Transcultural Adaptation, Validity and Reliability Testing of Infertility Risk Self- Assessment Questionnaire (FertiSTAT) to Indonesian Language A Cross-Sectional Study

Background: Declining fertility rates and limited awareness of fertility risk factors pose major reproductive health challenges. FertiSTAT is a self-assessment tool for fertility risk awareness but has not been culturally adapted suitable for Indonesian population. Objective: To perform transcultural adaptation and evaluate the validity and reliability of the Indonesian version of FertiSTAT as a screening tool for fertility risk awareness for Indonesian population. Methods: A descriptive cross-sectional study was conducted involving 7 expert panel members, 4 certified translators, and 92 subjects, through a transcultural adaptation process which included expert content validation, forward–backward translation, face validation, cognitive debriefing, and test–retest reliability assessment. Content validity was measured using the Content Validity Index, while reliability was assessed using Cohen’s kappa and Spearman correlation. Results: All items retained conceptual equivalence and cultural relevance. Content validity showed CVI > 0.80 for all items and face validity demonstrated mean Likert scores > 3. Test–retest reliability showed variable agreement; several items achieved strong consistency, while lower values were mainly due to sensitive, subjective, fluctiative or strong homogenity of test-retest responses. Stability was acceptable for screening purposes. One additional item, tuberculosis was included on expert panel recommendations due to its prevalence and relevance to infertility in Indonesia. Conclusion: The Indonesian version of FertiSTAT has been succesfully adapted transculturally with good content and face validity, acceptable reliability and is suitable as an initial screening tool for fertility risk awareness among reproductive-aged women in Indonesia.