Culture Counts: A Guide to Best Practices for Developing Health Promotion Initiatives in Mental Health and Substance Use with
In chapter 5 - Translate and adapt:
On this page:
When adapting a health promotion initiative for ethnocultural communities, translation may be of foremost concern. But even
where a different language is not used, it is important to take cultural differences into account. Cultural adaptation is
the process of ensuring your message, whether translated into another language or not, is presented using cultural references
and role models that your intended audience will identify with.
Canadians should understand the value of cultural adaptation, since many advertisers, marketers and others often treat the
Canadian and American markets as the same. Think how you respond when you see ads created for the American market and used
in Canada. For example, American advertisers may try to appeal to potential customers’ patriotism, using the American flag
and symbols such as the eagle. Such symbols will not create the intended response in most Canadians and may distract or even
offend some. In any case, the ad will not be as effective as one produced specially for Canadians.
Creating or adapting a health promotion initiative with an ethnocultural community for that community will always produce
a more useful and effective initiative than using one created for some other group.
“For the LRDGs, we found that the message that one should drink less to protect one’s health did not have much effect. ‘You’ve
got to die sometime’ is the attitude. Instead, concern about the effects of one’s drinking on one’s children seemed to get
people’s attention. So in the Polish version of the brochure, to the advice 'Talk to your kids about alcohol,' we added 'and
be a role model for them.'”
Elizabeth Gajewski, Polycultural Immigrant and Community Services
“Cultural adaptation” is the process of adjusting health messages to the intended audience by incorporating their cultural heritage, language and
ethnicity. Sometimes it means finding the right word. On other occasions, it is about finding cultural equivalents so that
information is accurate but is also relevant and understandable to a different cultural audience.
“We included more types of beverages in the Portuguese version of the LRDG brochure, such as homemade wine. We found some
focus group members had different ideas about the identification of an alcoholic drink. For example, they might say, ‘Oh,
I never drink alcohol.’ Then you ask, ‘You never add a little something to your morning coffee?’ And they say, ‘Sometimes—but
that doesn't count as an alcoholic drink. It’s coffee!’ ”
—Maria J. Benevides, MSW, RSW, Portuguese Mental Health and Addiction Service
To learn more about adapting existing materials:
This poster produced by the Alliance for South Asian AIDS Prevention (ASAAP) shows how the impact of a health message is increased
when cultural references and images reflect its intended audience. (Photo courtesy of ASAAP)
How much adaptation of existing material is needed to make it effective with the intended audience? To find out, start by
having the material reviewed by members of the intended audience and key informants. Do they feel the information is relevant
and culturally appropriate? For example, in the Culture Counts project, members of the Somali community felt the existing
brochure and message of the LRDG was not culturally appropriate for them. As alcohol is strictly forbidden by their religion
and cultural beliefs, an approach that starts with the acknowledgement that people do drink would not work.
If the reviewers feel the message is culturally appropriate, they should be asked to look at how the content of the original
material, both text and the graphics, should be adapted to be culturally appropriate and clearly convey the health promotion
message. You and your community partners can go over the recommendations and see if they can be acted on without altering
the accuracy of the information.
Role models from the community who are willing to speak up and write about their own experiences with mental health or substance
use problems can help break down barriers and stigma. The role model could be a well-known person or simply a typical member
of the intended audience. The role model can talk to community groups, be part of larger presentations, or have his or her
story included in media products.
"Like Minds, Like Mine" - Whakaitia te Whakawhiu ite Tangata" Factsheet. (New Zealand)
This fact sheet about mental illness and stigma for the Maori community in New Zealand includes stories in their own words
of community members who are living with mental illness.
Images, colours, and other graphic elements can add a lot but need to be carefully chosen. For example, the cover of the LRDG
brochure shows a wine glass, a tumbler with ice and a beer bottle. Many in the focus groups commented that the tumbler looked
much larger than the other two items. Also, a few groups commented that it was not their custom to put ice in their drinks.
So when the brochure was adapted, this graphic was changed to a smaller tumbler with no ice in it.
Here are some things to keep in mind when using pictures and other graphic elements:
- Use images that reflect members of the community.
- Use colours and other graphic elements with special cultural meaning to enhance the power of a message.
- Poorly chosen graphic elements can detract from a message. For example, in North America, the colour pink tends to imply femininity
and softness, while in some Asian cultures pink has a sexual connotation. In some cultures white is a sign of purity, while
in others it is a sign of mourning.
- Thoroughly test images and text on intended audiences to ensure they are effective and culturally appropriate.
“Plain language” means making your text easy to use for as wide a range of people as possible. Whether you are using English
or another language for the health promotion product, here are some ways to make it easier to read and understand:
- Use simple, everyday language
- Use shorter sentences (25 words or less) and paragraphs
- Do not use jargon
- Avoid using idioms, slang and humour; if you do use them, be sure to test them on your intended audience.
- Avoid using more than one term for the same thing. For example, instead of "In some cultures, white implies purity, while
in others it indicates mourning,'" "In some cultures white is a sign of purity, while in others it is a sign of mourning."
It is a good idea to use plain language approaches whenever you are producing health promotion texts. It makes them easier
for anyone to use and can also make translation go more smoothly.
To learn more about plain language:
Think about how the final product will be used
The physical format of a printed piece can also determine how or if it will be sued. For example, young people may not pick
up a brochure, but may take home an attractive poster to put up in their room. Women may not pick up a booklet if it is too
large to fit in a purse.
"We thought about doing a poster instead of the brochure, but we were concerned that posters would not get put up or that
if they did they would be discarded when they got a bit torn."
-Maria J. Benevides, MSW, RSW, Portuguese Mental Health and Addiction Service