We then systematically compared our translations to those produced by four professional translation firms to identify potential concerns in our own and the professional translations.
We identified three primary types of problems of relevance for researchers conducting studies where translation of written information is required. These included nonequivalent registers in particular, the introduction of more complicated language , errors of omission reducing the clarity of the information , and changes that altered the substantive meaning of the information. Moreover, translators who have a basic understanding of research are more likely to accurately convey essential research concepts.
We describe a series of steps researchers can take that may help to improve the quality of translated materials. For research involving human subjects, informed consent is required with limited exceptions , both ethically and legally.
In general, consent documents are often written using complex and technical language and empirical analyses continue to reveal major limitations in subject comprehension. Unfortunately, such efforts are often limited to development of English materials.
The challenges to providing non-English-speaking subjects with informative and understandable consent materials are compounded when information must be translated and adapted from English. As part of a National Institutes of Health NIH -funded study on simplifying informed consent for biobanking, we sought to produce high-quality translations of three empirically developed consent-related documents from English to Spanish.
To that end, we undertook a rigorous process by which multiple native Spanish speakers associated with our research team collaborated to translate the materials.
We then hired four professional firms to undertake independent translations in order to examine the types of errors and issues that can arise when a more typical translation process is used. Our goal was to produce high-quality Spanish translations of three consent-related documents originally developed in English: a 6-page consent form explicitly designed to closely resemble biobank consent forms in actual use, a 3-page simplified biobank consent form, and a question consent comprehension quiz with accompanying explanations of the correct answers.
All three documents were empirically developed in previous Aims of the grant. Step 1—Initial forward translation to Spanish. Two native Spanish speakers Argentine and Ecuadorian who routinely consent Spanish speakers to participate in biobank research provided the initial forward translations.
One individual generated each of the initial Spanish translations. The second then closely reviewed each translation against the original English version to identify potential problems e. These two individuals then discussed each issue to reach a resolution.
Step 2—Back translation to English. One of the co-authors E. Step 3—Comparison of back translation to original English materials. Two co-authors E. For each comparison document generated, the co-authors independently categorized each discrepancy as either acceptable or problematic.
Acceptable discrepancies included instances in which variations between the original and back-translated English forms did not alter the meaning but rather were expected effects of the translation process, such as variations in word order reflecting syntactic differences between the two languages, and other equivalent variations in tone, formality, and complexity, that is, different yet comparable ways of saying the same thing Table 1. Problematic discrepancies included variations between the original document and back translation that potentially altered the core or peripheral meaning of the content, including the omission or addition of key words or concepts and the use of terms that were not clear synonyms or were of nonequivalent registers e.
The co-authors compared their coding to resolve classification discrepancies. They then focused on the problematic discrepancies, comparing each against the original English form, the forward translation Step 1 , and the back translation Step 2 to determine where the issue arose. Errors related only to the back translation were disregarded for the remainder of the analysis since they did not reflect an actual issue with the Spanish translation.
Step 4 — Comparison of discrepancies related to the forward translation. They consulted with another member of the larger research team native Chilean Spanish speaker to discuss specific errors and get additional feedback on proposed revisions. Step 5 — Revisions to the forward translations.
Based on the results of Step 4, E. R and K. Step 6—Professional translations. We hired four professional translation firms to produce independent English to Spanish translations of each of the three consent-related documents generating a total of 12 documents, available upon request.
We selected both general and research-specific firms to examine whether there were differences in translation quality. Two firms A and D specifically marketed themselves as specializing in medical and scientific translation. The other two firms B and C marketed themselves more broadly; however, Firm B included scientific translation within its scope and claimed to employ translators with a diverse range of research-area expertise.
Firm C did not mention scientific translation as an emphasis or claim to have particular translator expertise. This resulted in 12 comparison documents, each with all changes marked to indicate differences between the professional translations and our own.
Step 8 — Comparison documents coded in NVivo The 12 comparison documents were uploaded to NVivo 11 for coding. One author E. Step 9 — Code review, resolution, and analysis. Because language is complex, contextually contingent, and subjective, there are often multiple more or less appropriate ways to communicate an idea. As such, we adopted a conservative approach to code errors, that is, both co-authors had to agree that a discrepancy was problematic rather than simply a matter of preference in order to code it as such.
We then analyzed code reports to describe translation errors and to identify ways to improve our own materials. Step 10 — Ease of readability measures. Step 11 — Development of final Spanish materials. We identified three basic types of translation errors: use of nonequivalent registers, errors of omission, and other mistranslations affecting meaning.
The most common translation problem related to equivalency of register, 31 specifically the appropriate use of language to capture the intended tone, formality, technicality, and comprehensibility of materials. Professional firms tended to replace less complex English terms with more advanced or technical terms in Spanish, despite the availability of comparable terms Table 3.
Table 4 provides additional examples of these kinds of non-equivalency issues. The use of nonequivalent registers was not only limited to the use of more complex and scientific terms but also extended to sentence construction. Some professional firms had a tendency to combine and restructure content to produce longer, more complicated phrases and sentences.
For example,. Professional Translation Firm C : Given that the Biobank personnel will talk with you about this form, ask them to explain any term or information that you have not comprehended with clarity. The use of more advanced technical terms, coupled with the use of longer, more complex syntactical constructions, contributed to variations in both short and long form readability Table 5. Professional firms specializing in scientific and medical translation Firms A and D appeared to produce more readable materials than other firms.
Professional firms commonly omitted words or phrases present in the original English forms. In many cases, omissions did not alter the pragmatic significance or core meaning of the material and thus are not described here, since the resulting translations were considered to be equally appropriate ways to convey the same material in Spanish.
Less use of this deferential hedge could have a subtle effect on the overall tone of the consent materials from more to less polite. Other types of omissions may have the effect of reducing the clarity of study information. Original English: Some of these studies may be about how genes affect health, or how genes affect response to treatment. Finally, a few simply did not understand why information regarding exceptions was relevant or how it related to biobank participation. How would you know if there is domestic violence through the blood?
Because the spoon is related to food, no? So no one eats blood. LA, 17, simplified. It sounds weird. NY, 07, traditional. LA, 05, traditional. Participants raised issues about tone and formality regardless of which consent form they read.
Many described the term as too informal, childish, and lacking the appropriate formality or enforceability necessary for this type of study. Specific reactions to the term included the following:. LA, 14, traditional.
In fact, it could be even best to get rid of this phrase …. LA, 06, simplified. Participants also felt some language communicated a standoffish, defensive, or aggressive tone. Participants also suggested a range of revisions that would have the effect of downplaying the risk. Several felt strongly that the consent form should describe protections before risks to avoid causing anxiety.
Other commonly proposed changes included the use of passive voice constructions and different adjectives to soften language and convey less risk. Some participants also recommended revisions to language describing potential benefits. Some suggested replacing active constructions with passive voice to soften the effect.
A few others recommended, as in the following examples, that the section be reorganized to highlight societal benefits and minimize—or remove any mention of—the lack of personal benefits:.
There is no monetary reward. W e also asked participants to rate their satisfaction with the amount of information provided and their willingness to participate in the hypothetical biobank. Few participants thought their form contained too little information. Most of those who said they probably or definitely would not participate did not specify a reason, but a few cited a fear of needles and a desire to speak with someone about the study.
Comprehension did not differ by form, a finding consistent with other studies involving native English speakers. Misconceptions regarding the personal health benefits of participation and provision of health care are particularly concerning, as these may motivate participation. Moreover, while a few participants may have overestimated the likelihood of receiving results, others simply had the perspective that, however unlikely, any chance of receiving results is a benefit.
Some of the concerns and confusion voiced by participants arose more often depending on the form. Those who received the traditional form, for instance, more often perceived specific language to be contradictory for example, concerning the scope and limits of individual protections.
These findings suggest there is a fine line between providing exhaustive detail in the interest of being thorough and overwhelming the primary intended message about the overall level of risk and protections, leading to reduced comprehension and confusion. Regardless of which consent form participants received, they voiced concerns about data use and data sharing. Most often, they wanted more information regarding how their medical records would be accessed, who might use their data and for what purposes, and the review processes for making those determinations.
Although participants were concerned by some aspects of the biobank, many were simultaneously reassured by the transparency with which risks were disclosed, and interpreted this as a sign of trustworthiness. Qualitative data captured through cognitive interviews allowed us to identify subtle but important issues with the materials as translated to Spanish. In one case described above, an incorrect translation that is, a failure to add a necessary preposition to the Spanish document left opaque the essential meaning of language describing certificates of confidentiality.
In another case described earlier, participants understood the basic meaning of a sentence about having blood drawn, but they found the specific reference to tablespoons to be awkward. Cognitive testing also allowed us to identify potential issues with tone, formality, and voice.
Participants felt some consent language was too abrasive, while other language was too informal for the project under consideration. Many of these characteristics of written Spanish are seemingly at odds with recommended actions to simplify consent forms. Indeed, to increase comprehensibility and clarity, it is widely recommended that consent forms be written in active voice, use simple sentence structures, and avoid complex, technical, or overly formal language.
Although we cannot assign cause and effect, it is nonetheless interesting to observe that our participants who received the simplified form indicated significantly less willingness to participate—despite much higher likelihood of saying they had received the right amount of information and no differences in comprehension quiz scores compared to those who received the traditional form.
Spanish speakers may understand the core meaning expressed using active voice and simple, informal words and sentences, but important pragmatic meaning—as well as the expected style and tone for example, formal, polite, indirect —may be or is lost. Revisions related to tone, formality, and voice should be carefully considered to ensure that any changes to improve cultural congruence do not come at the expense of comprehension, clarity, or accuracy and that revisions continue to meet regulatory requirements and best practice guidelines.
The witness understands both languages, so signs both. These approved translations are posted on the IRB website. If you require a short form consent in a different language, you must have the English version short form translated into the required language and submit it, with a Certificate of Translation, to the JHM IRB for approval. If more than an occasional non-English speaker will be enrolled in a study, the JHM IRB requires that all study-related documents are written in a language that is understandable to the participant population s.
This means that all study-related documents must be translated into the required language s and submitted, along with a Certificate of Translation , to the JHM IRB for approval. When should the investigator submit the translated version s of the study-related documents? The investigator may submit both the English version of the document s and any translated document s needed for the study along with a Certificate of Translation.
However, since any changes made by the JHM IRB to the submitted English version of the document s must be included in the translated document s , investigators are advised to have the translation completed after JHM IRB approval of the English version of the document s. Centro SOL offers a comprehensive research consultation service to promote culturally competent research inclusive of Latinx populations, especially those with limited English proficiency LEP.
Sign in. A noun is a word referring to a person, animal, place, thing, feeling or idea e. Spanish nouns have a gender, which is either feminine like la mujer or la luna or masculine like el hombre or el sol. Total or partial reproduction is forbidden without the author's prior consent. By mutual consent, the parties agree to terminate the contract. Las partes deciden de mutuo acuerdo rescindir el contrato.
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