ALSATION Study Protocol: Romanian Translation of Three Health Literacy Surveys.

Access to the internet and online resources changes the concept of health and increases people's autonomy. In this context, Health Literacy (HL) is a critical determinant of health-related choices. At World Health Organization (WHO) level, M-POHL (Action Network on Measuring Population and Organizational Health Literacy of WHO-Europe) created and validated on European population four questionnaires: digital HL (HLS19-DIGI), communication HL (with doctors from health care services - HLS19-COM-P-Q11 long version and HLS19-COM-P-Q6 short version), online navigation HL (HLS19-NAV), and vaccination HL (HLS19-VAC). Based on the expertise of the team, the present study aimed to report the study protocol for Romanian translation, culturally adapting and psychometric testing the following three M-POHL health literacy tools: HLS19-DIGI, HLS19-NAV, and HLS19-COM-P-Q11, HLS19-COM-P-Q6. We will conduct a qualitative descriptive study design in seven steps to translate and adapt the HLS19-DIGI, HLS19-NAV, and HLS19-COM-P-Q11, HLS19-COM-P-Q6 to the Romanian speakers. The study will begin with the translation of English (En)-Romanian (Ro) (2 researchers involved) (step 1), followed by the evaluation of the translation by a bilingual researcher independent of the two researchers who did the En-Ro translation (step 2), the translation of Ro-En (2 researchers but not those in step 1; step 3), the evaluation of the translation by a bilingual researcher independent of the two researchers who did the Ro-En translation (step 4), evaluation of the translation of the tool in an expert group (step 5), pilot testing on a sample of the target population (step 6) and full psychometric testing of the version resulting from step 6 (step 7).