Living Beyond Breast Cancer is a non-profit organization whose mission is to connect people to trusted breast cancer information and a community of support, ensuring no one impacted by breast cancer feels uninformed or alone. LBBC came to MTM LinguaSoft for help translating their information guide for newly diagnosed metastatic breast cancer patients. LBBC wanted to make the guide available to Chinese, Spanish, Tagalog, and Vietnamese-speaking audiences. We recommended a three-step process for the project: Cultural Consulting, Translation, and Layout/DTP (Desktop Publishing). The information guides in all languages are available for download here.

From the Chinese-language guide

Cultural adaptation

Different cultures understand illness and medicine differently; presenting information in culturally relevant terms is essential for establishing trust and comprehension. For example, the Western focus on the individual’s personal battle against a disease may seem alienating to an Asian patient, whose culture views illness in more holistic terms. The LBBC brand guidelines call for communications that sound less like a doctor and more like a trusted and well-informed friend; therefore it was essential for cultural consultants to review each guide to ensure a familiar, culturally relevant tone.

Our client provided us with audience profiles for each language group. These included descriptions of “personas” typical of the target audience. We drew on our network for bilingual, bi-cultural experts on women’s health in immigrant communities. Each consultant reviewed the English source text and recommended changes to make it more relevant to Asian and Hispanic audiences. Issues identified by cultural consultants included:

  • Acknowledging the role of the family. In many cultures, the family plays a central role in health care decision-making.
  • Understanding the healthcare system. We could not take for granted that the patients were familiar with US healthcare jargon.
  • Understanding differences between Western and Eastern medical ideas about treatment, healing, faith, disclosure of information, and perspectives on palliative care.
  • Addressing issues around privacy, dignity, “saving face,” and the role of health care interpreters.
  • Attention to the suitability of visual elements.

From the Spanish-language guide

Our cultural consultants suggested changes for the copywriters and graphic designers and LBBC updated the simplified English guidebooks accordingly. Once their reviewers had approved the final adapted versions, we began translation.

Glossary, Style Guide, and Translation

The first step in the translation workflow was to create a termbase: a glossary of terms and approved translations of these terms. The audience profiles, personas, and brand guidelines were shared and discussed with the translators. We worked with translators who specialized in health and outreach, and each translation was edited and proofread by a second subject matter specialist, then subjected to our customary in-house QA (quality assurance) process.

From the Tagalog guide

Desktop publishing

Once the translations were finished, our team formatted the brochures to accommodate the translated text within the style guidelines provided by the client. A particular design issue that arises in translation is “text expansion.”  It takes approximately 20% more characters to render an English text into languages like Spanish or Italian. For the guides, beyond the extra information that was needed, the Spanish, Tagalog and Vietnamese required more space than English. Chinese, on the other hand, has a tendency to contract, taking up less space on the page. Because the brochures were published in print rather than digital, radically adjusting the font size to accommodate expansion was not an option. Also, the client needed certain information to be on corresponding pages, so reformatting was required to reflow the text and resize text boxes and images to fit in the available space. New style guidelines were developed specifically for this process.

From the Vietnamese guide

We are currently working on LBBC’s translated guide for French-speaking audiences, which presents another set of challenges given the diversity of native French speakers in North America (Europeans, French Canadians, Haitians, West Africans, and more.) Overall, the LBBC project demonstrates that patient-facing healthcare translation can require a lot of front-end preparation to achieve a successful result. However, this preliminary work can be leveraged for future translation projects. For example, LBBC decided to publish some Spanish-language material on their website. Our translation memory software facilitates cross-platform publication; we leveraged the glossary and previously translated text to streamline the website project. Finally, although LBBC only serves US-based populations and works with US-based healthcare partners, nothing prevents international patients from getting the culturally-adapted and translated guides. We take pride in the part we played in providing useful medical information to patients in need of it, and we are glad our clients at Living Beyond Breast Cancer trusted us as their language services partners.

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