1. Global Youth Tobacco Survey (GYTS): Questionnaire Adaptation

2. Overview
GYTS Core Questionnaire, Optional Modules, and Optional Questions
Guidelines for Adapting, Translating, and Finalizing the GYTS Questionnaire

3. Documents Referenced GYTS Implementation Instructions manual
Questionnaire Adaptation Instructions, pages 7 to11

4. GYTS Core Questionnaire with Optional Questions

5. GYTS Questionnaire and School Policy Questionnaire
Standard core questionnaire and optional modules and questions of the GYTS Questionnaire permit adaptation to meet the data needs of the country
Completed by students aged 13 to 15 years old
GYTS School Policy Questionnaire provides information on tobacco-free policies and enforcement in schools
Completed by School Principal or Administrator
One School Policy Questionnaire for each school

6. GYTS Questionnaire A total of 153 questions available
Three main sections
Core Questionnaire
Optional Modules
Optional Questions
Lettering scheme designates a question’s section
Core Questionnaire (prefix C)
Optional Modules (prefix EL, B, S, SL)
Optional Questions (prefix O)

7. Core Questionnaire 43 total questions (prefix C)
All 43 questions must be included in a country’s adapted questionnaire and questions should not be changed
Some Core questions require that the Research Coordinator enter country-specific examples and answer choices (Ex. C3, C4, C26, C28, C29, etc.)
The maximum number of answer choices is eight (8)

8. Core Questionnaire Introduction Background Characteristics
Key Tobacco-Control Indicators
Tobacco Use
Cessation
Secondhand Smoke
Economics
Pro-/Anti-Tobacco Media and Advertising
Knowledge and Attitudes about Tobacco

9. Core Questionnaire – Introduction
Explains and provides examples of different types of tobacco products
Defines and groups tobacco use
Smoking Tobacco
Cigarettes
Other types
Shisha
Pipes
Cigars
Smokeless Tobacco
Chewing tobacco
Snuff
Dip

10. Examples: Smoking Tobacco
Water pipe
Shisha
Narguile
Pipes
Manufactured cigarettes
Hand-rolled cigarettes
Cigar
Kreteks cigarettes
Bidis

11. Examples: Smokeless Tobacco
Snus
Chewing tobacco
Snuff
Gutka
Dip

12. Core Questionnaire – Background Characteristics
Four questions on background characteristics
Age
Gender
School grade level
Spending money (economics)
Section includes questions that require Research Coordinator to provide country-specific answers

13. Core Questionnaire – Tobacco Use
Cigarettes
Ever use and current use
Age of initiation
Frequency of use (# of days smoked, # of cigarettes)
Other smoked tobacco
Smokeless tobacco
Smoking tobacco dependence

14. Core Questionnaire – Cessation
Desire to quit smoking
Attempts to quit smoking during past 12 months
Opinions on being able to quit smoking
Receive help/advice to help quit smoking

15. Core Questionnaire – Secondhand Smoke
Exposure to smoking in the past 7 days at home, indoor public places, and outdoor public places
Noticing others smoking at school
Knowledge of harmfulness of secondhand smoke
Opinion on banning smoking
Indoor public places
Outdoor public places

16. Core Questionnaire – Economics
Obtaining Cigarettes
Where cigarettes were purchased
Inability to buy cigarettes because of age
Package type
Individual sticks, packs, cartons, roll your own
Average cost of a pack of 20 cigarettes

17. Core Questionnaire – Media: Anti-Tobacco
Advertising messages against tobacco
Media (Television, radio, internet, billboards, posters, newspapers, magazines, movies)
Sports and social events (sports games, fairs, concerts, community events, social gatherings)
Attention to health warning labels on cigarette packages
School lessons about the dangers of tobacco use

18. Core Questionnaire – Media: Pro-Tobacco
Tobacco promotion and use on television shows, videos, and movies
Tobacco advertising/ promotions at points of sale
Items with tobacco brand logo: ownership, willingness (i.e., Marketing receptivity)
Tobacco company representative offering a free tobacco product

19. Core Questionnaire – Knowledge & Attitudes
Susceptibility to tobacco use
Using tobacco if offered by friends
Future tobacco use in the next 12 months
Ability to quit smoking
Smoking tobacco to feel comfortable
Curiosity (“I think I might enjoy smoking a cigarette.”)

20. Optional Modules
Four Optional Modules provide additional questions to capture further data on tobacco types and use
48 questions total
Electronic Cigarettes (3 questions, prefix EL)
Shisha (14 questions, prefix S)
Bidis (14 questions, prefix B)
Smokeless Tobacco (17 questions, prefix SL)
All or some questions of an Optional Module can be included

21. Optional Questions 62 Optional Questions for review (prefix O)
Incorporates Core and Optional Questions from previous GYTS questionnaires
New questions based on emerging topics about tobacco use
Optional Questions are broken out by key tobacco- control topics

22. Country-Created Questions
Research coordinators can revise or amend optional modules or optional questions
They can also create and include their own questions (i.e., country-created questions)
A justification or rationale for the inclusion of country- created questions must be provided for review

23. School Policy Questionnaire
Seven (7) questions on tobacco-free policies and enforcement for students, teachers, and other school personnel
Country-specific answer choices for position/role of person completing the questionnaire

24. Questionnaire Adaptation & Finalization

25. Questionnaire Adaptation
Research Coordinator has primary responsibility for adapting the GYTS Questionnaire
Works in collaboration with the country’s Ministry of Health or Education and technical experts
Use core questions, optional modules, and/or optional questions

26. Steps for Questionnaire Adaptation
Start with editable GYTS Core questionnaire
Fill in country-specific examples and answer choices for specific questions (Ex. C3, C4, C26, C28, C29)
Add questions from Optional Modules (if appropriate)
Add questions from the list of Optional Questions (if appropriate)
Add other questions (“country-created”) if needed to address important country-specific issues

27. Adding Questions
Optional Modules can be inserted at the end of the Core Questionnaire
Individual optional/country-created questions should be added at the end of the related key topic category
Questions may be reordered during the questionnaire review and finalization process to improve flow
The suggested maximum number of questions included in the final questionnaire should not exceed 75
The Research Coordinator is not required to add questions from the Optional Modules or the Optional Questions section; a GYTS Questionnaire can include only the Core Questionnaire

28. Submitting to WHO/CDC for Review
Submit the Microsoft Word version (English) of the country-adapted GYTS Questionnaire for WHO and CDC review
GYTS standard question lettering schemes (e.g., C1-C43 for Core, S1- S14 for Shisha Module) should be maintained until the Questionnaire is finalized
WHO/CDC will
Review the Questionnaire and provide comments or edits
Return the Questionnaire for final adaptations

29. Questionnaire Translation
Remove lettering prefixes and revise questionnaire to consecutive numbering (e.g., 1 to 75)
Translate adapted GYTS Questionnaire and School Policy Questionnaire into local country language
Back-translate into English for review
Translations and back-translations should be done independently by language experts
Content and survey experts should review for consistency

30. Questionnaire Testing
Questionnaire testing in group setting with a facilitator
6 to 8 participants (13-15 year old students)
Student debriefing session
Evaluate the following:
Wording translation
Comprehension of any new country-specific questions
Overall flow
Submit any revisions to WHO and CDC for approval; any approved revisions must be translated and back-translated to English

31. Finalizing the Questionnaire
Once finalized
The order of questions should not be changed
The numbering should be changed to remove the letter prefixes and to number the questions consecutively (e.g., 1-75)
RC sends the finalized questionnaire (English and translated versions) to WHO and CDC for documentation

32. GYTS Questionnaire Adaptation Process
RC, MoH/MoE, and technical experts
Translation and back-translation (reviewed by WHO/CDC)
Questionnaire testing
and modification
RC sends questionnaire (in English)
to WHO/CDC for review
Final questionnaire sent to all
for documentation
WHO/CDC works with RC to
review/analyze questionnaire for finalization

33. THANK YOU!
This concludes this presentation on the GYTS Questionnaire Adaptation process.