For cultural relevance assessment, the type of questions or questioning-style by itself would n't be effective enough for a quality of outcome; any culture-related evaluation could be started from (1). The sensitivity of setting (environment) of the an interview or a case-study location. The reason is that the concept of culture is similar to the building- block of psychology of humankind, especially in it is touches the perspectives of gender-related or the  religious subjects; for an example, safety and relaxation, sub-consiously reduces the anxiety of interviewee to stay more focused on her or his unbiased answers, without rush. (2). Although the attractiveness and related-questionare could be a Time buyer for the interviewer through increasing the tolorance of the interviewee to stay longer, but a "break-time" with serving a local snack, could break the ice, stretch the time pleasantly, and raise the blood-suger (focus) to answer better, in many levels.  

Have you thought about doing pilot interviews to check the cultural relevance with physicians (presumably of both genders)  familiar with and/or in the Lebanese context?

Dear Faranack and Diana thank you for your suggestions.

Would pilot testing it with a researcher or two be enough or should I pilot test it with a physician?

It will be hard to pilot test the tool with a physician since an ethical approval will be needed for the pilot test and another will be needed to collect the actual data.

Thank you

Hi Mohammad, I would suggest applying for ethical approval, including reference to the fact that your interview protocol will be pilot tested (which strengthens your ethics application), then do the pilot interview and refine/amend your questions as required. Thus you only need to apply once. Also I would strongly suggest piloting with physicians rather than researchers. :)

Thanks a million Diana. I think I will do that!

Appointing a critical reader from population you intend to select your participants might be useful. The reader should be briefed on the purpose of the request. 

That's what I intend to do. I will send the tool to two researchers and two family doctors and ask them to evaluate it in terms of clarity and cultural relevance and to suggest changes if need be. Thank you for the help Mathobosi 

One has to be familiar with the cultural context of the community / group to be studied and pilot study is required to localized the questionnaire. Some terms are really sensitive in one culture and usual in other. Engagement of native researcher during the planning and implementation is the easiest way.

 Thank you for your answer. So you believe that I must pilot test the review protocol rather than have it evaluated by a panel of experts? 

Thanks