Cross-Cultural Translation: Methodology and Validation

Translating questionnaires for cross-cultural research is fraught with methodological pitfalls that threaten research validity. Some flaws are difficult to detect, leading to the erroneous conclusion that cultural differences are substantive when, in fact, they stem from semantic inconsistencies. We describe the process of translation and validation of the Hebrew version of an American questionnaire for cross-cultural comparisons of medical students' attitudes toward preventive medical services. The results provide evidence to support the validity of the Hebrew instrument for cross-cultural comparisons. Although it is always possible to contend that differences in cross-cultural comparisons result from metiodological flaws rather than actual differences, we believe that the arduous step-by-step process of validation described here reduces that possibility to an acceptable minimum.