Supplementary Material for: Validation of the Opioid Overdose Knowledge (OOKS) and Attitudes (OOAS) Scales in French, Spanish, and German Languages, among a Sample of Opioid Users

<b><i>Introduction:</i></b> Improving the knowledge and attitudes of people facing an opioid overdose is one of the key prevention measures for reducing overdose occurrence and severity. In this respect, the Opioid Overdose Knowledge Scale (OOKS) and Opioid Overdose Attitudes Scale (OOAS) have been developed and validated in English to assess and improve knowledge and attitudes of opioid users and their families and care providers, in case of an overdose. Here, the OOKS and OOAS scales have been translated into French, Spanish, and German, and the different versions of the 2 scales have been assessed regarding their psychometric properties. <b><i>Methods:</i></b> The translation procedure of the scales was based on the international recommendations, including a back translation by a native English speaker. Subsequently, 80 (Spain: 29, France: 27, Germany: 24) former or current heroin users, aged from 20 to 61 years (M = 39.4 ± 9.23), completed the OOKS and OOAS versions of their native language, in test-retest, without specific between-assessment training. Internal consistency was assessed using Cronbach’s α, while test-retest reliability was assessed using intraclass correlation coefficient (ICC). The correlation between the OOKS and OOAS scores of a same language was assessed using Spearman’s (ρ) coefficient. <b><i>Results:</i></b> Internal consistency of the OOKS was found to be good to very good, with Cronbach’s α ranging from 0.62 to 0.87. Test-retest reliability was also very good, with ICCs ranging from 0.71 to 0.82. However, results were less reliable for the OOAS, as internal consistency was questionable to acceptable, with Cronbach’s α ranging from 0.12 to 0.63, while test-retest ICCs were very good for the French (0.91) and Spanish (0.99) versions and barely acceptable for the German version (0.41). No significant correlation was found between the OOKS and OOAS scores, irrespective of the version concerned. <b><i>Conclusion:</i></b> While satisfactory results were found for the 3 versions of the OOKS, results on the OOAS were relatively inconsistent, suggesting a possible gap between knowledge and attitudes on overdose among opioid users.

**引言：** 提升阿片类药物过量相关人群的认知水平与态度倾向，是降低药物过量事件发生率与严重程度的核心预防手段之一。就此背景而言，阿片类药物过量认知量表（Opioid Overdose Knowledge Scale, OOKS）与阿片类药物过量态度量表（Opioid Overdose Attitudes Scale, OOAS）已以英语编制并完成效度验证，用于评估并改善阿片类药物使用者、其家属及照护者在药物过量场景下的认知与态度。本研究将上述两款量表分别翻译为法语、西班牙语与德语，并针对各语言版本的两款量表开展心理测量学特征评估。

**方法：** 量表翻译流程遵循国际通用规范，其中包含由母语为英语的人员进行的回译环节。随后共招募80名既往或当前的海洛因使用者（西班牙29名、法国27名、德国24名），年龄介于20至61岁之间（均值M=39.4±9.23），所有受试者完成了各自母语版本的OOKS与OOAS量表测评，并进行重测，两次测评之间未接受专项培训。内部一致性采用克朗巴赫α系数（Cronbach’s α）进行评估，重测信度则采用组内相关系数（intraclass correlation coefficient, ICC）进行评估。同语言版本下OOKS与OOAS得分间的相关性采用斯皮尔曼ρ系数（Spearman’s ρ）进行评估。

**结果：** OOKS的内部一致性表现良好至极佳，克朗巴赫α系数介于0.62至0.87之间；重测信度同样表现极佳，组内相关系数介于0.71至0.82之间。不过OOAS的结果可靠性相对较弱：其内部一致性从存疑到尚可接受，克朗巴赫α系数介于0.12至0.63之间；而重测组内相关系数方面，法语版本（0.91）与西班牙语版本（0.99）表现极佳，德语版本（0.41）则仅勉强达标。无论采用何种语言版本，OOKS与OOAS得分之间均未发现显著相关性。

**结论：** 尽管OOKS的三个语言版本均取得了令人满意的测评结果，但OOAS的结果相对不一致，这提示阿片类药物使用者在药物过量相关的认知与态度之间可能存在一定差距。