Evaluating Culturally Tailored Strategies for Implementing Cognitive Interviewing on Edinburgh Postnatal Depression Scale Among Chinese Immigrant Women

Introduction: While the Edinburgh Postnatal Depression Scale (EPDS) is a standard clinical screening tool for postpartum depression, it is unclear whether it is culturally appropriate for Chinese immigrant women in the United States. Cognitive interviewing (CI) is a method for evaluating a scale’s cultural appropriateness. However, CI procedures are problematic with Chinese population. This study assesses three culturally tailored strategies for implementing CI to evaluate the Chinese version of the EPDS (C-EPDS). Methodology: CI was conducted with 12 participants in the United States. Three culturally tailored strategies—a CI description, a vignette exercise, and debriefing were used. Directed content analysis was used for data analysis. Results: The strategies increased participants’ understanding and ability to perform CI procedures, enabling them to discuss postpartum depression. Participants had difficulty responding to several C-EPDS items. Discussion: Findings highlight the importance of using culturally tailored strategies for implementing CI to assess cultural appropriateness of clinical screening tools.