Protocol: Spanish Adaptation of a Digital Health Readiness Screener
J. Rayo, R.L. Fritz.
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AbstractPURPOSE: Older Spanish-speaking adults face disproportionate barriers to telehealth and patient portals, exacerbating health inequities. While validated survey tools exist to measure digital health literacy in Spanish, no validated instruments comprehensively assess digital health readiness, including both technical preparedness and quality-of-care concerns. [1] To address this gap, this project applies a standardized methodology for translation and cultural adaptation to translate and culturally adapt the Digital Health Readiness Screener (DHRS; 24 items; two factors: technical readiness; quality-of-care concerns) for future use among Spanish-speaking older adults with chronic conditions, addressing a key equity gap in readiness measurement. [1,2] Method Phase 1 follows a multi-step translation and adaptation process to ensure linguistic, conceptual, and cultural equivalence with the original English DHRS. Steps include: (1) dual independent forward translations into Spanish, (2) reconciliation into a single Spanish version through translator consensus, (3) back-translation into English for verification, (4) bilingual expert-panel review to evaluate semantic and cultural relevance, and (5) cognitive debriefing interviews with Spanish-speaking older adults to optimize clarity, tone, and cultural appropriateness. [1] This abstract reports on Phase 1 methods and outlines the planned Phase 2 quantitative psychometric evaluation, including internal consistency, test-retest reliability, and two-factor confirmatory factor analysis. RESULTS AND DISCUSSION: The Phase 1 process demonstrates how a digital health readiness screener can be both linguistically and culturally adapted. Professional translators conduct forward translations and a reconciliation panel produces the harmonized draft. Experts with clinical and methodological experience use structured review logs and cognitive-debriefing guides to resolve discrepancies and document decisions. Cognitive interviews with older Spanish-speaking adults focus on clarity, comprehension, and cultural fit, ensuring items reflect contextual realities such as family-centered technology use and perceived provider trust. The pre-final Spanish version (DHRS-ES) will serve as the foundation for Phase 2 psychometric validation. Once validated, the DHRS-ES can inform navigation support, training programs, and equity-centered design strategies aimed at closing the digital readiness gap. This methodologically rigorous, equity-driven adaptation approach supports inclusive gerontechnology by ensuring readiness assessments are meaningful across linguistic and cultural groups.Keywords: digital health readiness; Spanish translation; older adults; psychometrics; equity
J. Rayo, R.L. Fritz. (2026). Protocol: Spanish Adaptation of a Digital Health Readiness Screener. Gerontechnology, 25(2), 1-10
https://doi.org/10.4017/gt.2026.25.2.1337.3