Spanish Translation and Cultural Adaptation of Therapist Education and Massage for Parent-Infant Outcomes (TEMPO) Parent Education Materials
Leslie Sierra-Arevalo, SPT
The University of North Carolina at Chapel Hill
Background and Statement of Need
The purpose of this project was to investigate the latest research on translation and cultural adaptation of parent-education materials to better assist me in translating and culturally adapting Dr. McCarty’s materials from her TEMPO project for the Spanish-speaking community.
Upon learning of the TEMPO project a couple of years ago, I inquired whether Dr. McCarty was anticipating recruiting Spanish-speaking caregivers and parents. Unfortunately, at the time, Dr. McCarty was unable to recruit Spanish-speaking parents and caregivers due to the TEMPO materials only being in English. Ana Clara “AC” Caldwell and I teamed up to help Dr. McCarty adapt her materials. The first step in starting this project was modifying Dr. McCarty’s IRB study so that we could have the approval to adapt these materials and use them in a focus group for feedback. After we received IRB approval, AC then took charge of translating the TEMPO website and creating mobile applications as part of her project, and I focused on the written materials. In addition to translating and culturally adapting the written materials, I took an online course on qualitative research so that I could help organize and lead a Spanish-speaking focus group with the assistance of Bilingual Communications, a North Carolina-based company that provides professional English to Spanish translation, transcription, and interpretation services. This focus group would help us gain valuable feedback about our materials in hopes that they would be appreciated, accepted, and understood by future Spanish-speaking TEMPO parents.
Language and cultural barriers that influence health disparities and inappropriate healthcare are not unknown to me and many of my loved ones who have limited English proficiency. I set out on a mission with this project to be able to combine my passion for pediatric physical therapy and my determination to use my bilingualism in my physical therapy practice. This project has allowed me to address a problem where language and culture were presenting barriers for my fellow Latinx community. By translating and culturally adapting TEMPO materials for Spanish-speaking families, AC and I have been able to ensure that Spanish-speaking parents with infants in the NICU have quality information for the care of their babies that is adapted in both language and cultural understanding. We have gained valuable knowledge and experience that will help us continue to address language and cultural barriers that our future Spanish-speaking patients will likely experience.
Additionally, North Carolina has the fastest growing Latinx population in the country and there is, therefore, a growing need for translated and culturally adapted parent education materials in the medical setting to help address incongruent care and health disparities for minorities.
Products
Critically Appraised Topic Paper
Translated and Culturally Adapted TEMPO Early Education Booklet
Translated and Culturally Adapted TEMPO Discharge Booklet
Focus Group Discussion Guide(participant information has been covered for confidentiality purposes)
Coming soon! Final manuscriptÂ
Below you can find the original English version of the TEMPO Early Education Booklet and Discharge Booklet. Many of the same infographics and pictures will remain the same when the Spanish versions are published. Additionally, you can view the recruitment flyer that was created for the focus group but ultimately not used as we were able to create a focus group with the help of Bilingual Communications and MURAL.
TEMPO Flyer_Spanish Version Final
Evaluation
Throughout the course of this project, my committee members have reviewed my materials and given valuable feedback. Additionally, we also conducted a focus group where the sole focus was receiving feedback on the translated and culturally adapted materials. The participants reviewed the materials and were asked to share their suggestions and correction throughout the focus group session held over Zoom. We created a discussion guide for the focus group to ensure we covered all important topics and questions needed to complete a thorough evaluation of all the materials. The feedback from the focus group was implemented into the materials and emerging themes from the focus group will be discussed in more detail in the upcoming manuscript.
Self-Reflection
Over the course of this project, I have learned not only valuable information regarding neonatal physical therapy interventions, but I have also been able to make a small dive into the research regarding translation and cultural adaption of educational materials for individuals with limited English proficiency. This is a topic that is personal for me as my family and other loved ones have experienced the consequences of health disparities and received inadequate and inappropriate care due to language and cultural barriers. One of the long-term goals that I hope to accomplish in my career is to play an integral part in ensuring Spanish-speaking patients receive equal and adequate care when compared to their English-speaking counterparts. This project has helped me learn about the importance of not just linguistic translation, but also cultural adaptation when providing care and education to patients and I hope to integrate many of the skills and knowledge that I have gained throughout this project in my future practice.
AcknowledgmentsÂ
To Dr. Dana McCarty, thank you for allowing me the opportunity to partake in this project and imparting your wisdom and knowledge about NICU PT and qualitative research on me. Thank you for your constant support, feedback, guidance, encouragement, and patience throughout this project as we were both learning to navigate the qualitative research world. I only hope to one day be even a fraction of the mentor and physical therapist you are.
A las doctoras Erica Ghigliotty y Maria Cristina Castro, gracias por ser parte de mi comité y por sus invaluables comentarios y sugerencias. Tener el apoyo de dos profesionales de la salud a las que admiro y respeto ha sido un honor. Somos pocas las proveedoras de servicios de la salud Latinas e hispanohablantes, y poder ayudarnos mutuamente es muy valioso. Desde el fondo de mi corazón, gracias.
To Dr. Lyda Arevalo-Flechas and Carlos Cano-Solis, thank you for your invaluable assistance in providing medical Spanish translation and providing pertinent suggestions about the cultural adaption of these materials. Your input as Colombian and Mexican emigrants who have experience providing direct care to Spanish-speaking patients is deeply appreciated and respected. Thank you both.
11 Responses to “Spanish Translation and Cultural Adaptation of Therapist Education and Massage for Parent-Infant Outcomes (TEMPO) Parent Education Materials”
Laurie Ray
Great capstone, Leslie! This is great for Dana’s study and important for our profession. I hear that speaking Spanish, alone, (controlling for other variables- chronic conditions, access to healthcare, etc.) is linked to poor COVID outcomes. This is something we must advocate for and ensure language equity in our practices.
I had a question about the cultural adaptation you did. Given that Spanish speakers are such a diverse group from varied cultures, how was this done? Did you adapt to one culture or more general adaptations?
I look forward to your leadership for our profession in this and many other areas!
Good luck!
Dana B McCarty
Leslie – wonderful work on a much needed project. I am so grateful to you and AC for using your skills to increase our reach to Spanish-speaking families. I enjoyed working with you and am excited about your future in pediatrics! Excellent work.
Dana
Leslie Sierra-Arevalo
Dana,
The honor has been mine! It has meant so much to be able to work on this project with you. Thank you for allowing me to partake and contribute to this awesome project. I can’t wait to see how it continues to evolve.
Thank you for everything.
-Leslie
Rachael Fiorentino
Leslie,
This was a spectacular idea for a Capstone, and much needed. Though this is not related to pediatrics, in my most recent acute care rotation, we had at least one Spanish speaking patient per day and being able to give them literature about their health in Spanish greatly benefitted their care and recovery, and I noticed that my CI’s bilingual skills also greatly contributed as he was able to build a patient rapport that those who only spoke English could not. I think this project does the same sort of thing, while addressing the barrier of language when it comes to health care. I imagine it is incredibly stressful for any parent to have a child in the NICU but to have a child in a NICU that does not have materials in the language you speak, or providers who primarily use that language, that only has to add to their stress. It is clear that this project meant a lot to you and you spent a significant amount of time on every detail, thinking it through. Great job Leslie, and I am so excited for you to become a practicing clinician and addressing these health disparities in your every day work.
Leslie Sierra-Arevalo
Rachael,
Thank you for your comment and for sharing those experiences! I’m so glad to hear that you were fortunate enough to have a Spanish-speaking CI and were in a place that provided education in Spanish. Those two things are hard to come by, especially in combination! I so look forward to the day that we will be practicing colleagues 🙂 Thanks for taking the time to visit my project and for commenting.
-Leslie
Sarah Richardson
Leslie,
Wow. I am absolutely blown away by the incredible work you have put into this project. Your passion comes through in every word and material that you produced. As we have discussed in personal conversations, I have encountered firsthand the frustration that patients face when they are not able to receive medical information in a culturally affirming and clear way. At a minimum, the Latinx community deserves to work with providers who provide a clear and culturally relevant translation of medical information. Additionally, this community deserves to see themselves and their identities represented in the medical community and within the providers who serve them. I am so honored to know you and to call you my classmate, and future colleague. I know you will continue to do incredible work for our profession and I cannot wait to see what future successes await you.
– Sarah R.
Leslie Sierra-Arevalo
Sarah,
It means so much to have someone understand not only my passion for this project but who can clearly see some of the why behind why I found this project to be so important.
Being aware of the disparities is one of the first steps to be able to take action, so even though I’m sure those experiences presented some challenges and frustrations, it’s a huge step that you are clearly able to recognize them and see that equity is lacking. I also can’t wait to see what great things you bring to the world of PT, and furthermore, I’m so excited to know that I will have a colleague who is similarly passionate about wanting to address health disparities and provide equal and adequate care for all of our patients.
-Leslie
Hannah Zimmer
Leslie,
Excellent job on this capstone project! It is incredible to see you combine and apply your passions for pediatric physical therapy and supporting the Latinx community. We’ve learned so much about health disparities while in school, and I know we’ve only scratched the surface of the impact that these disparities can have on individuals, families, and communities as a whole. I think you’ve done a fantastic job in aiming to address this language barrier to pediatric care, and I’m excited to see you continue this work throughout your career as a physical therapist. Congrats on a job well done!
-Hannah
sierraar
Hannah,
Thank you so much for your kind words! This project has definitely meant a lot to me and hits some personal notes for me. I hope that this project that AC and I have worked on makes its way somehow into those discussions about health disparities that we at times have in class. It would be great to see more discussions about these barriers of care. Thank you Hannah!
-Leslie
Erica Ghigliotty
Leslie, muchisimas gracias por tus palabras bonitas. !Estoy muy impresionada con tu proyecto! Se que la comunidad de hispanohablantes aprecia la esfuerza de personas como tu y yo porque es tan importante para que ellos (por fin) reciban las oportunidades y recursos que merecen. This is one of the most rewarding things I have found in my job – being the person to recognize the barriers and disparities that this community faces (as you have mentioned), make it known, and provide in not only the same language, but considering the cultural aspects as well. Translation is not as simple as it seems on the surface! I am so excited for you to implement this even further into your practice. Thank you for inviting me to be a part of it 🙂
– Erica
sierraar
Erica,
Thank you so much! I completely agree, often practitioners think that the linguistic translation is enough to relate to their patients but completely disregard the cultural aspect of care. I’m so excited to join you in the “real” PT world soon and begin to implement these practices and considerations! Thank you again for all your support.
-Leslie