Transcreation matters: A learner centric participatory approach for adapting cancer prevention messages for Latinos

Cathy D Meade; Nathanael B Stanley; Mariana Arevalo; Dinorah Martinez Tyson; Enmanuel A Chavarria; Claudia X Aguado Loi; Marlene Rivera; Liliana Gutierrez; Rania Abdulla; Shannon M Christy; Clement K Gwede

doi:10.1016/j.pec.2023.107888

Transcreation matters: A learner centric participatory approach for adapting cancer prevention messages for Latinos

Patient Educ Couns. 2023 Oct:115:107888. doi: 10.1016/j.pec.2023.107888. Epub 2023 Jul 7.

Affiliations

¹ Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, USA; Department of Oncological Sciences, University of South Florida, Tampa, USA; Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, USA. Electronic address: cathy.meade@moffitt.org.
² Office of Community Outreach, Engagement & Equity. Moffitt Cancer Center, Tampa, FL, USA.
³ Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, USA; Office of Community Outreach, Engagement & Equity. Moffitt Cancer Center, Tampa, FL, USA.
⁴ College of Public Health, University of South Florida, Tampa, FL, USA.
⁵ Behavioral, Social, and Health Education Sciences Department, Emory University, Atlanta, GA, USA.
⁶ Department of Health Science and Human Performance, University of Tampa, Tampa, FL, USA.
⁷ Community advisory board member, Tampa, FL, USA.
⁸ Family Maternity Center, EverGreenHealth, Kirkland, Washington, USA.
⁹ NTRO Non-Therapeutic Research Office, Moffitt Cancer Center, Tampa, USA.
¹⁰ Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, USA; Department of Oncological Sciences, University of South Florida, Tampa, USA; Department of Gastrointestinal Oncology, Moffitt Cancer Center, Tampa, USA; Center for Immunization and Infection Research in Cancer, Moffitt Cancer Center, Tampa, USA.
¹¹ Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, USA; Department of Oncological Sciences, University of South Florida, Tampa, USA; Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, USA; Department of Gastrointestinal Oncology, Moffitt Cancer Center, Tampa, USA.

PMID: 37463555
DOI: 10.1016/j.pec.2023.107888

Abstract

Background: Advancing health equity requires innovative patient education approaches for adapting English-language evidence-based interventions (EBIs) to resonate with multicultural, multilingual audiences.

Objective: Examine the benefit, functionality, and practical considerations of transcreation (translation + cultural adaptation) as a critical and salient learner-centric process for developing a Spanish-language intervention (photonovella + video): Un examen sencillo para un colon saludable (A simple test for a healthy colon).

Patient/community involvement: We involved patients/community members in a participatory reflective process, from problem identification to intervention design, development, delivery, and impact measurement.

Methods: A community-based participatory research (CBPR) approach involving formative research plus systematic iterative pretesting and learner verification checks augmented by a community advisory board guided the transcreation processes.

Results: Data collected using a learner-centric approach effectively produced a new Spanish-language EBI and substantiated the value of co-learner/co-design methods. Learner-centric methods identified cultural nuances that were treated as knowledge and integrated into the intervention materials and study design. Pilot testing of the intervention among Latinos receiving care at community clinics demonstrated improved initial colorectal cancer screening uptake, awareness, and perceived susceptibility.

Discussion: Inherent in the transcreation process was learner involvement that informed essential modification and adaptation of the materials. The transcreation methods led to the development of a culturally salient intervention that maintained theoretical integrity and message intent as well as behavioral activation. Findings have broad implications for the creation and transfer of EBIs to new audiences for greater adoption, engagement, and 'reach' of interventions.

Practical value: Transcreation aligns with a growing paradigm shift in health communication science that brings to light the beneficial effect that construction and application of cultural knowledge has on patient education toward health equity.

Keywords: Cultural adaptation; Cultural knowledge; Health communication; Health equity; Intervention adaptation; Latinos; Learner-centric; Patient education; Transcreation; Translation.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Colorectal Neoplasms*
Community-Based Participatory Research*
Culturally Competent Care
Health Equity
Hispanic or Latino
Humans
Language*
Patient Participation*
Research Design
Social Determinants of Health