Development of a Linguistically and Culturally Appropriate Booklet for Latino Cancer Survivors: Lessons Learned

Abstract

In response to the need for linguistically and culturally appropriate cancer survivorship materials for Latinos, the Office of Education and Special Initiatives and the Office of Cancer Survivorship at the National Cancer Institute (NCI) set out to test, adapt, and refine a Spanish translation of an English-language booklet for adult cancer survivors titled Facing Forward: Life After Cancer Treatment (Siga adelante: la vida después del tratamiento del cáncer). The authors used a process called "transcreation," which involves translating existing English-language materials into Spanish and then adapting them for Latino audiences. The Spanish version of the booklet was reviewed by nine Spanish-speaking reviewers who were cancer survivors. The multistage transcreation process reinforced the importance of conducting formative research as well as adjusting the methodology to address the needs of changing demographics.

Using a Participatory Four-Step Protocol to Develop Culturally Targeted Cancer Education Brochures

“…The chosen medium must be appropriate for the message and the audience, the information must be seen as coming from a credible source, there must be congruence between the message text and graphics, the look should be culturally appealing, and the message must be clear so that the audience comprehends its learning and behavioral intentions (Brandt, McCree, Lindley, Sharpe, & Hutto, 2005;Doak et al, 1985;Flay et al, 1980;Hunter, 2005;Meade, 2005;NCI, 1998;Solomon et al, 2005;Taylor et al, 2002). Looking specifically at cancer messages, research suggests that individuals want cancer messages that give them hope for preventing cancer and that use neutral terms (e.g., the word risk raises alarm, whereas the word chance minimizes it; NCI, 1998;Richard et al, 1999).…”

“…It is important also to include information on risk, screening recommendations, and where to get additional information. Formative research strategies, such as focus groups, are helpful in learning audience preferences for credible sources of health information, effective messaging, and the look of the educational materials (Morgan & Krueger, 1998;Solomon et al, 2005). Draft materials must be tested for attractiveness, as well as for readability and message comprehension (Doak et al, 1985;NCI, 1998).…”

Feasibility trial of a Spanish-language multimedia educational intervention

“…18–21 Furthermore, the video used in our study was transcreated rather than translated with voiceover. Transcreation has been shown to be more effective than translation in educating Hispanics because it considers both the language and culture of the target population 8, 22 . Our study differs from other audiovisual interventions reporting increased knowledge in that the post-intervention questionnaire was administered two weeks after the intervention, rather than immediately after exposure to the intervention.…”

“…6–8 Transcreation is the process of adapting not only the text of written materials, but infusing culturally relevant context, photos and themes. In transcreated materials, the text is not merely translated into another language, but reconstructed to meet the health literacy and informational needs of the target audience.…”

“…7 Multistage qualitative approaches are needed to ensure health education materials are linguistically and culturally relevant for the heterogeneous populations of Hispanics. 7, 8 …”