Willis,
1
Margaret Stone,
1
Shaun Barber,
2
Laura Gray,
2
Melanie Davies,
1
and Kamlesh Khunti
1
1
Diabetes Research Centre, University of Leicester, Leicester, UK
2
Department of Health Sciences, University of Leicester, Leicester, UK
Correspondence should be addressed to Andrew Willis; aw187@le.ac.uk
Received 3 March 2016; Accepted 12 July 2016
Academic Editor: Gill Rowlands
Copyright © 2016 Naina Patel et al. Tis is an open access article distributed under the Creative Commons Attribution License,
which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Aims. To apply and assess the suitability of a model consisting of commonly used cross-cultural translation methods to
achieve a conceptually equivalent Gujarati language version of the Leicester self-assessment type 2 diabetes risk score.
Methods. Implementation of the model involved multiple stages, including pretesting of the translated risk score by conducting
semistructured interviews with a purposive sample of volunteers. Interviews were conducted on an iterative basis to enable fndings
to inform translation revisions and to elicit volunteers’ ability to self-complete and understand the risk score. Results. Te pretest
stage was an essential component involving recruitment of a diverse sample of 18 Gujarati volunteers, many of whom gave detailed
suggestions for improving the instructions for the calculation of the risk score and BMI table. Volunteers found the standard and
level of Gujarati accessible and helpful in understanding the concept of risk, although many of the volunteers struggled to calculate
their BMI. Conclusions. Tis is the frst time that a multicomponent translation model has been applied to the translation of a type 2
diabetes risk score into another language. Tis project provides an invaluable opportunity to share learning about the transferability
of this model for translation of self-completed risk scores in other health conditions.
1. Introduction
Te prevalence of type 2 diabetes (T2DM) and the number
of people at high risk of T2DM in the UK have been
rising at an increasing rate in recent decades and both are
predicted to continue to rise over the next decade [1]. Up to 7
million people in the UK are currently undiagnosed with this
condition [2].
Earlier identifcation and treatment of T2DM can reduce
the risk of complications [3, 4]. National consensus guidelines
[5–7] relating to the identifcation of people at high risk of
T2DM refect this evidence.
Guidance recommends a two-staged approach to screen-
ing [8] involving the use of a validated risk assessment tool
followed by a confrmatory blood test. Tis can be followed
by appropriate referral to evidence based structured lifestyle
intervention programmes [5]. In the UK, this approach
forms the basis of an innovative national diabetes prevention
programme (NHS DPP) currently being piloted, to be imple-
mented nationally in 2016 [9].
Earlier identifcation of T2DM and those at high T2DM
risk is particularly salient for South Asian (SA) populations
as their risk of T2DM and associated mortality and morbidity
is signifcantly higher than white Europeans [10]. Due to the
increased risk in this population, NICE recommend ofering
screening at an earlier age of 25 rather than 40 years as
for the general population. Although the benefts of NICE
recommendations have been acknowledged, concerns have
been raised about the capacity of the National Health Service
(NHS) to implement these recommendations, particularly in
communities characterised by high numbers of people from
diverse ethnic groups. Tis has led to NICE suggesting that
non-NHS organisations (faith, voluntary, and community
centres) can facilitate access and support for lay people to self-
assess their own risk using a validated risk score [5].
Hindawi Publishing Corporation
Journal of Diabetes Research
Volume 2016, Article ID 8107108, 9 pages
http://dx.doi.org/10.1155/2016/8107108