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Do you work in the healthcare space and you’re looking for patient-friendly translations? You’re not alone! This topic has crossed our desk more than once lately, from determining Spanish readability to questions about the Japanese translation for “fast heartbeat.” Patient-friendly translation brings together a few of our specialties: plain language and healthcare translations.

What is plain language?

A hand draws two ways to get from point A to point B, one is winding and complicated, and the other is a straight line.Despite the Plain Writing Act being in effect in the United States for over a decade, there are still many misconceptions about what plain language is. The Center for Plain Language defines it as “communication with clear wording, structure, and design for the intended audience to easily find what they need, understand what they find, and use that information.” And while you may be familiar with certain readability metrics or tests, plain language doesn’t mean “only using words with 3 or fewer syllables” or “only using sentences with 10 or fewer words.” One of the reasons a definition like this doesn’t hold up is because “plain language” goes beyond “plain English.” Different languages’ vocabulary and grammar require different metrics where plain language is concerned. Some words also have a limited number of synonyms, and attempting to convey their meaning with several shorter words may lead to confusion rather than clarity. Patient-friendly translation will incorporate plain language principles.

Patient-friendly translation means writing (and translating) with patients in mind.

We find that plain language can be used in most communications. With that being said, translating a medication insert for doctors is very different from translating a medication insert for patients. If you know for sure that your audience has specialized knowledge of the subject matter at hand, technical terms in your source copy (and your translation) shouldn’t be a problem. It’s important, however, not to assume that someone with a high level of education will understand something that was written for a professional in a specialized field. Someone with a master’s degree in accounting, for example, will easily understand a tax form, but they may still struggle to understand their doctor’s notes in their patient portal or instructions for how to install a new smart appliance in their home. Our recommendation for patient-friendly translation is to start with plain language in your source document. We can help with plain language writing!

Another consideration in patient-friendly translation is how to handle short-hand terms or acronyms. You may be familiar with the FAST acronym for stroke detection. The letters F, A, and S stand for “face drooping,” “arm weakness,” and “speech difficulty,” which are telltale symptoms of a stroke, while T stands for “time to call 911.” “Fast” is a straightforward word that native English speakers should be able to easily remember, especially since it alludes to the importance of early detection and treatment of a stroke. For non-English speakers, however, the acronym “FAST” may very well be meaningless. Researchers at the University of Texas Health Science Center at Houston created a Spanish version of this mnemonic: RÁPIDO. You can now find various Spanish-language materials about stroke detection that include the RÁPIDO acronym. If these translated equivalents don’t already exist, however, we don’t necessarily recommend creating them yourself. The team who came up with RÁPIDO spent months developing it and it’s important to test these tools with target audiences (more on that in a bit), rather than assuming they will be effective or well-received.

Patient-friendly translation involves a team who understands plain language principles.

An excerpt from a Spanish patient guide for BIKTARVY that uses the word "medicina"The Plain Language Association International (PLAIN) has resources available in several languages. Ask your language service provider (LSP) to give you some background on their experience with plain language. When translating medication inserts or information about managing certain conditions, we are always intentional about the words we’re using in the target language. For example, we tend to prefer translating “medication” as “medicina” in Spanish, rather than “medicamento.” “Medicamento” is not incorrect, and we do use that translation sometimes. “Medicina,” however, is not only a shorter word, but it is also much more widely used. According to the Real Academia Española’s 21st century Spanish language corpus, the word “medicina” is used approximately four times as often as the word “medicamento.” Recently, we were helping a client update a Spanish-language brochure about stroke risk. Whoever translated the brochure previously used the term “derrame cerebral” for stroke. That term is not incorrect, but translations such as “ataque cerebral” and “accidente cerebral” are also correct and use words that are understood in a wide variety of contexts. This could be seen as a more patient-friendly translation.

A flyer about COVID-19 prevention in Haitian CreoleI had the pleasure of hearing Marleen Julien, the founder and chief Creolist at Creole Solutions, speak about plain language at the American Translators Association conference in Miami last month. You can listen to her discuss plain language with Leslie Miller O’Flahavan on the Creole Solutions blog. Marleen explains that “Haitian Creole follows many of the principal rules [of plain language writing].” She specifies that Haitian Creole has fewer verb tenses than English, doesn’t use the passive voice, and is more likely to identify subjects and objects (i.e., use specific pronouns rather than make passive, impersonal statements). Like many languages, however, Haitian Creole is also typically expansive compared to English. This means that it may take more words to say the same thing. This doesn’t mean, however, that it’s not a patient-friendly translation. One example Marleen gives is the phrase in English “participation is voluntary.” A direct translation into Haitian Creole would be essentially meaningless, while a translation that says “you do not have to participate” uses more words but is more easily understood.

Sandra Fisher-Martins, a plain language advocate in Portugal, gave a TEDx talk in 2011 with some powerful takeaways that are applicable across languages and cultures. She quotes Einstein, who once said “if you can’t explain it simply, you don’t understand it well enough.” It’s easy to hide behind big words and technical terms that seem to demonstrate expertise. But if you can’t explain what those words and terms mean, do you really understand them? Sandra recommends three primary strategies: start with what’s most important, use short sentences, and use words people know. To a certain degree, these concepts are subjective. But that’s what makes her message applicable across cultures, languages, and fields. And when in doubt, test your materials with members of your target audience.

Begin and end with patient perspectives.

A woman takes notes while a man next to her uses a computerIf you’ve ever asked someone to edit an essay or even an email for you, you are likely aware that we can’t always know how someone else will read and comprehend our writing. Our standard translation process involves a professional translator + editor team. This helps ensure accuracy, comprehension, and originality. But no matter how qualified your translation team is, they may not necessarily fit the profile of your target audience. To cover all your bases, we recommend testing your materials (source and translation) with your target audience. Employ the teach-back or the show-me method. Don’t ask your testers “did you understand?” This question may elicit a deceiving response for several reasons. For example, the person may think they understood, they may be embarrassed to say that they did not understand, or they may be in a hurry to move on to something else. Asking them to execute an instruction or explain to you what they just read in their own words is a much more effective way to determine whether your asset communicates what you mean it to.

If you’re looking for patient-friendly translations, you’ve come to the right place. We strive to help like-minded clients achieve positive outcomes for their patients, clients, and employees. Get in touch to see if we’re a good fit for you and those you serve.