Cultural and Linguistic Adaptation of a Multimedia Colorectal Cancer Screening Decision Aid for Spanish-Speaking Latinos

Abstract

As the United States becomes more linguistically and culturally diverse, there is a need for effective health communication interventions that target diverse, vulnerable populations, including Latinos. To address such disparities, health communication interventionists often face the challenge to adapt existing interventions from English into Spanish in a way that retains essential elements of the original intervention while also addressing the linguistic needs and cultural perspectives of the target population. The authors describe the conceptual framework, context, rationale, methods, and findings of a formative research process used in creating a Spanish-language version of an evidence-based (English language) multimedia colorectal cancer screening decision aid. The multistep process included identification of essential elements of the existing intervention, literature review, assessment of the regional context and engagement of key stakeholders, and solicitation of direct input from target population. The authors integrated these findings in the creation of the new adapted intervention. They describe how they used this process to identify and integrate sociocultural themes such as personalism (personalismo), familism (familismo), fear (miedo), embarrassment (verguenza), power distance (respeto), machismo, and trust (confianza) into the Spanish-language decision aid.

Acknowledgments

This project was supported by the Carolina Community Network, the North Carolina Translational and Clinical Sciences Institute, University of North Carolina, Lineberger Population Science Award, American Cancer Society (117192-CCCDA-09-215-01-CCCDA), and Foundation for Informed Medical Decision Making.

Notes

Note. Some categories may not total 100% because of rounding. Data shown are M (±SD) or n (%), unless otherwise indicated. One participant had a missing value for age. Three participants had a missing value for frequency of computer use.

Note. CRC = colorectal cancer; FOBT = fecal occult blood test.

Additional information

Notes on contributors

Linda K. Ko

Linda K. Ko was supported in part by the University of North Carolina Lineberger Comprehensive Cancer Center Cancer Control Education Program (R25 CA057726). Drs. Ko and Reuland contributed equally. The authors acknowledge Marisa Hall, Brenda Cepeda, and Karen Roque for their research and administrative support.