Meeting the challenge of Easy-to-Read language - Translating the North Rhine-Westphalian Public Health Report 2015 into Easy-to-Read language

Abstract

The United Nations Convention on the Rights of Persons with Disabilities determines amongst others the right of access to information. Information for the general public must be made accessible for persons with disabilities in formats and technologies appropriate to different kinds of disabilities. The language poses the largest barrier for people with learning difficulties. Therefore, we translated parts of the Public Health Report 2015 of North Rhine-Westphalia into an Easy-to-Read language.The translation was performed by a professional translation agency in cooperation with an assessment group, composed by people with learning problems, and the NRW Centre for Health (LZG.NRW).During the translation the population health monitoring group of the LZG.NRW experienced several challenges. The scope of these challenges and the chosen solutions are described in detail in this paper. 3 challenges were experienced clearly during the translation of the Public Health Report: (1) (Large) numbers and rates are a key element in population health monitoring but they should be avoided in texts in Easy-to-Read language. (2) The translation of the age-standardization approach and the related effects appeared to be difficult. (3) Finding the right balance between the description of lifestyle influences and the influence of the wider health determinants as well as finding a non-discriminatory wording regarding the influence of social health determinants were challenging.The following approaches were chosen to counteract these challenges: (1) We avoided to report numbers and rates. In some cases simple fractions are presented. In addition, all of these fractions were explained and visualized in the introductory section of the translated report. (2) We resigned to describe time trends. In some cases time trends were mentioned as crude rates and an explanation of potential effects (e.g., demographic change) was added. If gender specific differences occurred in the crude and age-standardised rates, we described the age-standardised differences. (3) The relativization of direct and striking formulations regarding the influence of the social health determinants and the inclusion of recommendations related to the scope of upstream determinants needed to be recognized and incorporated. Translating a public health report into Easy-to-Read language is a challenging process. Continuous and smooth cooperation between translators, the assessment group and the authors of the original report is mandatory to be successful.