title: Evaluating the linguistic appropriateness and cultural sensitivity of a self-report system for spanish-speaking patients with cancer.
abstract: Spanish speakers in the United States encounter numerous communication barriers during cancer treatment. Communication-focused interventions may help Spanish speakers communicate better with healthcare providers and manage symptoms and quality of life issues (SQOL). For this study, we developed a Spanish version of the electronic self-report assessment for cancer (ESRA-C), a web-based program that helps people with cancer report, track, and manage cancer-related SQOL. Four methods were used to evaluate the Spanish version. Focus groups and cognitive interviews were conducted with 51 Spanish-speaking individuals to elicit feedback. Readability was assessed using the Fry readability formula. The cultural sensitivity assessment tool was applied by three bilingual, bicultural reviewers. Revisions were made to personalize the introduction using a patient story and photos and to simplify language. Focus group participants endorsed changes to the program in a second round of focus groups. Cultural sensitivity of the program was scored unacceptable ([Formula: see text]) for audiovisual material and acceptable ([Formula: see text]) for written material. Fry reading levels ranged from 4th to 10th grade. Findings from this study provide several next steps to refine ESRA-C for Spanish speakers with cancer.
authors.affiliation: University of South Florida, 4202 E Fowler Avenue, Tampa, FL 33620, USA ; University of Massachusetts Boston, 100 Morrissey Boulevard, Boston, MA 02125, USA ; Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA 02215, USA.
authors.forename: Cindy
authors.identifier: 0000-0002-3757-5823
authors.initials: C
authors.lastname: Tofthagen
authors.affiliation: Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA 02215, USA.
authors.forename: Barbara
authors.identifier: 0000-0001-6273-8674
authors.initials: B
authors.lastname: Halpenny
authors.affiliation: Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA 02215, USA.
authors.forename: Maribel
authors.identifier: 0000-0001-5314-0830
authors.initials: M
authors.lastname: Melendez
authors.affiliation: University of Central Florida, 4000 Central Florida Boulevard, Orlando, FL 32816, USA.
authors.forename: Laura
authors.initials: L
authors.lastname: Gonzalez
authors.affiliation: California Department of State Hospitals, P.O. Box 2297, Vacaville, CA 95696, USA.
authors.forename: Veronica
authors.identifier: 0000-0002-1778-6551
authors.initials: V
authors.lastname: Sanchez Varela
authors.affiliation: University of Massachusetts Boston, 100 Morrissey Boulevard, Boston, MA 02125, USA.
authors.forename: Rosalyn
authors.initials: R
authors.lastname: Negrón
authors.affiliation: Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA 02215, USA.
authors.forename: Donna L
authors.initials: DL
authors.lastname: Berry