# Danish translation and cultural adaptation of three implementation outcomes of healthcare innovations—acceptability, appropriateness, and feasibility

## TL;DR

This paper translates and adapts three tools for evaluating healthcare innovation implementation into the Danish context, ensuring they remain clear and relevant.

## Contribution

The study provides a culturally adapted Danish version of AIM, IAM, and FIM for assessing healthcare innovation implementation.

## Key findings

- The Danish versions of AIM, IAM, and FIM were successfully translated and adapted following Beaton’s guidelines.
- Pretesting showed items were generally clear, though some overlap and confusion were identified and resolved.
- The adapted tools maintain conceptual alignment with the original measures and are ready for practical use in Danish healthcare.

## Abstract

Implementation science has become increasingly important for improving uptake of healthcare innovations, which typically involves a broad range of stakeholders. The Acceptability of Intervention Measure (AIM), Intervention Appropriateness Measure (IAM), and Feasibility of Intervention Measure (FIM) are generic and adaptable outcome measures to assess the implementation of innovations across various settings and populations. However, their use in Denmark requires translation into the Danish language and a cross-cultural adaptation into the Danish healthcare context.

The study aimed to translate and cross-culturally adapt the AIM, IAM, and FIM for use in Danish healthcare settings. The translation process followed Beaton’s guidelines, encompassing six stages: translation, synthesis, backward translation, expert committee review, pretesting, and appraisal of the adaptation process. Both quantitative (questionnaires) and qualitative (interviews) methods were applied during pretesting to evaluate the Danish versions.

All stages of the translation and adaption process were completed. Linguistic challenges were identified, such as ensuring distinction between items, but they were resolved during the expert review. Pretesting with 33 Danish healthcare professionals showed that items were generally clear and relevant, but some overlap between AIM, IAM, and FIM items caused confusion. For example, IAM item 4 (“… seems like a good match”) was difficult to interpret, leading to missing responses, and FIM item 3 was revised to improve clarity.

The translation and cross‑cultural adaptation, including pretesting, of the AIM, IAM, and FIM resulted in Danish versions that maintained conceptual alignment with the originals. While additional evaluation across interventions, contexts, and practices will strengthen the evidence base, the current versions already provide a practical tool for assessing implementation outcomes in Danish healthcare contexts.

The online version contains supplementary material available at 10.1186/s43058-025-00848-0.