Translation is not enough

ECDC report
European Centre for Disease Prevention and Control guide to multilingual adaptation of health communication materials

Introduction to guide

This guide introduces an innovative five-step, stakeholder-based approach to adapting health communication materials. It describes how countries can take any health communication material, produced in English or other languages) and create adapted products which reflect national or local realities, needs and assets without losing the scientific correctness, core concepts and messages of the original version.

Translation alone is not enough. End-user utility is key. Country-based users of internationally-produced health communication resources need to be able to read, understand and apply the translated materials within their own contexts. Too often however, little or no attention is given to end-user comprehensibility and the cultural appropriateness of even well translated materials. Valuable health communication materials that have been shown to effectively inform, motivate, guide and support health interventions in their countries of origin can get ‘lost in translation’.

Multi-country health communication material translation projects usually devote too little time and resources to assessing the specific information needs and assets of different national audiences. End-users tend to be the passive recipients of translated products and have little or no input into the cultural adaptation of these materials to national and local contexts. Formative research, aimed at involving relevant stakeholders, is not routinely included in the planning, development, dissemination and evaluation of translation project processes. A variety of useful approaches to gathering end-users’ insights and process inputs have been described by health promoters, social marketers, behavioural communicators and others. Few, however, have been systematically tested and applied to the adaptation of internationally developed (and translated) health communication materials in different contexts. No internationally acknowledged adaptation standards have been agreed to date.

The five-step methodology presented here has been developed, tested and evaluated through a series of European Centre for Disease Prevention and Control (ECDC) projects with public health practitioners, agencies and associations in seven European Union countries. These pilot projects focussed on translating and adapting the first version of an ECDC communication action guide for healthcare providers entitled ‘Let’s talk about protection’. While this methodology was developed for specific communicable disease-related materials (the guide focuses on increasing childhood vaccination uptake), it can be applied to any communication or training resource in public health and other sectors.

This guide is divided into two parts. Part 1 describes the five steps of the stakeholder-based approach. Part 2 describes lessons learned from applying this approach in ECDC-supported projects to pilot and adapt the guide in Bulgaria, Croatia, Czech Republic, Estonia, Greece, Hungary and Romania.

To find out more

European Centre for Disease Prevention and Control (2016) Translation is not enough: Cultural adaptation of health communication materials, Stockholm. ECDC.

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