title: Cognitive Interviewing to Enhance Comprehension and Accuracy of Responses to a Spanish-Language Nutrition Program Evaluation Tool.
abstract: OBJECTIVE
  To cognitively test a Spanish translation of a questionnaire evaluating parent and child food and activity behaviors and assess accuracy of understanding and ease of answering.
  
  
  METHODS
  Iterative rounds of cognitive interviewing, qualitative analysis, and revision were conducted with 19 low-income, native Spanish-speaking mothers of children aged 3-11 years, in 5 communities in New York. Key informant interviews were conducted with 2 Spanish-speaking nutrition educators experienced with the questionnaire.
  
  
  RESULTS
  Based on responses, improvements were made to (1) ensure clear and familiar wording, (2) clarify time frames for specifying the frequency of behaviors, and (3) express constructs not amenable to direct translation or for which meanings differed by country of origin. Cognitive interviewing results also informed improvements to the English language version.
  
  
  CONCLUSIONS
  Even after translation by native speakers, in-depth cognitive interviewing is needed to ensure that questionnaires are understood as intended by low-literacy, immigrant populations and to facilitate collection of valid evaluation data.
authors.affiliation: Division of Nutritional Sciences, Cornell University, Ithaca, NY. Electronic address: kld12@cornell.edu.
authors.forename: Katherine L
authors.initials: KL
authors.lastname: Dickin
authors.affiliation: Division of Nutritional Sciences, Cornell University, Ithaca, NY.
authors.forename: Flor
authors.initials: F
authors.lastname: Larios
authors.affiliation: Division of Nutritional Sciences, Cornell University, Ithaca, NY.
authors.forename: Pilar A
authors.initials: PA
authors.lastname: Parra
mesh_terms: D003144:Communication Barriers; D032882:Comprehension; D006266:Health Education / Q000379:methods* / Q000592:standards*; D006630:Hispanic or Latino; D006801:Humans; D007407:Interviews as Topic; D009752:Nutritional Status; D011203:Poverty; D015397:Program Evaluation; D011795:Surveys and Questionnaires; D014177:Translations
keywords: Hispanic; low-income families; nutrition education; questionnaire development