Table 1.

Practical issues in the use of multiple languages and implications for future research.

Practical Issues	Implications for Future Research
Difficulties in recruiting and retaining bilingual research team members.	Establish the plan for transitions from an old member to a new member. Plan frequent training sessions. Make plans for recruitment, retention, and training of bilingual research team members in advance.
Maintaining the Consistency in Translation Process	Set the standards for translation process at the early stage of the study. Need to be flexible in decisions making on research process.
Keeping Cultural and Conceptual Equivalence	Set the rules for direct phonetic translations in advance and as the study progresses. Use “transcreation” or adaptation process.
Repeating IRB Protocol Modifications	Need to check institutions’ IRB policies related to the use of multiple languages at an early stage of the study. Prepare the documents related to qualifications of translators, the rules set to ensure the consistency in translation among different translators, and the measures to ensure the accuracy of translation. Prepare multiple language versions of the informed consent, study flyers, and sample study announcements in advance.
Finding and Using Existing Translated Versions	Need to contact the original authors, conduct literature searches, and seek experts’ advice to check if there already exist different language versions of specific instruments.
Technological Issues	Check on the versions of electronic data system or software before planning their studies using multiple language versions. Try to adopt the most recent version of the system or software.