Strengthening alcohol consumption screening in primary care for culturally diverse populations in Latin America: Adaptation and content and face validity of the AUDIT in Guaviare, Colombia

Background The World Health Organization developed the Alcohol Use Disorders Identification Test, widely used to detect alcohol consumption and guide interventions in primary care. Despite its broad use, evidence of its validity in culturally diverse settings remains limited. Although Spanish versions exist, none have been culturally adapted for Guaviare, a Colombian Amazon region with multicultural communities and socioeconomic and healthcare inequities. Such inequities may intensify alcohol consumption and related consequences. Without cultural adaptation, AUDIT screening may underestimate consumption and hinder effective primary-care interventions. Objective This study aimed to culturally adapt and assess the content and face validity of the AUDIT in both interview and self-administered formats for alcohol consumption screening among adults in Guaviare, Colombia. Methods This study followed a descriptive qualitative approach to guide the cultural adaptation and validation of a scale. Phase 1: cultural adaptation was conducted through consensus among researchers and a panel of community experts (n = 11), using a nominal group technique to prioritize adjustments from the community’s perspective. Phase 2: Field testing involved cognitive interviews (n = 18) to assess content and face validity, as well as semantic and technical equivalence. Additional cultural refinements were made based on participants’ feedback. Results Cultural adaptations were made to the instructions, questions, and response options. Most adjustments focused on improving comprehension of the scale and guiding respondents to answer each item accurately. In addition, modifications were implemented to make the scale more recognizable and culturally appropriate for the community. Conclusion This study shows that the culturally adapted AUDIT for adults in Guaviare demonstrates adequate content and face validity, representing the first validated version of the scale for this population. The findings underscore the importance of context-sensitive adaptations to ensure accurate identification of alcohol consumption and to strengthen primary care interventions.