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Patient-Centered Measure Development and Spanish Validation Exemplar.

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    Developing accessible research tools is crucial for individuals with cognitive impairments after traumatic brain injury (TBI). This study outlines a systematic process to adapt and validate the Behavioral Assessment Screening Tool (BAST) for diverse linguistic and literacy needs.

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    Area of Science:

    • Neuroscience
    • Linguistics
    • Health Services Research

    Background:

    • Traumatic brain injury (TBI) frequently leads to cognitive deficits impacting comprehension.
    • Standardized research instruments may pose challenges for individuals with TBI due to language and literacy barriers.
    • Accessible survey instruments are essential for accurate data collection in TBI research.

    Purpose of the Study:

    • To describe an iterative language validation process for the Behavioral Assessment Screening Tool (BAST) and its Spanish version (BAST-ESP).
    • To adapt the BAST for English speakers with TBI, focusing on lower literacy levels.
    • To translate, validate, and cognitively test the BAST-ESP for Spanish speakers with TBI.

    Main Methods:

    • A two-phase iterative process involving scientific experts and target population members.
    • Phase 1: Adapting the BAST for accessible literacy in English-speaking individuals with TBI.
    • Phase 2: Translating, validating, and cognitively testing the BAST-ESP for Spanish-speaking individuals with TBI, including focus groups and cognitive interviews.

    Main Results:

    • Modifications included simplified language, improved clarity, rephrased idioms, and culturally sensitive wording.
    • Focus groups and cognitive interviews confirmed the accuracy and ease of comprehension of the adapted instruments.
    • The process yielded a lower-literacy BAST and an enhanced BAST-ESP, validated for specific populations.

    Conclusions:

    • A systematic adaptation and validation process is vital for creating scientifically sound, accessible instruments for populations with cognitive deficits.
    • This methodology enhances research tools beyond simple translation, ensuring cultural and linguistic appropriateness.
    • The study provides a roadmap for researchers adapting scientific instruments for low-literacy and non-English-speaking populations.