Development and validation of the Somali WHOQOL-BREF among refugees living in the USA

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Abstract
This study is the first translation and validation of the WHOQOL-BREF for general use in Somali refugee populations. A community sample of 303 Somali refugees living in the USA responded to the WHOQOL-BREF following translation, adaptation, and validation guidelines established by the World Health Organization. Psychometric properties of the quality of life instrument were assessed including tests of the four-domain factor structure using multiple regression and principal component analysis. Principal component analysis demonstrated an acceptable fit between PCA components and original WHOQOL-BREF domains. Four components had eigenvalues greater than one and explained 63.4 % of the observed variance. Most scale items loaded like the original WHOQOL-BREF domains, with the notable difference among four items of physical health that loaded more strongly under the environment domain. Construct validity of the scale was confirmed by higher intercorrelations of each WHOQOL-BREF item with its intended domain (all r 2 > 0.50) than with other domains. Multiple regression analyses of the domain scores on overall quality of life (Q1) and health satisfaction (Q2) explained half of the observed variance in each measure. Item correlations showed good internal consistency (0.65 ≥ Cronbach’s alpha ≤ 0.82). Validation of this first Somali version of the WHOQOL-BREF provides further evidence that this instrument can be a valid measure for cross-cultural comparative studies of quality of life. Policies that address health disparities can be more broadly evaluated if quality of life is systematically measured in the community. This is particularly important for evaluating policy impact and implications for refugee populations.
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