1. Understanding and Implementing the CLAS Standards
Standard 7: Translated Materials (mandate)
Cont.
Community Involvement
Translated written materials should reflect the dialects and cultures of the communities being served, which requires more than just literal translation of the text. An alternative approach is to develop original written material in the target language through collaboration between members of the target community and the writer. Target-community focus groups can help:
- Avoid inclusion of any content that may be
embarrassing or offensive - Suggest the most culturally appropriate practices (eg, eating rice instead of pasta)
- Check whether graphics that include facial features or clothing reflect the diversity of the target community
This approach can be especially valuable for health education and disease prevention materials meant to motivate behavior change. When feasible, healthcare organizations should consider offering financial compensation or in-kind services to avoid overburdening community organizations that may be frequently asked to provide translation and review services.
Translation of Technical Information
In cases of translating highly technical medical language into consumer-oriented, easily understood materials—whether English or another language—balancing accuracy with patients’ language, culture, and literacy levels can pose complications and risks. Literal translations can be incomprehensible, irrelevant, or culturally insensitive; poor translations can provide inaccurate information.
For legal reasons, some healthcare organizations may employ highly precise, legalistic wording in their informed consent and other standard forms, but there are approaches that may help to head off concerns about legal difficulties:
- Meetings between the translator and practitioners to gain understanding of highly technical materials
- Having different criteria for translating forms, which are more specialized than educational materials and often involve legal issues
- Obtaining permission to revise and simplify the state health department’s standard English-language consent forms before translating them
New Technologies and Alternative Formats
Storing easily printed and updated documents electronically can let organizations maintain smaller inventories of these items. By using online (or “cloud”) storage for translated materials, organizations can maintain a centralized repository of commonly used documents, which can be downloaded and customized as needed. Such a repository can also facilitate necessary reviews and updates, which is necessary to keep materials current with healthcare advances.
Providers may consider seeking input from community-based organizations that have experience in developing information in a variety of formats that communicate ideas and reinforce important concepts. Examples include:
- A video showing a Haitian woman going through a grocery store and touching indigenous foods that contribute to a healthy diet
- Radio and audiotapes for people who cannot read
- Photographs or drawings showing medication dosages or a clock face with the times to take them to promote adherence among patients who cannot read labels
- A photoessay on early cancer detection to illustrate screening techniques with minimal words
Furthermore, various types of picture books can deliver health messages through a story format, and storytelling and drama may be effective in communicating with people who do not have a written language. For people with visual impairments, there are large-print, Braille, and audio materials and American Sign Language for hearing-impaired persons.
Oral Interpretation
In whatever form translated written materials are available, they cannot completely replace oral communication, which is a critical part of the exchange of information between healthcare providers and patients. This means that an organization whose language services are limited to providing written materials is, by definition, limiting access to LEP individuals. Therefore, organizations should develop an appropriate mix of written and oral language assistance.
