Addressing Cross-Cultural Adaptation of Patient Reported Outcome Measures for Distal Radius Fractures - PROJECT SUMMARY: Distal radius fractures are one of the most commonly occurring fractures and represent a great morbidity burden in the United States and worldwide. Patient reported outcome measures (PROMs) that assess patients’ physical function are the standard for assessing treatment outcomes and can help inform treatment decisions for patients with distal radius fractures. Notably, however, PROMs must be linguistically and culturally relevant to appropriately measure physical function and inform care. There are currently no appropriately culturally adapted PROMs to assess the physical function of Spanish-speaking patients with distal radius fractures. As PROM scores affect care decisions, mismeasurement from the lack of cultural adaptation can affect clinical care and patient outcomes. The development and validation of culturally adapted PROMs for Spanish- speaking patients with distal radius fractures will yield new knowledge about gaps in the cultural adaptation of linguistically translated PROMs and provide the foundation for future R01 proposals to study the impact of cross-culturally adapted PROMs on measuring physical function, subsequent treatment decisions, and outcomes for patients with distal radius fractures and other orthopaedic injuries. By including patients from two countries, we can assess the impact of culture on outcome measurement which may be generalizable to patients in the United States and worldwide. This K23 Award will provide Dr. Shapiro focused training and mentorship in three critical areas: 1) conducting psychometric evaluations of PROMs using mixed-methods research designs, 2) understanding the cultural and linguistic influence on health and outcome measurement, and 3) conducting trials of outcomes measurement tools in diverse populations. Dr. Shapiro has assembled a team of mentors that includes: Dr. Patricia Katz (Professor Dept. of Medicine, UCSF), Dr. Alicia Fernandez (Professor Dept. of Medicine and Associate Dean, UCSF), Dr. Theodore Miclau (Professor Dept. of Orthopaedic Surgery and Vice Chair, UCSF). This is supplemented by a team of expert advisors and domestic and international collaborators. We aim to 1) assess the content validity of the Patient-Reported Outcomes Measurement Information System – Physical Function (PROMIS-PF) for measuring physical function in Spanish-speaking patients, 2) adapt the PROMIS-PF for two Spanish-speaking populations with distal radius fractures, and 3) validate and pilot test the new culturally-adapted PROMIS-PF tools. This will be the first study to evaluate the impact of culture on PROM items and to subsequently cross-culturally adapt, validate, and pilot test cross-culturally adapted PROMs using mixed-methods design for two Spanish-speaking populations. The new PROMs can serve as the foundation for future R01 proposals to study the impact of cross-culturally adapted PROMs on treatment decisions and outcomes.
