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

Abstract

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.

Hispanic Children With Special Health Care Needs From Spanish-Language Households

“…[19][20][21][22] An earlier study identified reluctance on the part of Hispanic parents who have limited English proficiency to disclose details about their children's health to anonymous telephone interviewers, 4 yet we found that the parents of Hispanic CSHCN living in Spanish-language households were as likely as parents of non-Hispanic white CSHCN to report the functional difficulties of their children.…”

“…12 Results of cognitive testing, however, indicate that the Spanish translations of the questions are well understood both culturally and linguistically by parents whose primary spoken language is Spanish. 4 Psychometric assessment of the screening instrument also did not reveal any measurement bias when comparing Hispanic children from Spanish-speaking households to other groups of children. 13 To better understand the nature of this disparity in CSHCN prevalence, we used data from the 2005-2006 NS-CSHCN to examine the health care needs of Hispanic children and focused on those who live in households in which Spanish is the primary language spoken.…”

“…2,3 However, the Hispanic child population has the lowest estimated prevalence of special health care needs relative to all other ethnic and racial groups except Asian children. 4,5 The lower estimated prevalence of special health care needs in the Hispanic population is driven primarily by the substantially lower proportion of children with special health care needs (CSHCN) identified among Hispanic children from households with limited English proficiency. In 2001, the prevalence of CSHCN among Hispanic children whose parents responded to the National Survey of Children With Special Health Care Needs (NS-CSHCN) interview in Spanish (5%) was less than half that of Hispanic children whose parents responded in English (12%).…”

“…In 2001, the prevalence of CSHCN among Hispanic children whose parents responded to the National Survey of Children With Special Health Care Needs (NS-CSHCN) interview in Spanish (5%) was less than half that of Hispanic children whose parents responded in English (12%). 4,6 Similarly, the 2003 National Survey of Children's Health and the 2004 Medical Expenditure Panel Survey revealed lower special-needs prevalence estimates (odds ratios [ORs]: Ͻ0.5) for children with Spanish (compared with English) as the primary language at home. 5 This observed disparity could be real (eg, if immigrant Hispanic children are indeed healthier 7,8 ), or it could result from underidentification of existing special needs as a result of health care access and communication barriers.…”

Tradução e adaptação do Children with Special Health Care Needs Screener para português do Brasil

“…Na versão em espanhol foi verificada a mesma dificuldade 13 . Ademais, aqueles em atendimento no ambulatório avaliaram a utilização do serviço médico como rotina e não como um follow-up.…”