The Process of Translating and Culturally Adapting a Digital Elder Abuse Intervention

Elder Abuse is a national public health problem affecting one in ten older adults. It is estimated that only 4% of cases are reported to authorities. Latino populations that reside in the U.S. are less likely to report abuse, and language barriers may limit access to resources and prevent seeking help. There is a need for tools and services to not only be translated but culturally adapted to ensure the integrity and comprehension of the translated product. We conducted an extensive literature review that informed our multi-step language translation and cross-cultural adaptation of the VOICES digital health elder abuse intervention from English to Spanish. This process involved a team of independent translators for an iterative, step-by-step approach that included synthesis and review at each step of the process. Translations were individually rated by the review team based on a 7-point Likert scale. The review team found the translations appropriate and highly satisfactory. Comparison of separate versions of translated items highlighted key linguistic variations and issues that informed the team when producing the final translated product. Challenges found during the translation process were categorized as a posteriori. Examples are included. Following a multi-step, iterative framework for the translation and cultural adaptation provided a highly accurate product. Involving multiple translators from varying backgrounds reduced the risk for translation bias and flagged cultural nuances that allowed the research team to identify areas that needed more attention and care. The product will be further culturally adapted with the help of the community via cognitive interviews with Spanish-speaking individuals relevant to the intervention's intended target population before following up with a study to compare with the original findings of the intervention's parent study.