title: Translation of health surveys using mixed methods.
abstract: OBJECTIVE
  The purpose of this study was to determine the effectiveness of a process-based translation method for a health survey instrument, Searching for Hardships and Obstacles to Shots (SHOTS), using a community-based participatory approach with the Hmong community.
  
  
  METHODS
  The study was based on a cross-sectional survey to assess the reliability and validity of the SHOTS immunization survey, an instrument used in the Hmong community, who are refugees originally from Laos living in the United States.
  
  
  METHODS
  Process-based universalistic health survey translation methods were used in a six-step procedure to translate the instrument. Mixed methods were used to analyze results, including cognitive interviewing, content validity indexing, Cronbach's α, t tests, and the Kolmogorov-Smirnov test.
  
  
  RESULTS
  Participants were able to accurately complete the SHOTS survey in either Hmong or English, depending on participant preference.
  
  
  CONCLUSIONS
  Universalistic, process-based, mixed methods used to analyze language translation, in combination with the principles of community-based participatory research, provide effective methods to translate health surveys. Involvement of the community strengthens the quality of translation and improves reliability and validity of survey results.
  
  
  CONCLUSIONS
  Healthcare providers require accurate and reliable information from evidence-based health surveys to plan for culturally responsive care. Cross-cultural research often relies on language translation. Translation of a health survey instrument may be improved with universalistic, process-based methodology.
authors.affiliation: Betty Irene Moore School of Nursing, University of California-Davis, 4610 X Street, Sacramento, CA 95616, USA. dibaker@csus.edu
authors.forename: Dian L
authors.initials: DL
authors.lastname: Baker
authors.forename: Joy
authors.initials: J
authors.lastname: Melnikow
authors.forename: May Ying
authors.initials: MY
authors.lastname: Ly
authors.forename: Janice
authors.initials: J
authors.lastname: Shoultz
authors.forename: Victoria
authors.initials: V
authors.lastname: Niederhauser
authors.forename: Rafael
authors.initials: R
authors.lastname: Diaz-Escamilla
mesh_terms: D000328:Adult; D001294:Attitude to Health / Q000208:ethnology*; D002140:California; D055812:Community-Based Participatory Research / Q000379:methods*; D003430:Cross-Sectional Studies; D003627:Data Interpretation, Statistical; D054242:Emigrants and Immigrants / Q000523:psychology / Q000706:statistics & numerical data; D005260:Female; D006297:Health Services Accessibility; D054624:Health Status Disparities; D006306:Health Surveys / Q000379:methods*; D054625:Healthcare Disparities; D006801:Humans; D007114:Immunization / Q000523:psychology; D007812:Laos / Q000208:ethnology; D008297:Male; D008875:Middle Aged; D015404:Nursing Methodology Research / Q000379:methods*; D012036:Refugees / Q000523:psychology* / Q000706:statistics & numerical data; D012660:Semantics; D018709:Statistics, Nonparametric; D014177:Translations