Objectives To translate and culturally adapt an English language patient decision aid addressing prostate cancer screening, so it can be used by Portuguese men.
Design Qualitative study. We followed the European Centre for Disease Prevention and Control’s (ECDC) five-step, stakeholder-based approach to adapting health communication materials: (1) selection of materials and process coordinators, (2) early review, (3) translation and back translation, (4) comprehension testing with cognitive semi-structured interviews and (5) proofreading. Content analysis was performed using Ligre software.
Setting and participants Cognitive interviews with 15 men to refine a decision aid after its translation. Eligible participants were Portuguese native-speaking men aged 55–69 years old recruited from the local community (urban and suburban) of Oporto district through advertisements in social media and senior universities between January and March 2019. A previous diagnosis of prostate cancer was the single exclusion criterion.
Results Five main themes are presented: informational content, information comprehension, sociocultural appropriateness, feelings and main message and personal perspective concerning prostate cancer screening. Most men found the translated version of the decision aid to be clear, comprehensive and appropriate for its target population, although some suggested that medical terms could be a barrier. The data collected from men’s interviews afforded the researchers the opportunity to clarify concepts and expand existing content.
Conclusions A decision aid was successfully translated and adapted to the Portuguese cultural setting. Our ECDC based approach can be replicated by other workgroups to translate and culturally adapt decision aids.
- decision making
- decision aid
- patient participation
- prostate cancer
- early detection
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Presented at 89th European General Practice Research Network meeting (EGPRN) - prize for best poster.
Contributors SB, BH, CM, MP and KLT designed the study. SB coordinated the translation process. SB, BG and DC conducted the interviews and their transcription, supervised by MP. SB and JPR coded the interviews. SB, JPR and AT undertook the data analysis. SB made the final manuscript. All authors approved the final manuscript after revising it critically.
Funding The authors have received financial support of €3808.20 from the #H4A Primary Healthcare Research Network scholars programme for support of research. This article was supported by National Funds through FCT - Fundação para a Ciência e a Tecnologia,I.P., within CINTESIS, R&D Unit (reference UIDB/4255/2020).
Competing interests None declared.
Patient and public involvement statement As target end-users of the prostate cancer screening decision aid, men are at at the core of our methodology. They were first involved during the usability and comprehensibility testing by participating in cognitive interviews. Men’s opinions and preferences were used to refine the decision aid and complete its cultural adaptation. We also intend to make the decision aid publicly available to all Portuguese men.
Patient consent for publication Not required.
Ethics approval The study was approved by the Health Ethics Committee from Centro Hospitalar Universitário de São João/Faculdade de Medicina da Universidade do Porto (reference 339-18).
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information.
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