[Adequacy of translating health survey questionnaires for cross-cultural surveys--the case of the Todai Health Index].
The adequacy of the language translation of self-administered questionnaire items was examined in a comparative study of adolescent mental health between Japan and the United States. As a screening instrument to be used in both countries, the Todai Health Index (THI) questionnaire had been translated from original Japanese into English. The original version was administered to 570 Japanese adolescents and the translated version was given to 295 middle school students in the United States (aged 12 to 15). The equivalence of the two versions was re-examined based on the results of the surveys by a team of researchers from both countries including a bilingual investigator. For the items which produced a statistically significant different response pattern between the two samples, the investigators attempted to determine whether the observed difference could be attributed to an inadequate translation or to a real cultural difference. For those items judged to suffer from inadequate translation, modifications were made to improve cross-cultural equivalence. The above methodological procedure, though not perfect, proved to be relatively simple but very useful in resolving many practical issues in cross-cultural studies and produced interesting findings. For example, the phrase "worry about" was found to not adequately capture the Japanese meaning of "ki-ni-naru" and instead the phrase "concern about" or "care" was suggested as a more appropriate substitute. Very little is known and insufficient attention has been given to the effect of translation in cross-cultural surveys. These investigations suggest the benefit of more extensive studies and focused discussions of reliability of the translated survey instruments by public health researchers involved in international comparisons.
Takeuchi
K
K
Department of Public Health, Gunma University School of Medicine.
Aoki
S
S
Suzuki
S
S
D000293:Adolescent; D002648:Child; D006306:Health Surveys; D006801:Humans; D007564:Japan; D007802:Language; D011795:Surveys and Questionnaires; D014177:Translations; D014481:United States