Translating best practice into real practice: Methods, results and lessons from a project to translate an English sexual health survey into four Asian languages

Forward and Back is Not Enough: Applying Best Practices for Translation of Pediatric Sleep Questionnaires

Cultural differences in the experience of sleep warrant consideration in the measurement of sleep across populations. This requires careful attention to both language and culture when translating survey measures. While forward and back translation is the most commonly used approach, it has numerous limitations if used as an isolated method. Best practice guidelines recommend a multi-step team-based approach for translating questionnaires. We present our recent experience applying best practices in a study with both Spanish and English-speaking Mexican American mothers of toddlers. This work is part of a larger project that will measure parental sleep-related beliefs and parenting practices in Mexican American parents of toddlers. We utilized a team-based approach to translation and cultural adaptation, assembling a diverse, bilingual, and bicultural team. The translation process started with items and measures that we had selected, revised as needed, or created. New items were based on constructs identified in semi-structured interviews and focus groups used to explore parental sleep-related beliefs and parenting practices in the target population. Following this, our translation process included forward and back translation, harmonization and decentering, cognitive interviewing, debriefing, adjudication, and proofreading. We outline details of our process and the rationale for each step. We also highlight how each step contributes to ensuring culturally appropriate items with conceptual equivalence across languages. To ensure inclusivity and scientific rigor within the field of sleep research, investigators must utilize best practices for translations and cultural adaptations, building on the foundation of cultural constructs often identified in qualitative work.

HIV-Related Knowledge and Practices among Asian and African Migrants Living in Australia: Results from a Cross-Sectional Survey and Qualitative Study

Australian HIV notification rates are higher for people born in Northeast Asia, Southeast Asia and sub-Saharan Africa compared to Australian-born people. The Migrant Blood-Borne Virus and Sexual Health Survey represents the first attempt to build the national evidence base regarding HIV knowledge, risk behaviors and testing among migrants in Australia. To inform survey development, preliminary qualitative research was conducted with a convenience sample of n = 23 migrants. A survey was developed with reference to the qualitative data and existing survey instruments. Non-probability sampling of adults born in Northeast Asia, Southeast Asia and sub-Saharan Africa was undertaken (n = 1489), and descriptive and bivariate analyses of data were conducted. Knowledge of pre-exposure prophylaxis was low (15.59%), and condom use at last sexual encounter was reported by 56.63% of respondents engaging in casual sex, and 51.80% of respondents reported multiple sexual partners. Less than one-third (31.33%) of respondents reported testing for any sexually transmitted infection or blood-borne virus in the previous two years and, of these, less than half (45.95%) tested for HIV. Confusion surrounding HIV testing practices was reported. These findings identify policy interventions and service improvements critically needed to reduce widening disparities regarding HIV in Australia.

Autism spectrum disorder knowledge scale: Chinese revision of the general population version

The general population of China has misconceptions about Autism Spectrum Disorder (ASD). The measurement of ASD knowledge is conducive to conducting widespread scientific publicity. However, China lacks a structurally complete ASD knowledge scale with good reliability and validity. Therefore, this study aimed to introduce a suitable Chinese ASD knowledge scale. Based on 317 participants, this study revised the Chinese version of the Autism Spectrum Disorder Knowledge Scale(ASKSG), assessed its reliability, validity, and psychometric properties, and analyzed the ASD knowledge of the Chinese general population of this subject sample. The results provided support for the Chinese version of the ASKSG as a suitable measure for assessing ASD knowledge and indicated that ASD knowledge in this study's sample was relatively poor, particularly with regard to etiology and epidemiology.

Strategies for Recruiting Migrants to Participate in a Sexual Health Survey: Methods, Results, and Lessons

In this article, we describe the approaches taken to recruit adult migrants living in Australia for a sexual health and blood-borne virus survey (paper and online) and present data detailing the outcomes of these approaches. The purpose was to offer guidance to redress the under-representation of migrants in public health research. Methods of recruitment included directly contacting people in individual/organizational networks, social media posts/advertising, promotion on websites, and face-to-face recruitment at public events/venues. Search query strings were used to provide information about an online referral source, and project officers kept records of activities and outcomes. Descriptive statistical analyses were used to determine respondent demographic characteristics, proportions recruited to complete the paper and online surveys, and sources of referral. Logistic regression analyses were run to predict online participation according to demographic characteristics. The total sample comprised 1454 African and Asian migrants, with 59% identifying as female. Most respondents (72%) were recruited to complete the paper version of the survey. Face-to-face invitations resulted in the highest number of completions. Facebook advertising did not recruit large numbers of respondents. Same-sex attraction and age (40-49 years) were statistically significant predictors of online completion. We encourage more researchers to build the evidence base on ways to produce research that reflects the needs and perspectives of minority populations who often bear the greatest burden of disease.

Exploring the translation process for multilingual implementation research studies: a collaborative autoethnography

Introduction

In an increasingly globalised and interconnected world, evidence to evaluate complex interventions may be generated in multiple languages. However, despite its influence in shaping the evidence base, there is little literature explicitly connecting the translation process to the goals and processes of implementation research. This study aims to explore the processes and experience of an international implementation research team conducting a process evaluation of a complex intervention in Tibet Autonomous Region, China.

Methods

This study uses a collaborative autoethnographic approach to explore the translation process from Chinese or Tibetan to English of key stakeholder interview transcripts. In this approach, multiple researchers and translators contributed their reflections, and conducted joint analysis through dialogue, reflection and with consideration of multiple perspectives. Seven researchers involved with the translation process contributed their perspectives through in-depth interviews or written reflections and jointly analysed the resulting data.

Results

We describe the translation process, synthesise key challenges including developing a ‘voice’ and tone as a translator, conveying the depth of idioms across languages, and distance from the study context. We further offer lessons learnt including the importance of word banks with unified translations of words and phrases created iteratively during the translation process, the need to collaborate between translators and the introspective work necessary for translators to explore their positionality and reflexivity during the work. We then offer a summary of these learnings for other implementation research teams.

Conclusion

Our findings emphasise that in order to ensure rigour in their work, implementation research teams using qualitative data should make concerted effort to consider both the translation process as well as its outcomes. Given the numerous multinational or multilingual implementation research studies using qualitative methods, there is a need for further consideration and reflection on the translation process.

A web-based audio computer-assisted self-interview (ACASI) application with illustrated pictures to administer a hepatitis B survey among a Myanmar-born community in Perth, Australia: Development and user acceptance study (Preprint)

BACKGROUND

Self-administered paper or electronic surveys can create accessibility issues for people with language barriers and limited literacy, whereas face-to-face interviews can create privacy issues and give rise to reporting biases, particularly in the context of sensitive subject matters. An audio computer-assisted self-interview (ACASI) offers an alternative mode of survey administration, and its use has been tested against other survey modes to determine whether the presence of a background narration helps overcome literacy and privacy issues. There are still gaps with the ACASI survey administration because audio narration alone does not assist respondents with limited literacy in choosing response options. To overcome literacy issues, a few studies have used illustrated pictures for a limited number of response options.

OBJECTIVE

This study aimed to illustrate all the questions and response options in an ACASI application. This research is part of a larger study comparing different modes of survey administration (ACASI, face-to-face interviews, and self-administered paper surveys) to collect data on hepatitis B knowledge, attitudes, and practices among the Myanmar-born community in Perth, Australia. This study describes the 2-phase process of developing a web-based ACASI application using illustrated pictures.

METHODS

The first phase was the preparation of the ACASI elements, such as questionnaire, pictures, brief descriptions of response options, and audio files. Each element was pretested on 20 participants from the target population. The second phase involved synchronizing all the elements into the web-based ACASI application and adapting the application features, in particular, autoplay audio and illustrated pictures. The preprototype survey application was tested for user acceptance on 5 participants from the target population, resulting in minor adjustments to the display and arrangement of response options.

RESULTS

After a 12-month development process, the prototype ACASI application with illustrated pictures was fully functional for electronic survey administration and secure data storage and export.

CONCLUSIONS

Pretesting each element separately was a useful approach because it saved time to reprogram the application at a later stage. Future studies should also consider the participatory development of pictures and visual design of user interfaces. This picture-assisted ACASI survey administration mode can be further developed and used to collect sensitive information from populations that are usually marginalized because of literacy and language barriers.