Translating the CAHPS™ 1.0 Survey Instruments Into Spanish

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Abstract
Objectives. Collecting accurate health data on the growing number of ethnic minorities in the United States has increased in policy relevance in recent years. Today, most general population sample surveys conducted in the United States, including the CAHPS™ 1.0 Surveys, require translation into Spanish and often other languages as well. This article discusses the process used to translate the CAHPS™ 1.0 survey instruments into Spanish and the techniques used to evaluate these instruments. Methods. The CAHPS™ team used a technique of translation-backtranslation to translate the survey instruments into Spanish and conducted cognitive testing and pretesting of preliminary versions of the 1.0 Survey Instruments in both English and Spanish. Results. The translation-backtranslation method produced Spanish-language versions of the survey instruments that were adequate for more educated respondents but were inadequate for less educated respondents and respondents who seemed to be less acculturated. Conclusion. Adept translation of a survey instrument is an integral part of the instrument-development process, but it alone does not ensure that a culturally appropriate survey instrument will result. Producing a survey instrument that is culturally appropriate for Latinos in the United States may require modifying the English versions of instruments as well as subjecting Spanish-language instruments to more rigorous testing that includes cognitive testing, pretesting, and an evaluation of the reading level by a literacy expert.

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