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An Evaluation of the Linguistic and Cultural Validity of the Spanish Language Version of the Children with Special Health Care Needs Screener

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Abstract

Objectives

The 2001 National Survey of Children with Special Health Care Needs (CSHCN) used the CSHCN Screener, a 5-item survey based tool, to identify children with special health care needs. The prevalence of special health care needs for Hispanic children was lower than that reported for all other ethnic and racial groups, with the exception of Asian children. To better understand the reasons for the lower prevalence rate, this study examined variations in CSHCN prevalence for Hispanic children according to whether parents responded to the National Survey of CSHCN screening interview in Spanish or English. The Spanish translation of the CSHCN Screener was further evaluated through a series of face-to-face interviews with parents with limited English proficiency (LEP).

Methods

The 2001 National Survey of CSHCN screened 372,174 children ages 0–17 years for special health care needs. Bivariate and multivariate analyses were conducted to examine the effects of interview language on the CSHCN prevalence rates for Hispanic children (n = 47,371). Using a standardized protocol, cognitive interviews were conducted in Spanish with 19 LEP parents to elicit their comprehension of and reactions to the screening questions.

Results

When parents were interviewed in English, 11.7% of Hispanic children were identified as CSHCN. When parents were interviewed in Spanish, 5.1% of Hispanic children were identified as CSHCN. Lower prevalence of the need for or use of prescription medications for chronic conditions made the largest contribution to the observed difference in CSHCN prevalence. Cognitive interviews with parents did not identify any linguistic or cultural deficiencies in the Spanish translation of the CSHCN Screener. Parents did express disinclination toward sharing details of their children’s health in the context of a typical telephone survey.

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Author information

Authors and Affiliations

  1. Department of Pediatrics, School of Medicine, The Child and Adolescent Health Measurement Initiative, Oregon Health and Science University, 707 SW Gaines Road, Mail Code CDRCP, Portland, OR, 97239-2998, USA

    Debra Read & Christina Bethell

  2. National Center for Health Statistics, Centers for Disease Control and Prevention, 3311 Toledo Road, Room 2112, Hyattsville, MD, 20782, USA

    Stephen J. Blumberg

  3. Prevention Research Center, Boston University School of Public Health, Boston, MA, 02118, USA

    Milagros Abreu

  4. Private Consultant, Spanish Interpretation Services, Portland, OR, USA

    Clara Molina

Authors
  1. Debra Read
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  2. Christina Bethell
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  3. Stephen J. Blumberg
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  4. Milagros Abreu
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  5. Clara Molina
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Corresponding author

Correspondence to Debra Read.

Appendix A: Children with Special Health Care Needs (CSHCN) Screener as Used in the National Survey of CSHCN

Appendix A: Children with Special Health Care Needs (CSHCN) Screener as Used in the National Survey of CSHCN

English language versiona

Spanish language versiona

(1) Does your child (Do any of your children) need or use medicine prescribed by a doctor, other than vitamins?

(1) Actualmente, ¿necesita o usa su niño/a (alguno de sus niños) medicamentos recetados por un doctor, aparte de vitaminas?

  (1_a) Is (CHILD 1, CHILD 2...)’s need for prescription medicines because of ANY medical, behavioral or other health condition?

  (1_a) Con respecto a [CHILD #1, Child #2]: ¿Es la necesidad por medicina recetada debido a algún problema médico, de comportamiento o otro problema de salud?

  (1_b) Is this a condition that has lasted or is expected to last 12 months or longer?

  (1_b) ¿Eséste un problema que ha durado o se piensa que dure 12 meses o más?

(2) Does your child (Do any of your children) need or use more medical care, mental health or educational services than are usual for most children of the same age?

(2) ¿Su niño/a (Alguno de sus niños) necesita o usa más servicios de atención médica, salud mental, o educativos de lo que es común para la mayoría de los niños de la misma edad?

  (2_a) Is (CHILD 1, CHILD 2...)’s need for medical care, mental health or educational services because of ANY medical, behavioral or other health condition?

  (2_a) Con respecto a [CHILD #1, Child #2 ]: ¿Es la necesidad por atención médica, salud mental o educativos debido a algún problema médico, de comportamiento o otro problema de salud?

  (2_b) Is this a condition that has lasted or is expected to last 12 months or longer?

  (2_b) ¿Eséste un problema que ha durado o se piensa que dure 12 meses o más?

(3) Is your child (Are any of your children) limited or prevented in any way in his or her (their) ability to do the things most children of the same age can do?

(3) ¿Está su niño/a (alguno de sus niños) limitado(a) o impedido(a) de alguna manera en su habilidad de hacer cosas que la mayoría de niños de la misma edad pueden hacer?

  (3_a) Is (CHILD 1, CHILD 2...)’s limitations in abilities because of ANY medical, behavioral or other health condition?

  (3_a) Con respecto a [CHILD #1, Child #2]: ¿Es este limitado(a) o impedido(a) el de debido a algún problema médico, de comportamiento o otro problema de salud?

  (3_b) Is this a condition that has lasted or is expected to last 12 months or longer?

  (3_b) ¿Eséste un problema que ha durado o se piensa que dure 12 meses o más?

(4) Does your child (Do any of your children) need or get special therapy, such as physical, occupational, or speech therapy?

(4) ¿Su niño/a (Alguno de sus niños) necesita o recibe terapia especial, como terapia física, ocupacional o del habla?

  (4_a) Is (CHILD 1, CHILD 2...)’s need for special therapy because of ANY medical, behavioral or other health condition?

  (4_a) Con respecto a [CHILD #1, Child #2]: ¿Es la necesidad el de por terápia especiál debido a algún problema médico, de comportamiento o otro problema de salud?

  (4_b) Is this a condition that has lasted or is expected to last 12 months or longer?

  (4_b) ¿Eséste un problema que ha durado o se piensa que dure 12 meses o más

(5) Does your child (Do any of your children) have any kind of emotional, developmental, or behavioral problem for which he/she (they) need(s) treatment or counseling?b

(5) ¿Tiene su niño/a (alguno de sus niños) algún tipo de problema emocional, de desarrollo o de comportamiento, por lo que necesita tratamiento o terapia/consejería?*

  (5_a) Has (CHILD 1, CHILD 2...)’s emotional, developmental, or behavioral problem lasted or is it expected to last 12 months or longer?

  (5_a) Con respecto a [CHILD #1, Child #2]: ¿Es este un problema de emocional, de desarrollo o de comportamiento que ha durado o se piensa que dure 12 meses o más?

  1. a Affirmative responses to the initial question about the health care consequence and to each of the two follow-up questions are necessary for a child to meet a specific screening criterion
  2. b Question 5 has a single follow up question asking about duration of child’s emotional, developmental, or behavioral health conditions. Affirmative responses to the initial question about the need for treatment and counseling and to the follow-up question about the duration of the condition are required for a child to meet this screening criterion

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Read, D., Bethell, C., Blumberg, S.J. et al. An Evaluation of the Linguistic and Cultural Validity of the Spanish Language Version of the Children with Special Health Care Needs Screener. Matern Child Health J 11, 568–585 (2007). https://doi.org/10.1007/s10995-007-0207-2

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