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Evidence‑informed strategies for implementing cultural and linguistic adaptations in clinical research
Journal article   Open access   Peer reviewed

Evidence‑informed strategies for implementing cultural and linguistic adaptations in clinical research

Kari G. Vance, Raymond Teets, Lisa Doan, Sydney Whack, Dixie Ecklund, Laura Wandner, Kathleen A. Sluka and Giovanni Berardi
Journal of clinical and translational science, Vol.10(1), e162
09/21/2026
DOI: 10.1017/cts.2026.10821
Appears in  UI Libraries Support Open Access
url
https://doi.org/10.1017/cts.2026.10821View
Published (Version of record) Open Access

Abstract

Introduction: Large-scale pain studies risk reduced generalizability when participants do not reflect the linguistic and cultural representation of populations disproportionately affected by chronic pain. Cultural and linguistic adaptations can improve recruitment and retention of non‑English‑speaking participants, yet implementation remains inconsistent and under‑documented. This study aimed to characterize real‑world strategies, barriers, and facilitators encountered by clinical research teams implementing cultural and linguistic adaptations and to develop practical guidance for future studies. Methods: A survey was distributed to 36 NIH‑HEAL–funded studies with evidence of recruiting of non‑English recruitment. Respondents (principal investigators, coordinators, and study staff) reported on cultural and linguistic adaptation methods, resources, experiences, and outcomes. Quantitative items were summarized descriptively, and open‑text responses were analyzed using an iterative descriptive qualitative approach integrating thematic and quantitative findings. Results: Eighteen surveys were completed and included in the analysis. Three recommendation-based orientations emerged, full, conditional, and reserved endorsement, aligning with differences in motivations, timing, resource allocation, and demographic recruitment success. Common barriers included regulatory delays, translation and database integration costs, and difficulty or shortages of hiring bilingual staff. Key facilitators included embedded linguistic and cultural expertise, alignment between recruitment sites and local demographics, and early, sustained community engagement. Conclusions: Implementing cultural and linguistic adaptations is feasible but resource‑intensive. Early planning, adequate budgeting, bilingual staffing, strategic site selection, and stakeholder engagement are central to successful recruitment of non‑English‑speaking participants. These findings offer guidance to enhance equity, generalizability, and efficiency in pain‑focused clinical research.
 Cultural competency implementation science cultural adaptation linguistic adaptation clinical research UIOWA OA Agreement

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