Cultural Adaptation and Validation of the WHO QualityRights Training to Brazilian Portuguese

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Abstract

Background : Human rights violations in mental health care can worsen conditions, while their protection fosters recovery and dignity. The WHO QualityRights training is an important educational tool for empowering health professionals and driving institutional change. Recognizing the need for culturally relevant mental health training materials in Brazil, this study aimed to adapt and validate the WHO QualityRights training modules into Brazilian Portuguese. Methods : Seven modules were translated and validated through four stages (translation, synthesis, expert committee review, and pretesting), following models by Beaton et al. (2000) and Pasquali (1998). A total of 42 experts evaluated semantic, idiomatic, and conceptual equivalence using the Content Validation Index (CVI). The pretest involved 21 primary health care professionals, who assessed the training's relevance through closed and open-ended questions. Quantitative analyses were performed using IBM® SPSS Statistics version 25, while qualitative data were analyzed using Braun & Clarke’s Thematic Analysis. Results : The CVI ranged from 93% to 99% across modules, confirming content validity. During pretesting, 82.6% of participants found the training relevant and applicable to their practice. Responses to open-ended questions revealed three themes, highlighting increased empathy, understanding of human rights-based approaches, and the effectiveness of the training methodology used by facilitators. Conclusions : The training modules were well-received and understood, demonstrating potential to promote human rights-oriented mental health care tailored to Brazil’s cultural and contextual needs. This approach could also serve as a replicable model for other low- and middle-income countries aiming to integrate human rights into health services.

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