title: Improving access to shared decision-making for Hispanics/Latinos with inadequately controlled type 2 diabetes mellitus.
abstract: OBJECTIVE
  To describe the cultural and linguistic adaptation and Spanish translation of an English-language patient decision aid (PDA) for use in supporting shared decision-making in Hispanics/Latinos with type 2 diabetes mellitus (T2DM), a group at a high risk for complications.
  
  
  METHODS
  A steering committee of endocrinologists, a primary care physician, a certified diabetes educator, and a dietician, each with extensive experience in providing care to Hispanics/Latinos was convened to assess a PDA developed for English-speaking patients with T2DM. English content was reviewed for cultural sensitivity and appropriateness for a Hispanic/Latino population. A consensus-building process and iterative version edits incorporated clinician perspectives. The content was adapted to be consistent with traditional Hispanic/Latino cultural communication precepts (eg, avoidance of hostile confrontation; value for warm interaction; respect for authority; value of family support for decisions). The PDA was translated by native-speaking individuals with diabetes expertise.
  
  
  RESULTS
  The PDA underwent testing during cognitive interviews with ten Spanish-speaking Hispanics/Latinos with T2DM to ensure that the content is reflective of the experience, understanding, and language Hispanic/Latino patients use to describe diabetes and treatment. Content edits were made to assure a literacy level appropriate to the audience, and the PDA was produced for online video dissemination.
  
  
  CONCLUSIONS
  High-quality, well-developed tools to facilitate shared decision-making in populations with limited access to culturally sensitive information can narrow gaps and align care with individual patient preferences. A newly developed PDA is available for shared decision-making that provides culturally appropriate treatment information for inadequately controlled Hispanics/Latinos with T2DM. The impact on the overall health of patients and care management of T2DM requires further study.
authors.affiliation: Touchstone Diabetes Center, University of Texas Southwestern Medical Center, Dallas, TX, USA.
authors.forename: Jaime A
authors.initials: JA
authors.lastname: Davidson
authors.affiliation: Rosales Communications, Philadelphia, PA, USA.
authors.forename: Aracely
authors.initials: A
authors.lastname: Rosales
authors.affiliation: EPI-Q, Inc., Oakbrook, IL, USA.
authors.forename: Alicia C
authors.initials: AC
authors.lastname: Shillington
authors.affiliation: Health Economics and Outcomes Research, Janssen Scientific Affairs, LLC, Raritan, NJ, USA.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Bailey
authors.affiliation: EPI-Q, Inc., Oakbrook, IL, USA.
authors.forename: Chris
authors.initials: C
authors.lastname: Kabir
authors.affiliation: Division of Endocrinology and Metabolism, Emory University, Atlanta, Georgia, GA, USA.
authors.forename: Guillermo E
authors.initials: GE
authors.lastname: Umpierrez
keywords: Hispanic; decision making; language adaptation; patient decision aid; type 2 diabetes