The global trend of population aging, combined with Brazil’s socioeconomic dynamics, has significantly reshaped Brazil’s labor force, thereby increasing the presence of individuals aged 50 years and older and making inclusion strategies a structural requirement for economic and social stability [1,2]. Worldwide, the number of people aged 60 years and older is projected to rise from 1.1 billion in 2023 to 1.4 billion by 2030 [3], underscoring the need for age-friendly work environments and policies to combat ageism. In the Brazilian context, these demographic shifts are evidenced by the proportion of individuals aged 60 years and older (15.6% of the total population), which has already surpassed the share of youth aged 15 to 24 years (14.8%) since 2023. The average age of the Brazilian population increased from 28.3 years in 2000 to 35.5 years in 2023 and is projected to reach 48.4 years by 2070 [2]. These demographic changes not only reshape population structures but also pose concrete challenges for the labor market, particularly regarding the inclusion of older workers.

Individuals aged 50 years and older must be integrated into the labor market under safe and adequate conditions. This group represents approximately 18% of formal employment in Brazil, totaling approximately 8.3 million workers [4,5]. Despite this substantial presence in the formal sector, informality (ie, employment without formal registration, a written contract, or access to social security contributions and labor rights) remains disproportionately high: rates reach 40.6% among workers aged 50 to 59 years and rise to 53.8% among those aged 60 years and older [4]. However, employment opportunities available to these workers in both formal and informal sectors are frequently characterized by lower wages and reduced job quality [4].

This demographic’s continued participation in the workforce is influenced by factors such as the increase in the minimum retirement age under recent social security legislation in Brazil; financial considerations, including supplementing retirement income or contributing to household earnings; and the desire to remain active and socially integrated through work, which is often closely linked to an individual’s social identity [4,6,7]. Nevertheless, remaining in the workforce is not without consequences as older workers face specific risks that demand attention.

Beyond adverse employment conditions, occupational health is another critical dimension as integrating this population into the workforce entails unique challenges such as an increased risk of disability following an occupational injury and a more complicated recovery period [8,9]. In the Brazilian context, 744,477 occupational accidents were recorded in 2024, and 133,583 involved individuals aged 50 years and older, accounting for approximately 18% of all leaves due to occupational injury [10]. Although this group accounts for a smaller proportion of cases, it consumes disproportionately more benefit time because recovery is typically longer, averaging 45 to 60 days compared to the overall population mean of 38 days [10]. These extended recovery periods are attributed to age-related structural and functional degeneration of tissues and bones, as well as comorbidities that impair healing and increase the complexity of rehabilitation [8,9]. Occupational health issues represent a major global public health concern [11,12], affecting workers, families, and organizations by reducing work performance and productivity [13,14] and imposing significant economic costs through health care and social security expenditures [15].

According to the International Labour Organization, the global costs of workplace accidents and occupational illnesses amount to nearly US $3 trillion, representing approximately 3.94% of the world’s gross domestic product [12]. The Brazilian Ministry of Labor and Employment estimates that occupational accidents account for a loss of up to 4% of the country’s total economic output. The impact is so significant that, in 2025, a national campaign for the prevention of occupational accidents aimed to raise awareness of occupational safety and health standards, fostering debate and encouraging the adoption of preventive measures to ensure safer working environments for Brazilian workers [16].

The prevention of occupational injuries and prolonged disability cannot be attributed solely to individual factors; rather, it reflects a dynamic interplay among personal, organizational, and systemic determinants, as conceptualized by the ecological model of disability management [17,18]. This model emphasizes that workplace practices, health care interventions, and legislative frameworks operate interdependently, making multilevel collaboration essential to prevent prolonged disability and ensure sustainable work participation [18]. Within this integrated system, workers play a crucial role at the individual level, particularly through preventive behaviors, which interact with organizational practices and broader systemic conditions [19,20]. The concept of preventive behaviors at work or related constructs has been explored in various fields of the literature, including psychology [21,22], work organization and management [23,24], ergonomics [25], and occupational therapy [20,26,27].

Psychological research typically conceptualizes preventive or safety behaviors at work within 2 primary dimensions: carefulness and safety initiatives [21,22]. The domain of work organization and management emphasizes information exchange, problem-solving, and employee involvement as central elements for driving organizational change [23,24]. From an ergonomic perspective, the analysis emphasizes the observation of work processes to identify risks and the worker’s ability to apply knowledge in strategic decision-making for prevention. Ergonomic literature further highlights contextual influences such as work intensity and duration, physical and mental workload, task division, interpersonal relationships, and biomechanical aspects [25].

Authors in the field of occupational therapy have defined preventive behaviors at work as observable and measurable actions that workers may adopt to protect their own health and safety as well as that of their colleagues, thereby contributing to overall occupational health. Importantly, these actions extend beyond the prevention of physical accidents to include social and mental health dimensions [26]. The literature indicates that these behaviors play a vital role in occupational health and safety performance [28], reinforcing the need for instruments capable of measuring them.

This definition of preventive behaviors is supported by the assumptions of the model of preventive behaviors at work (MPBW), which is based on the results of 3 studies combining data from scientific literature and empirical observations in the domains of physical safety, psychological health, and social health [29-32]. The MPBW describes 6 types of behaviors that workers can adopt to preserve their health at work in relation to the context in which they operate. These behaviors are (1) adopting a reflective practice; (2) pondering rules and procedures; (3) taking initiatives for health, safety, and well-being; (4) caring about others; (5) communicating; and (6) adopting a healthy lifestyle. The model also distinguishes the direction of these behaviors, which may be oriented toward the worker, colleagues, or the organization. It integrates contextual factors specific to the individual (eg, personal resources) and to the organization (eg, social support and workplace civility), which influence a worker’s ability to adopt these behaviors. Finally, the model posits that these behaviors can generate positive effects on indicators related to the person, the organization, and society, such as work motivation, reduction in occupational injuries, or the development of a culture of prevention. The model was subjected to different stages of content validation with various stakeholders [20,26,27].

On the basis of this model, researchers developed the Échelle de Fréquence des Comportements Préventifs au Travail (Preventive Behaviors at Work Frequency Scale; EFCPT), a French-language questionnaire that measures, for a typical work week, how frequently a worker adopts each of the 6 behaviors in the MPBW taking the work context into account. The EFCPT consists of 23 items rated on a 5-point Likert scale (1=never; 5=always), enabling calculation of dimension-specific scores to generate behavioral profiles or a total score for an overall view of adherence to preventive behaviors [33]. Psychometric analyses demonstrated a 6-factor structure explaining 64.75% of the variance, satisfactory internal consistency for each dimension (McDonald ω>0.70), and high test-retest reliability with intraclass correlation coefficients (ICCs) from 0.76 to 0.89, supporting the instrument’s validity for assessing preventive behaviors [33].

Validated Brazilian Portuguese versions of instruments addressing important dimensions of occupational health are available, such as the Job Stress Scale (demand-control-support) [34], Copenhagen Psychosocial Questionnaire I and II (psychosocial risks) [35-37], Work Role Functioning Questionnaire 2.0 (functional capacity) [38,39], Resilience at Work Scale (resilience) [40], and Healthy Work Environment Assessment Tool (healthy environment) [41]. More recently, the Brazilian version of the Centers for Disease Control and Prevention Worksite Health ScoreCard [42] was adapted and validated as a comprehensive tool for assessing organizational-level health promotion strategies. However, none of these instruments measures the frequency of preventive behaviors adopted by workers, which is the central focus of the EFCPT and a critical component for monitoring individual-level practices that sustain workplace health promotion. In older adults, aligning preventive behaviors into daily routines is essential for long-term maintenance as repetition fosters automatization, with behavior frequency serving both as evidence of consolidation and as a target for intervention, reinforced through self-assessment and awareness [33,43].

By introducing a behavioral perspective and identifying specific practices that promote health, safety, and well-being at work, the EFCPT addresses a critical gap in occupational health assessment. Validating this instrument in Brazil is essential to capture effective workplace preventive practices within the national context, supporting research, policy development, and interventions aimed at fostering healthier and safer work environments. Given the study’s focus on healthy and sustainable aging at work, the translation, cross-cultural adaptation, and psychometric evaluation of the EFCPT will be conducted specifically among workers aged 50 years and older. Cross-cultural validation will ensure linguistic and conceptual equivalence as well as reliability and comparability, enhancing the instrument’s applicability in this population.

This paper aims to describe the study protocol that will be used to conduct the Brazilian Portuguese transcultural adaptation and validation of the EFCPT for workers aged 50 years and older.

This study constitutes methodological research focusing on cross-cultural adaptation and psychometric validation. This type of study aims to translate, culturally adapt, and evaluate the psychometric properties of measurement instruments (scales or questionnaires) to ensure equivalence with the original version in semantic, conceptual, and cultural terms, as well as reliability and validity for the target population [44,45].

Cross-cultural adaptation and psychometric validation are inherently complex processes, and Cruchinho et al [46] emphasize that insufficient justification for methodological decisions and limited documentation are frequent sources of bias that undermine reproducibility. Our aim in drafting this protocol was to bring clarity, rigor, and traceability to all stages of the adaptation of the EFCPT into Brazilian Portuguese, thereby contributing to more standardized methodological practices and supporting the generation of robust evidence for workers aged 50 years and older.

The EFCPT [33] is a questionnaire originally developed in Canadian French to assess the frequency of preventive behaviors at work. The instrument comprises 23 items distributed across six dimensions: (1) adopting a reflexive practice (4 items); (2) pondering rules and procedures (3 items); (3) taking initiatives for health, safety, and well-being (4 items); (4) caring about others (4 items); (5) communicating (4 items); and (6) adopting a healthy lifestyle (4 items). Responses use a 5-point Likert scale (“never,” “rarely,” “sometimes,” “often,” and “always”), with an additional “not applicable” option when an item does not apply to the participant’s work context. Dimension scores and an overall score are calculated according to the original instrument guidelines. A score is calculated for each dimension by summing the scores of the corresponding items and dividing the total by the number of valid responses within that dimension, excluding items marked as “not applicable.” The overall score is calculated using the same procedure across all 23 items, dividing the sum of all valid item scores by the total number of valid responses. Higher scores indicate more frequent engagement in preventive work behaviors.

This study is based on international guidelines for cross-cultural adaptation of measurement instruments [44-46] and comprises six sequential steps, which are (1) forward translation, (2) forward translation synthesis, (3) back translation, (4) harmonization and expert appraisal of relevance, (5) pretesting with the target population, and (6) field-testing and psychometric evaluation. The study commenced in February 2026 and is expected to be completed within 12 months.

This study will adhere to all applicable ethical principles and has received ethics approval from the Research Ethics Committee of the University of Quebec in Trois‑Rivières (UQTR; CER-26-328-07.25) and from the Research Ethics Committee of the Federal University of Pernambuco (approval 8.260.740; CAAE 95375426.8.0000.5208).

This paper describes the protocol for the cross-cultural adaptation and psychometric validation of the Brazilian Portuguese version of the EFCPT among workers aged 50 years and older. The adaptation process is expected to result in an instrument with cultural relevance and conceptual equivalence that preserves the conceptual foundations of the original scale while ensuring its applicability within the Brazilian context. The study will also provide evidence regarding the structural validity and reliability of the Brazilian Portuguese version, supporting its use in occupational health research and practice.

Given the global aging of the workforce and the need to promote healthy and sustainable working lives, a validated instrument for assessing preventive work behaviors may facilitate the identification of factors associated with safer and healthier work environments for older workers in Brazil while enabling cross-cultural comparisons across countries [1,54,75]. These efforts are aligned with the World Health Organization’s Decade of Healthy Ageing (2021-2030), which recognizes the creation of age-friendly environments that support functional ability, participation, and well-being throughout the life course as a global priority [76].

Beyond the adaptation of the instrument itself, this protocol may offer methodological insights for future cross-cultural adaptation and validation studies involving older workers. By documenting the procedures, challenges, and recruitment strategies adopted throughout the study, particularly those designed to address barriers related to digital access and literacy, this research may help inform similar studies with aging worker populations in diverse occupational contexts.

A major strength of this study is the use of a rigorous and internationally recognized cross-cultural adaptation process involving forward translation, forward translation synthesis, back translation, harmonization and expert appraisal of relevance, pretesting with the target population, and field-testing and psychometric evaluation [44-46]. In addition, the research internship at UQTR facilitated collaboration with French-speaking experts and researchers involved in the development of the original instrument [33], supporting the linguistic and conceptual adaptation process. The planned psychometric evaluation will further provide evidence regarding the measurement properties of the Brazilian Portuguese version.

Potential limitations include challenges in recruiting adults aged 50 years and older and the possibility of selection bias associated with workplace-based recruitment. Experiences from the pretesting phase suggested that reliance on remote data collection could exclude individuals with limited internet access or lower digital literacy, a challenge that has been widely documented among older adult populations [61,77]. Therefore, the field phase will prioritize face-to-face administration and workplace visits to promote participation and reduce digital access barriers. In addition, the minimum occupational tenure required for participation in the field-testing phase was reduced from 1 year to 6 months to broaden eligibility while ensuring sufficient exposure to the occupational context and preventive work practices [60]. Despite efforts to maximize participation and diversity, the study sample may not fully represent the diversity of occupational sectors, employment contexts, and geographic regions across Brazil. These factors will be considered when interpreting and generalizing the study findings.

Workers aged 50 years and older were selected as the target population because this study is part of a broader research initiative focused on understanding and promoting healthy and sustainable work participation among aging workers. Consequently, the evidence generated will be most directly applicable to this population. Although the instrument may have potential applicability to the broader workforce [33,54], additional studies will be needed to establish its measurement properties in other age groups within the Brazilian workforce. Furthermore, while the proposed sample size is consistent with established psychometric recommendations, the interpretation of the psychometric findings should also consider the multidimensional structure of the instrument and the characteristics of the study sample.

Recognizing the potential contribution of the study findings to occupational health, healthy aging, and sustainable work participation, stakeholders engaged throughout the study will support the timely dissemination of preliminary findings during the data collection and analysis phases. Following completion of the study, a structured set of knowledge transfer activities will be implemented, including publication in peer-reviewed journals and presentations at national and international scientific conferences. Additional dissemination strategies may include workshops for occupational health and safety professionals, meetings with organizational stakeholders, and public outreach initiatives aimed at promoting the translation of research findings into practice.

Future research may expand validation efforts across diverse occupational sectors and regions of Brazil, examine the responsiveness of the instrument in longitudinal studies, and investigate associations between preventive behaviors and occupational health outcomes. Additional studies may also evaluate the feasibility and measurement equivalence of digital administration formats, assess the instrument in younger worker populations, and explore its integration into occupational health and safety monitoring and intervention programs.

This paper describes a rigorous and internationally recognized process for the cross-cultural adaptation of what will be the first Brazilian Portuguese version of the EFCPT for use among workers aged 50 years and older, a population of increasing relevance in contemporary labor markets. The adapted instrument is expected to support cross-national research; inform evidence-based workplace interventions; and contribute to the promotion of safe, inclusive, and sustainable work participation among aging workers. Moreover, the detailed description of the study procedures may serve as a methodological reference for researchers planning and conducting similar cross-cultural adaptation and psychometric validation studies.