Emergency Preparedness Translation Toolkit 2010

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1 Emergency Preparedness Translation Toolkit 2010 Community Health Center Association of Connecticut 1

2 Table of Contents Abstract Background Objective Methods Conclusion Connecticut Counties.5 Translation Resources 6 Language Line Services Applied Language Services Healthy Roads Media Instructions Determine the languages spoken by city/county Translate simple signage or instructions Translate websites Print emergency communication from public health associations Access to prescription and medication information Example of translation: Influenza Prevention brochure Self Assessment Survey and Feedback Form for Health Centers Community Health Center Association of Connecticut 2

3 Abstract Background There is a growing need for accurate and readily available translation services in health care. An article in points out that Language barriers can result in misdiagnoses, medication errors, and potentially fatal mistakes that are costly for both patients and providers. This article was covering the need for medical translation in New York City, and because of the large immigrant population there, it is obvious that the need for translation services exist. The need for these services in Connecticut is just as imperative. The Board of Education review of our public schools identifies that in the school year, one in 20 of Connecticut s public school students was an English language learner 36 districts provided instruction for students speaking 20 or more different languages, and these numbers are indicative of what our providers confront in the community health centers of Connecticut. According to the review published by the Board of Education the Family Literacy programs give families access to the training and support they need to create literate home environments and enhance the academic achievements of their children. The same type of awareness, knowledge, and support is needed within Connecticut s health care delivery system. The data collected from the last published US Census in 2000 shows that 19.7 percent of residents 5 years and older speak a language other than English at home ( The Connecticut Board of Education identifies that the following languages are spoken by at least 300 students each: Spanish, Portuguese, Polish, Chinese, Creole-Haitian, Albanian, Vietnamese, Arabic, Serbo-Croatian, Urdu, Russian, French, Korean, Gujarti, Japanese, Turkish, Bengali, Lao, Somali, and Hindi. In light of this information it is important to address the need for access to translation resources in our community health centers. Objective The purpose of this binder is to be a comprehensive tool for health centers to reference when they are in need of translation materials or instructions. It will also provide the materials for a web page on the CHCACT site that will contain the information within the binder and be available for health care providers and staff to access online. This toolkit covers written communications to patients and focuses mainly on how to present this information to them in other languages and what online resources have health information in other languages. The translation needed during the patient/provider interaction that happens in an office visit is outside the scope of this toolkit. Community Health Center Association of Connecticut 3

4 Methods The information from the Language Line Services website and its translation capabilities was researched and provided. The information for the Applied Language Services website and its translation capabilities was researched and provided. The US Census Data and Connecticut Department of Education Data were used to determine the most prevalent languages spoken in the different regions of Connecticut. Instructions showing how to steps for Identifying Languages Spoken, Translating Simple Signage or Instructions, Print Emergency Communications, and Accessing Prescription Instructions were developed using the resources previously described. The Yale New Haven Hospital Influenza Brochure provided a sample translation of a typical communication that might exist within the community health centers. The Self Assessment Survey was composed for the community health centers and will be made available online to aid them in assessing their current resources, ability to use translation tools to communicate to their patient populations, as well as areas that they identify needs and ways to address these needs. Conclusions The result of this tool is that we have a better perspective on the specific needs of the health centers in the state of Connecticut and their use of translation services. The tool has identified the most prevalent languages that will be encountered by the health centers in each region. The Self Assessment survey allows the health centers to focus on the strengths and weaknesses of their current process for addressing the needs of a multi-lingual population. The assessment also provides feedback to Scott Selig and CHCACT on areas that the community health centers could use more support in getting access to these translation services. The bulk of the information provided in by the Translation Toolkit will address the needs of the health centers in communicating with their specific patient populations and also serve to improve another aspect of their emergency preparedness plan in light of any new public health announcements or events. As the use of this tool is made available to the community health centers the Feedback Form should be collected from each site concerning the clarity of the instructions, relevance to the processes in the clinic, whether the information provided was comprehensive and relevant, as well as any other suggestions that can be made to improve the translation toolkit. Community Health Center Association of Connecticut 4

5 Connecticut Counties The information listed below is derived from the 2000 US Census Data and shows the five most spoken languages, listed in order of prevalence, for each of the eight Connecticut counties. Spanish is the most commonly spoken language in all counties. Hartford: Spanish, Polish, French, Italian, Portuguese New Haven: Spanish, Italian, Portuguese, French, Polish New London: Spanish, French, Italian, Polish, Chinese Middlesex: Spanish, Italian, French, Polish, German Fairfield: Spanish, Portuguese, Italian, French, Polish Litchfield: Spanish, Italian, French, German, Polish Tolland: Spanish, French, Polish, Italian, Chinese Windham: Spanish, French, Polish, German, Italian Community Health Center Association of Connecticut 5

6 Translation Resources Language Line Services Language Line Services is a professional translation company that does provide specific certified medical interpreting services. This company also has a website containing a wealth of resources that can be used by the community health centers to assist them in communicating with their diverse patient populations. The Healthcare tab on the homepage allows you to review information on translation specifics to the healthcare field. The website link is Applied Language Services Applied Language Services is another company providing translation services, information, and text translation. This company includes many resources on their website, which is very easy to navigate, and is presented in a professional and organized way. The tab for Free Tools provides access to text, , and website translation. Also, there is a tab for Translation Articles that provides a small library of information on different aspects of translation, things to look out for, and common practices. This company also keeps your budget in mind and can provide a service called Post Editing of Machine Translation (PEMT) which is priced at half of the cost of traditional translation because the document is translated by a machine and then edited by a staff member. The traditional translation services they provide are all done by highly trained staff and they assure accuracy, however, this service may take longer and cost up to twice as much as PEMT. The website link is Healthy Roads Media Healthy Roads Media is a company that provides information on health care topics, more specifically on different disease states, in a variety of different languages and is very easy to use for patients and providers. The website link is Community Health Center Association of Connecticut 6

7 Instructions Determine the languages spoken by city/county Go to: Select: Resource Center Select: Demographics ad Census Data Select: MLA Language Map Data Center Enter: State and County for your region data or City and Town for your site specific data Or Go to: Enter: State and County for your region data or City and Town for your site specific data Translate simple signage or instructions Use free online text translators like: Google Translator at Word Lingo Translator at Babylon Translator at Translate Websites Go to: Select: Free Online Translation, in the blue box on the right side of the page Select: Website Translation, the third gray tab above the text boxes Enter: the exact web address into the box and select the language from the drop down box Note: This is a great tool for viewing a web page in another language. You can type the web address into the box or you can copy and paste it from another browser window if that is easier. However, once you are viewing the translated page and click a link on that page this tool will not translate the new page Community Health Center Association of Connecticut 7

8 that the link brings you to. You must again enter the exact web address of the new page into the box on the translation tool. Therefore, this is not a great tool for consuming a lot of website media. Also, the languages available for this translation tool are limited. Print emergency communication from public health associations Go to: Select: Resource Center, on the tool bar at the top Select: Emergency Resources to the right under the Resource Center links column Select: American Red Cross, Federal Emergency Management Agency (FEMA), Center for Disease Control (CDC), World Health Organization (WHO), National Resource Center, or Food Defense and Emergency Response The American Red Cross site can be viewed in Spanish by clicking the link in the toolbar at the top or bottom of the page The FEMA site can be viewed in Spanish by clicking the link at the very top right corner of the page On the CDC site, scroll to the bottom of the page, select the All Languages option and choose the language that you would like the website to be translated into. The language selection is limited. This will translate the site, portions of the site, or PDF documents into the new language depending on the language. You will be able to view the English titles on the language pages as they will be grayed out below the translated headings in order to print specific articles or information. The WHO website has six different language options available immediately and they are listed at the top of the page. If you use any of these language options it will keep the site translated for the duration of your browsing, there is no need to retranslate after clicking on links. For the National Resource Center scroll to the bottom of the page and select the Browse by Language option. This will give you access to all of the different languages and when you select a language it will show all of the resources that may be printed to hand out in that language. The site remains in English. For the Food Defense and Emergency Response site there is a Spanish option at the top right of the tool bar. This will bring you to the site in Spanish and will maintain the translation as you browse different links. Patient Education Go To: Community Health Center Association of Connecticut 8

9 This site provides information on disease states and common health information and you can select the language that you want it to be delivered in right at the top of the site. It is a comprehensive media device providing text, audio, video, and pod-cast formats. Access to prescription and medication information Go to: Select: Resource Center Select: Multimedia: Videos, Audio under Resource Center Links on the right of the page Choose: the link for Prescription information in more than 175 languages by Rite-Aid Pharmacy to see the press release about this resource Or Go to: and type language translation services into the SEARCH Box Select: Press Release link for more information After consulting the Rite-Aid website, the Walgreens website, the CVS website, and the Wal-Mart Pharmacy website it seems that it is not feasible to access translation services online concerning medication. When using the SEARCH box on the pharmacy sites there were no results found for any translation or language services. Rite-Aid does show its recent developments to translation services in a press release as mentioned above. Walgreens does show that prescriptions can be translated into 15o languages but there is no other information accessible. Therefore, patients/caregivers will have to consult their individual pharmacies for what services are available for prescription information and live telephone translators. Community Health Center Association of Connecticut 9

10 Example of Translation Document: Influenza Prevention Brochure from Yale New Haven Hospital (2 page Word document formatted to be a brochure) Translated: from English to Polish Resource Used: Language Line Services Online Contact: Go to Products and Services tab. Select the Document Translation link. Select the option for single electronic file. Fill in the spaces for contact information and attach the file in the Browse menu. After the billing information section you will see the Send A Quote box which you can tick if you just want to receive a price for your request (you do not actually need to enter any billing info if you tick the Send A Quote box). Phone Contact: For Document Translation Assistance call (west coast location on pacific-time) Quote: There is hour turn around for the quote. The price that was given for the example Influenza Prevention Brochure was $ Document Description: The document will be kept in the same exact format as the one that you send to them in the file so you will not need to worry about any alterations if this a document formatted for a brochure, for billing, for a survey, etc. An example of the English document and the Polish translation provided by Language Line are on the following pages. Community Health Center Association of Connecticut 10

11 Community Health Center Association of Connecticut 11

12 Community Health Center Association of Connecticut 12

13 LECZENIE objawów grypy w domu Istnieje wiele domowych sposobów łagodzenia objawów grypy, które możesz zastosować sam lub w stosunku do członków swojej rodziny, należy jednak pamiętać o skonsultowaniu się ze swoim lekarzem, który udzieli konkretnych wskazówek Dużo wypoczywaj Pij dużo płynów, szczególnie takich, które zawierają elektrolity (takie jak Gatorade lub Powerade ) Kiedy masz gorączkę, ubieraj się warstwami Postępuj zgodnie z wytycznymi CHIRP (na odwrocie), aby chronić pozostałych członków rodziny Unikaj palenia papierosów i picia alkoholu Lecz objawy grypy odpowiednimi lekami dostępnymi bez recepty*: Paracetamol lub Ibuprofen na gorączkę i bóle mięśni Środek zmniejszający przekrwienie na zalegającą wydzielinę, kaszel i katar Jeśli wystąpią objawy grypy i jednocześnie chorujesz na poważne schorzenie, skonsultuj się ze swoim lekarzem Większość osób z grypą leczona jest w domu. Powinieneś jednak zwrócić się po pomoc do lekarza, jeśli wystąpią poniższe objawy: Ostre lub przedłużające się (10 dni lub dłużej) objawy Trudności w oddychaniu; szybki lub bolesny oddech Zasinienie skóry Zawroty głowy lub omdlenia Nawrót gorączki lub kaszlu po wcześniejszym ustąpieniu objawów Odwodnienie (suchość w ustach lub zwiększone pragnienie) Kaszel z żółtym śluzem lub śliną Dezorientacja Ostre lub utrzymujące się wymioty Pogorszenie istniejącego wcześniej poważnego schorzenia (np. choroba serca lub płuc, cukrzyca, HIV, nowotwór). Centrum Gotowości i Reagowania w Sytuacjach Kryzysowych Zdrowotne informacje kontaktowe Imię i nazwisko lekarza Apteka Inne Numer telefonu Numer telefonu Numer telefonu PYTANIA NA TEMAT GRYPY? Zadzwoń do Yale New Haven Health Call Center (888) PSST! ZASADY POSTĘPOWANIA W PRZYPADKU GRYPY NIE POWINNY BYĆ TAJEMNICĄ! Narzędzie PSST informuje jak CHRONIĆ siebie i swoją rodzinę, rozpoznać OZNAKI I OBJAWY grypy oraz LECZYĆ objawy grypy w domu *Dzieciom i osobom poniżej 18 roku życia nie należy podawać aspiryny bez wcześniejszej konsultacji z lekarzem One Church Street, 5th Floor New Haven, CT Tel (203) center@ynhh.org 2006 None of this publication may be reproduced or transmitted in any form without permission from Yale New Haven Health System. Community Health Center Association of Connecticut 13

14 3-6 FEET CHROŃ siebie i swoją rodzinę Planując ochronę własną i rodziny przed grypą, a nawet epidemią grypy, nie zapominaj o: C H I R P Zakrywaniu buzi podczas kaszlu lub kichania używaj chusteczek higienicznych, prawidłowo je usuwaj a następnie myj ręce. Utrzymywaniu czystości rąk myj ręce często i dokładnie. Izolacji utrzymuj osobistą przestrzeń 3-6 stóp w celu zminimalizowania narażenia na działanie wirusa grypy od osób, które mogą być chore; pozostań w domu, jeśli zachorujesz. Ograniczeniu zarazków w domu i pracy - regularnie dezynfekuj powierzchnie wspólne, takie jak telefony, piloty, klamki, włączniki światła, zabawki itp. Przygotuj siebie i swoją rodzinę stwórz plan i zestaw awaryjny przeciw grypie dla siebie oraz swojej rodziny. FLU KIT 3-6 FEET PRZYGOTUJ siebie i swoją rodzinę Stwórz swój własny oraz rodzinny plan i zestaw awaryjny przeciw grypie. Pamiętaj, aby mieć pod ręką: Acetaminophen i/lub ibuprofen w odpowiedniej dawce i formule do leczenia gorączki i bólów mięśni u członków rodziny Produkty do higieny rąk (np. Purell ) Środki dezynfekujące (takie jak Lysol lub rozcieńczony wybielacz) Napoje bogate w elektrolity (takie jak Gatorade i Powerade ) Apteczkę pierwszej pomocy Kroplomierz do leków Leki na receptę (1-miesięczny zestaw) - Trzymaj listę leków na receptę (nazwa, dawka i częstość przyjmowania) - Zaopatrzenie medyczne, takie jak glukoza czy urządzenie monitorujące ciśnienie Sprawny termometr Chusteczki higieniczne Uwaga: Należy rozważyć zaopatrzenie się w papierowe maski podczas opieki nad osobą chorą na grypę. PRZYGOTUJ siebie i swoją rodzinę Inne przedmioty, jakie powinny znajdować się w zestawie awaryjnym przeciw grypie to: Woda, galon na osobę na dzień Żywność nie psująca się zbyt szybko - Co najmniej siedmiodniowy zapas żywności, najlepiej mieć miesięczny zapas pod ręką - Na przykład: puszkowane mięso, owoce, warzywa, zupy; proteiny lub batony owocowe, suche płatki zbożowe lub muesli, masło orzechowe lub orzechy, suszone owoce, krakersy i karma dla zwierząt Ręczny otwieracz do konserw Formuła dla niemowląt i pieluchy (jeśli posiadasz niemowlę) Radio zasilane bateryjnie i zapasowe baterie Latarka i zapasowe baterie Telefon analogowy/telefon stacjonarny Gotówka, czeki podróżne lub drobne Ważne dokumenty rodzinne Przedmioty z higieny osobistej Wilgotne chusteczki do celów sanitarnych Klucz lub szczypce do wyłączenia urządzeń domowych Worki na śmieci i plastykowe zawleczki do utrzymania czystości Jak odróżnić grypę od przeziębienia? Ogólnie rzecz biorąc, objawy takie jak gorączka, bóle mięśni, zmęczenie i suchy kaszel są częstsze w przypadku grypy natomiast katar lub zatkany to objawy częściej występujące przy przeziębieniu. OBJAWY GRYPY: Gorączka ( ) trwająca 3-4 dni Bóle głowy Bóle mięśni Ogólne osłabienie, skrajne zmęczenie DODATKOWE OBJAWY: Suchy kaszel Ból gardła Wysięk lub niedrożność nosa Sporadyczne bóle żołądka lub jelit (nudności, wymioty, biegunka), częściej występujące u dzieci niż u osób dorosłych. Community Health Center Association of Connecticut 14

15 Self Assessment Survey The following questions are to help identify the current capability of the community health center and to pinpoint resources or skills that will need to be developed to provide the best care for your patient population in the languages that they will understand. 1) What are the top five languages spoken in the county where your Community Health Center (CHC) is located? 2) Does your Community Health Center have a point person responsible for translation services at the clinic? Does your CHC have specific procedures for providing all public health information, signage, and patient education in the top five languages spoken in your city/region? 3) Ask 10 different members of the staff at the Community Health Center (CHC) if they know where to go to translate a Please cover your mouth when you are coughing sign for the waiting area. Collect their immediate responses. What percentage of the people asked could do this? Is the staff at the CHC aware of resources that they can use to translate instructions? 4) If a health care provider at the Community Health Center needed to provide a patient with prescription information in a language other than English where would they go to do this? If they needed to provide disease background information for a newly diagnosed patient where would they find this information or how could they access a translation for a document that they usually provide that is in English? 5) If you needed t provide nutrition information to a patient in a language other than English how could you do this? 6) If you were a provider directing a patient to websites where they can find out more information on their health or their specific conditions what sites could your use? 7) If you were going to have a public health document translated so that you could distribute it at the Community Health Center or send it to all of your patients in a mailing what resources would you use to do this? 8) Do you have access to funds to be spent for document translation services, live telephone translators, and/or in-person translators at the clinic? Community Health Center Association of Connecticut 15

16 Feedback On behalf of the Community Health Center Association of Connecticut I want to thank you for reviewing the Emergency Preparedness Translation Toolkit. This project was designed with all of the community health centers and their patients in mind and it aims to be as informative and relevant as possible. Therefore, we invite you to provide us with feedback below on how we can improve and expand this project. I would like to leave the evaluation open ended instead of directing the responses with a premeditated questionnaire but please consider each section of this document in your response. Additionally, this tool will be made available online, so if there is anything that you would find helpful to have included in an online resource please mention that so we may take this into account in our design of the web page. Please use the space below to share your thoughts. Community Health Center Association of Connecticut 16