Measuring and Applying Motivational Constructs in a Brief Intervention for Reducing Harmful Alcohol Use in ED Patients in Moshi, Tanzania

Abstract

Background: Self Determination Theory (SDT) conceptualizes human motivation in terms of a spectrum. However, literature is scarce on how to measure self-determination in different languages or how self-determination can influence the effectiveness of healthcare interventions. The aim of this study was to translate and culturally adapt a psychometric questionnaire on self-determination (TSRQ) as well as SMS booster messages for a Brief Intervention (BI) aimed at reducing harmful alcohol use among injury patients presenting at Kilimanjaro Christian Medical Centre (KCMC) in Moshi, Tanzania. Methods: A mixed-methods approach was used to evaluate the psychometric properties of the TSRQ and SMS booster messages. Likert-scale surveys were administered on expert panels to assess translation quality and adherence to theory. Results: Quantitative analyses confirmed that the Swahili translation of the TSRQ accurately reflected SDT constructs. Exploratory Factor Analysis (EFA) revealed a two-domain model had a better fit than the original three-domain TSRQ. Expert panel surveys indicated that the SMS booster messages maintained strong connections to tenets of SDT. Conclusion: This was the first study to conduct a cross-cultural validation of the TSRQ in Tanzania and the first to implement and assess motivational constructs in SMS booster messages for a BI to promote safe alcohol use. The TSRQ is a valid, clinically useful scale but could be improved with more items. SMS booster messages touch on many SDT constructs, affirming their motivational utility.