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A larger pilot study (see page 21) is needed after translation to test whether the questions are understood correctly and discover those that may cause problems and require clarification (see page 13).
Cognitive interviewing is one approach to establish whether questions are understood, whether participants have the knowledge to complete questions and consistency of interpretation [ 18].
Cognitive interviewing techniques are well suited for this because the verbalized reflections of patients provide an excellent source of information to verify that questions are understood and answered to as intended.
It is difficult to know how these questions are understood by the respondents, and a reported rise in this behaviour may just refer to a rise in sexual activity among this population group- a finding worth consideration, but not the intended meaning of the question.
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The extent to which the results are representative of general practice is dependent on the number of responders, their geographic spread, how well the questions were understood, and whether they could be responded to in a reasonable amount of time.
An exploratory interview was conducted with an authorized auditor prior to the distribution of the questionnaire in order to check whether our questions were understood in the way we intended.
The principal investigator ensured that the questions were understood.
This may have affected how the questions were understood and answered.
The enumerators made sure that the questions were understood by the respondents.
Lastly, the questionnaire was piloted with five health workers to make sure the questions were understood and not unpleasant.
In order to ensure that questions were understood by the respondents, we had the questionnaire pilot tested by Gallup.
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Since I tried Ludwig back in 2017, I have been constantly using it in both editing and translation. Ever since, I suggest it to my translators at ProSciEditing.

Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com