Language Access in Healthcare
EvidenceE-0379Initial AI draft

Readers described the functionalist translation as natural and native-authored and the literal one as awkward and foreign

2026-06-053 out · 0 in

Source

Colina (2022). Research Documents for Populations with Limited English Proficiency: Translation Approaches Matter. Ethics Hum Res.

Description #

In the thematic analysis of the interviews, participants characterized the functionalist translation B as easier to read, more reader-friendly, and sounding as though it had been written by a native Spanish speaker, while they described the literal translation A as awkward, overly direct, and structured like the English source. Some experienced the literal directness as offensive: one participant said form A felt "like an attack" and would read as a rejection to a Spanish speaker.

"Participants referred to translation B overall as easier to read and more reader friendly, commenting, for example, "Easy to understand" (Participant 1), "User friendly, easy to follow" (Participant 2), "Better flow, the ideas came clear [sic] and understandable" (Participant 10), and, "[L]o entendí mucho más fácil" ("[I]t was easier to understand") (Participant 15)." (Colina, 2022, p. 34)

"Este siento que lo escribió alguien que habla español, alguien que está confortable con el idioma" ("I feel like this one was written by someone who speaks Spanish, someone who's comfortable with the language") (Participant 20)" (Colina, 2022, p. 34)

"Un cuestionario en la forma A se siente más como un ataque o es tan directo que una persona que habla español se va a sentir que es un rechazo" ["This questionnaire on form A feels more like an attack; it is so direct that a Spanish-speaker is going to feel that it is a rejection"] (Participant 14)" (Colina, 2022, p. 34)

Methods Context #

What? #

The observable: the themes and specific comments participants voiced about each translation's readability, naturalness, and textual features.

"We identified three themes from the interview responses: overall difficulty of the text, textual features and comprehension, and audience and educational background." (Colina, 2022, p. 34)

How? #

Semistructured interview comments were coded by preference (survey A or B), then reviewed and thematically organized to surface the most frequently repeated themes.

"For the qualitative analysis, all comments in the semistructured interviews were coded according to preference (for survey A or B). After coding was complete, comments were reviewed and thematically organized. The most often repeated themes were identified." (Colina, 2022, p. 33)

Who? #

The 20 English-Spanish bilingual adults (most Spanish-dominant) reviewing the two Mexican-Spanish translations of the Perceived Stress Scale.

"We recruited 20 bilingual participants at the campus of the University of Arizona and in its surrounding community using flyers written in English and Spanish and by word of mouth." (Colina, 2022, p. 32)

Other Notes #

This is a qualitative finding grounded in participant voice; the criticisms of translation A (awkward syntax, source-like structure) mirror the higher issue count recorded quantitatively.

Caveats #

  • Study measured only perceived difficulty not actual reading comprehension of the translations The study captured only participants' perceptions of difficulty and their stated preferences; it included no reading-comprehension test or readability instrument, so the findings speak to perceived difficulty and preference, not to objectively measured comprehension. The authors caution that translation B might be only perceived as more formal or difficult and note that future studies should test actual difficulty.
  • Spelling errors in the literal translation could have influenced participants perceptions Translation A (the literal version) was a real published translation that contained spelling errors, which the authors retained because their interest was the translation approach rather than spelling. However, those spelling errors are a confound: they could independently have depressed participants' evaluations of translation A, so part of the observed preference and issue-count gap may reflect spelling rather than the literal-versus-functionalist approach. The authors recommend using an error-free text in future studies.
  • Sample was bilingual not monolingual LEP limiting generalizability to true limited-English readers All 20 participants were bilingual to some degree rather than monolingual or truly limited-English-proficient, because recruiting participants with no English skills in Tucson, Arizona was difficult. Their knowledge of English could make them more accepting of English-influenced, literal renderings than a genuinely LEP reader would be, which limits how far the preference and comprehension findings generalize to the target population — the authors call for a future study recruiting monolingual speakers.