Language and culture barriers have long presented challenges in the provision of healthcare. 8.3% of the U.S. population speaks English less than “very well,” accounting for over 25+ million individuals. To add to the urgency, Limited English Proficiency (LEP) can lead to health disparities, discrimination, and lower-quality care. Improving health equity in the United States requires a nuanced understanding of diverse voices and experiences.
When conducting public health research, it’s crucial that diverse populations be included in the research that shapes programs and policies. Culturally attuned research can be critical to getting results that are accurate and meaningful, and whether you’re conducting surveys, in-depth interviews, or focus groups, language should be at the forefront of your research design.
How to Amplify Diverse Voices in Public Health Research
Conducting research among diverse audiences? Here are a few key ways to ensure that limited-English proficient populations are included in meaningful ways.
1. Be Selective About Who Translates Your Survey
Surveys are an important means of collecting data about the experiences of your target audience. When that audience speaks a language other than English, translation is an essential step. While someone on your team may speak that language, be discerning about who translates your survey. Are they a native speaker? Do they have an understanding of orthographic norms (for example, punctuation and capitalization rules aren’t consistent across languages)? Do they have the required subject matter expertise? Also essential is the need to localize cultural concepts – do they have the skills to do this? And do you have a second language expert to review the survey before it’s finalized?
If the answer to any of these questions is no, consider working with a professional translation agency that specializes in survey translation. Professional translators are not just native speakers; they’re professionals who understand the nuance of language and culture, who understand how to tailor your message to your audience, and who use the best of industry technology to ensure efficiency and consistency across projects.
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2. Deepen Trust Through Bilingual Moderation of Interviews and Focus Groups
If your research involves in-depth interviews or focus groups, having an experienced researcher who is also a language and culture insider can help your participants feel comfortable expressing themselves openly and honestly. Bilingual moderators understand what’s said – but they often understand what’s not said and can probe in a way that non-native speakers can’t. Nuance matters in research, and often the deepest insights come from an understanding of those nuances. And don’t forget to translate your discussion guide!
3. If Needed, Fall Back to Interpretation Services
If working with a bilingual moderator isn’t an option, the next best thing is working with an experienced interpreter. Simultaneous interpretation ensures that the conversation flows smoothly, no matter the language – whether virtual or in person.
4. Make Sure your Transcripts Capture Your Participants’ Voices
After all the effort of perfecting your discussion guide, recruiting your participants, and facilitating your interviews or focus groups, don’t leave the transcription of your audio to AI alone. AI can be a great tool as a first pass, but it’s not ready to fly solo. Tests done in 2023 showed that AI has around a 9% word error rate for clear, two-person interviews in English.* The output of AI transcription varies from language to language and by subject matter, audio quality, and number of speakers. Even for languages like Turkish, with around 75 million speakers, AI accuracy is well below the accuracy for similar English audio. Having a human in the loop – and in particular, one who has experience with editing AI transcription – ensures that your transcripts are an accurate representation of your participants’ voices.
The Importance of Humans in Public Health Research
Public health is about humans. And no one understands humans like, well, humans. As noted above, AI is not sufficient for transcription. And same goes for translation: these tools can’t be used “with the training wheels off,” as they currently result in serious errors and even gibberish. Just consider that doctors who use Google Translate to give instructions to non-English speaking patients may face errors of “clinically significant harm” in 2% of Spanish cases and 8% of Chinese cases.
Minority communities are more likely to distrust the healthcare system – and for good reason. Racial and cultural biases, plus large disparities in access and equity, are driving factors for certain communities to have low confidence in medicine. Show people that you want to understand their lived experiences, and create trust by working to create connections across languages and cultures.
Where does that leave you and your organization? In the capable hands of Multilingual Connections to provide global translation services with localization in mind.
Since 2005, Multilingual Connections has helped public health researchers, clinics, and hospital systems understand and engage their multilingual communities. We’re a Chicago-based, woman-owned company that provides translation, transcription, bilingual moderation and interpretation services in over 75 languages. We’re tech-savvy, but we’re also a very human company.
Whether you’re preparing a survey, focus group, educational content, or marketing materials, our experts at Multilingual Connections are here to support your needs. Our top-notch professionals boast of linguistic excellence, localization, research experience and cultural know-how so you can get accurate, illuminating data. Reach out to Multilingual Connections to get research translation expertise in 75+ languages!
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