# Design, adaptation and content validation of the Sheffield Profile for Assessment and Referral for Care in Colombian Spanish (SPARC-Sp-Col)

## TL;DR

This paper introduces a culturally adapted version of a tool to assess palliative care needs in Colombia, improving clarity and relevance for local patients.

## Contribution

The paper presents a Colombia-specific module for the SPARC-Sp tool, enhancing its cultural relevance and usability in low-literacy settings.

## Key findings

- The SPARC-Sp-Col tool achieved good content validity with Aiken’s V > 0.5.
- The adaptation process included 17 new items addressing local needs like housing and healthcare navigation.
- Cognitive interviews and focus groups improved clarity and cultural resonance of the tool.

## Abstract

Palliative Care (PC) aims to improve the quality of life of individuals with life-threatening illnesses through the early identification and management of holistic needs. Many Colombians in need of PC die without having access to it. When we previously adapted and validated the Sheffield Profile for Assessment and Referral to Care for Spanish-speaking populations (SPARC-Sp), users reported unmet needs and challenges in comprehension and self-administration, particularly among those with lower literacy levels. We designed, culturally adapted, and validated a Colombia-specific module, SPARC-Sp-Col, as an enhancement to SPARC-Sp, to better capture the holistic PC needs of Colombian patients.

We used a five-step qualitative methodology: (1) preliminary adaptation of a Colombia-specific module as add-on to SPARC-Sp for the Colombian context; (2) online expert panel review; (3) integration of feedback and iterative refinement; (4) cognitive interviews with patients; and (5) focus groups with healthcare professionals, patients, and caregivers from across Colombia.

The iterative adaptation process led to the refinement of item language for improved clarity and cultural resonance, while maintaining semantic equivalence with its original version. We included 17 new items to reinforce existing domains and a dedicated Colombia-specific module to address unmet local needs (5 of them) including housing conditions, violence and navigating the health care system. The evaluation of the resulting tool, SPARC-Sp-Col, demonstrated good content validity according to Aiken’s V (> 0.5), reflective of feedback from expert consensus, allied and social healthcare professionals, patient and caregivers.

SPARC-Sp-Col is a culturally adapted, content-validated instrument that expands SPARC-Sp by incorporating a Colombian-specific module. It enables a more accurate and context-sensitive assessment of the holistic care needs of cancer patients in Colombia. Its development marks a key step toward improving the timely and equitable delivery of PC in a country where access to appropriate support is often lacking.

The online version contains supplementary material available at 10.1186/s12904-026-02030-2.