Establishing a process to translate and adapt health education materials for natives and immigrants: The case of Mandarin adaptations of cardiac rehabilitation education

Purpose. To determine if a mailed health promotion program reduced outpatient visits while improving health status. Design. Randomized controlled trial. Setting. A midsized, group practice model, managed care organization in Ohio. Subjects. Members invited (N = 3214) were high utilizers, 18 to 64 years old, with hypertension, diabetes, or arthritis (or all). A total of 886 members agreed to participate, and 593 members returned the initial questionnaires. The 593 members were randomized to the following groups: 99 into arthritis treatment and 100 into arthritis control, 94 into blood pressure treatment and 92 into blood pressure control, and 104 into diabetes treatment and 104 into diabetes control. Measures. Outpatient utilization, health status, and self-efficacy were followed over 30 months. Interventions. Health risk appraisal questionnaires were mailed to treatment and control groups before randomization and at 1 year. The treatment group received three additional condition-specific (arthritis, diabetes, or hypertension) questionnaires and a health information handbook. The treatment group also received written health education materials and an individualized feedback letter after each returned questionnaire. The control group received condition-specific written health education materials and reimbursement for exercise equipment or fitness club membership after returning the 1-year end of the study questionnaire. Results. Changes in visit rates were disease specific. Parameter estimates were calculated from a Poisson regression model. For intervention vs. controls, the arthritis group decreased visits 4.84 per 30 months (p < 0.00), the diabetes group had no significant change, and the hypertension group increased visits 2.89 per 30 months (p < 0.05), the overall health status improved significantly (−6.5 vs. 2.3, p < 0.01) for the arthritis group but showed no significant change for the other two groups, and coronary artery disease and cancer risk scores did not change significantly for any group individually. Overall self-efficacy for intervention group completers improved by −8.6 points (p < 0.03) for the arthritis group, and the other groups showed no significant change. Conclusions. This study demonstrated that in a population of 18 to 64 years with chronic conditions, mailed health promotion programs might only benefit people with certain conditions.

The aim of this study was to gain insight on the views of Hindi-speaking mothers on readily available English language oral health education materials and to evaluate the acceptability of Hindi language adapted versions of these materials. This qualitative study is nested within an ongoing multi-centre birth cohort study in Greater Western Sydney, Australia. Following purposive selection of Hindi-speaking mothers (n = 19), a semi-structured interview was conducted. Two English leaflets were mailed to participants prior to the interview. The simplified English and translated Hindi versions of the leaflets were provided at the interview, and the participants were asked to compare and evaluate all three versions. Interviews were audio recorded, and thematic analysis was used to analyse data from interview transcripts. A majority of the participants reported a certain degree of difficulty in reading and comprehending oral health messages in Hindi. Although Hindi translations were accurate, mothers preferred the simplified English as opposed to the Hindi version. Visual illustrations and a simple layout facilitated the understanding of oral health messages. Developers of oral health education leaflets should thoroughly research their prospective user groups, particularly migrant populations, and identify the need for simplified or translated oral health education leaflets.

The public health impact of limited literacy has begun to be explored. The elderly and those with limited formal education are often the most vulnerable populations at risk of having low health literacy. Health promotion specialists must be cognizant of the literacy demands of health education materials (e.g., pamphlets, questionnaires) distributed to the elderly. Care must be taken to ensure that health education materials are both linguistically and culturally appropriate for whom they are intended.

Purpose The purpose of this paper is to describe the course, “Designing Education for Better Prisoner and Community Health,” which provided students with the knowledge, skills and resources needed to build real-world health education materials for persons who are criminal justice involved. Design/methodology/approach A multiphase engaged scholarship course was designed and implemented through the Brown University School of Public Health in Rhode Island, USA. Findings Students collaborated closely with instructors, subject matter experts and affected community members to develop highly tailored health education projects across six topic areas. The structure and outcomes of the paper are described with the hope that other instructors and institutions might replicate components of the model. Originality/value Engaged scholarship in public health can provide students with rich, collaborative learning experiences, and when executed effectively, these endeavors can provide underserved communities with robust and informed health education interventions and programs.