Evaluation of Adapted Health Education Materials for Limited English Proficient Spanish-Speaking and Mexican Indigenous Populations

Theoretical Background and research questions/hypothesis: In the United States, almost 30 million people who speak a language other than English at home have limited proficiency in English. As this population continues to grow, so does their need for culturally and linguistically appropriate health communications. Providing health information that takes into account their cultural framework, is at the proper literacy level, and uses language they can understand is crucial for reaching limited English proficient (LEP) populations. The largest share of LEPs is Spanish speakers who represent a very diverse population from Latin America, the majority of whom are foreign-born and have their own cultural and linguistic identities. Current communication practices at CDC primarily focus on English materials and in recent years, producing content that follows plain language recommendations. Some materials are translated into Spanish and, less frequently, into other foreign languages, though there is no systematic process to ensure that those translations are also in plain language and take into consideration cultural or linguistic nuances. This evaluation will add to the limited body of knowledge available about communication and channel preferences for Spanish-speaking and Mexican indigenous LEP populations on communicable diseases.

Methods: First, a literature review and environmental scan were conducted to examine the health communication and education needs of these two groups. Findings determined that radio and visual formats with limited text are recommended for this audience. Nine key informant interviews were then conducted with CDC internal and external subject matter experts on best practices and communication preferences for Spanish-speaking and Mexican indigenous LEPs. They emphasized the need to evaluate existing materials and to develop and test new materials that meet the communication needs of the target population. This feedback was used to determine the need to adapt posters in Spanish plain language on TB and unsafe queso fresco (fresh cheese), translate existing educational materials about influenza into Spanish plain language, and translate and culturally adapt an existing audio recording about TB into an indigenous dialect.

Results: This presentation will ultimately summarize the findings from 10 focus group discussions taking place between May and July 2013 during which the adapted communication materials will be evaluated with the target audience. Groups will be conducted in two regions of the U.S. with individuals representing different countries of origin in Latin America, including indigenous Mixtec and/or Zapotec communities.

Conclusions: The conclusions presented will be based upon the findings of the evaluation.

Implications for research and/or practice: Results from this evaluation will assist CDC in better reaching LEP Spanish-speaking and Mexican indigenous populations with effective culturally and linguistically appropriate health information.