Creating Culturally and Linguistically Appropriate Health Communication Materials for Latinos

Background: Glaucoma, one of the main causes of blindness in the United States, is a group of eye diseases that damages the optic nerve. Left untreated, glaucoma can lead to vision loss. Studies have shown the early detection and treatment of glaucoma, before it causes major vision loss, is the best way to control the disease. Glaucoma disproportionately affects Latinos. The National Eye Institute and Prevent Blindness project the number of Latinos with glaucoma will increase by 484% by the year 2050.

Program background: The National Eye Health Education Program (NEHEP) of the National Eye Institute at the National Institutes of Health established the Watch out for your vision! program to promote eye health among Latinos and to assist health professionals and community health workers (CHWs) in educating them about vision health. NEHEP provides culturally and linguistically appropriate educational materials and resources about eye diseases and conditions Latinos are at higher risk for and information on how they can protect their vision.  As part of its education efforts, NEHEP has used a rigorous adaptation process to develop eye health resources tailored for Latinos, including toolkits, public service announcements (PSAs), infographics, infocards, brochures, and more.

Evaluation Methods and Results: In 2014, NEHEP adapted the Keep Vision in Your Future: Glaucoma Toolkit for use with Latinos. The adaptation process included a rapid assessment of English content with bilingual health professionals; language simplification; design changes to make the resources culturally acceptable; audience testing; and final revision based on testing results. Results from the rapid content assessment showed that the materials were useful, but the reading level was too high for the audience. NEHEP revised the toolkit and added adding photo vignettes to help explain content. The toolkit was then used by health providers and CHWs for one month. In-depth interviews revealed very positive responses to the toolkit by both community members and providers. The participants overwhelmingly shared the information in Spanish was straightforward and words, phrases, and expressions were easy to understand. The materials have now been launched on the NEHEP website and training efforts are underway to build the capacity of CHWs to use these resources in their communities. Pre and posttests have shown that the toolkit is effective in increasing knowledge about glaucoma.

Conclusions: Adapting materials to better address the cultural and linguistic needs of the target audience is crucial to ensuring comprehension and acceptability. Beyond simply translating materials from English to Spanish, NEHEP has employed a robust adaptation process to develop eye health education materials that are scientifically sound and audience friendly.

Implications for research and/or practice: The advent of online translation services has made it easier to create materials in Spanish for Latinos. However, relying on literal translations can result in materials that do not make sense or appeal to the target audience. An adaptation process that includes language simplification, culturally relevant design and images, and audience testing will help communication practitioners develop materials that target audiences will understand and use to improve their health.