The health behavior in school-aged children study in Semarang, Indonesia: methodological problems in cross-cultural research

Since the 'Health Behavior in School-Aged Children' (HBSC) study was implem ented by three European countries in 1982, it has been adopted by over 25 c ountries, including Canada and Australia. It is generally expected that Afr ican and Asian countries will follow. This paper reviews some methodologica l constraints in adapting the HBSC study in Indonesia. Although the interna tional HBSC team has reported methodological problems in the cross-national study, no attempt to extend the original European study to South-east Asia has been described before. Cultural, religious, economical and social diff erences create specific obstacles as well as challenges. Next to problems r elated to adaptation of the questionnaire, we experienced more structural p roblems both in its preparation and implementation. Lack of technical infra structure and communication facilities can serve as an example This might b e a problem insofar it affects the results. It is argued that for some beha viors such as smoking, cross-national comparability is probably not a probl em. For others, e.g. use of alcohol, comparability of the data should be tr eated with caution. Smoking is one of the most compromising health-risk beh aviors among male youngsters in Indonesia, with about 25% regular smokers ( at least once a week) among 15-year-old boys. Alcohol use is less common, b ut data are probably less reliable because of the social and religious tabo os on alcohol use and confusion about alcoholic drinks. Move efforts should be made in order to examine validity of the HBSC study in non-Western coun tries. Furthermore, insofar developing countries will participate in this s tudy in the near future, it is recommended that specific strategies are ela borated. These include derailed rules for translation and adaptation of the standard questionnaire, and the development of specific culture-relevant a dditional packages.