Translating the CAHPS 1.0 survey instruments into Spanish
Collecting accurate health data on the growing number of ethnic minorities in the United States has increased in policy relevance. Today, most general population surveys require translation into Spanish and other languages. This article discusses the process used to translate the Consumer Assessment of Health Plans Study (CAHPS) 1.0 survey instruments into Spanish and techniques used to evaluate these instruments. The CAHPS team used a technique of translation-backtranslation, and conducted cognitive testing and pre-testing of preliminary versions in both English and Spanish. The translation-backtranslation method produced Spanish-language versions adequate for more educated respondents but inadequate for less educated and less acculturated respondents. Producing a survey instrument culturally appropriate for Latinos in the United States may require modifying English versions of the instruments, as well as subjecting Spanish-language instruments to more rigorous testing that includes cognitive testing, pre-testing, and an evaluation of reading level by a literacy expert.