Module 5: Culture, Language Barriers and Interpreters

Cultural Differences

The nature and scope of diverse cultural perspectives on health and illness, and beliefs about disease etiology, treatment efficacy, truth telling, and decisional authority concerning health care have serious implications for the application of ethical guidelines for scientific research.”(1)

Most researchers have been taught from a predominantly western perspective regarding health and disease.  Although cultural competency is often emphasized as part of any education in research methodology, it is an inescapable fact that the framework through which the researcher observes the world is fundamentally built upon a set of assumptions about health and disease that are built in to the culture in which he or she was educated.  For this reason, researchers must carefully consider the local culture in which they seek to conduct a project.  Is the ambient cultural view of health closely tied to religious beliefs?  How are doctors or other health specialists perceived?  Is the concept of ‘fate’ connected to physical health?  What are the prevailing conversational norms and how do these affect what questions are appropriate to ask?  These are just a few of the questions a good researcher will consider when designing a research protocol in a community that has different cultural practices than their own.  Without such considerations, the entire basis for an informed analysis of the researcher’s hypothesis is invalidated.(2)

The Researcher as an Outsider

When entering a community, the researcher is almost always an outsider.  “Gender, racial identity, social class and shared experience can affect the research process and willingness of respondents to talk to the researchers.”  However, these need not be detrimental: differences between the researcher, the study participants, and the interpreter can actually be beneficial by giving all parties involved the opportunity to articulate their feelings about their different life experiences.  The one potential exception to this is gender: sometimes, due to the prevailing cultural norms of a community, gender may be an impediment to interaction.(3)  It is important for researchers to understand the cultural significance of gender roles in the community so that they might respect them to the best of their ability.

Language Barriers: Partnering with Interpreters

One of the most difficult parts of conducting methodologically sound research in a developing community is the language barrier that may exist between the researcher and the participants.  Combined with the probable presence of significant cultural differences, the language barrier deserves a great deal of attention and consideration on the part of the researcher if it is to be circumvented effectively.  Partnering with interpreters is a great way to overcome these differences, provided that the partnership is well thought out and performed properly.  Rather than being a mere translation device, interpreters should be “actively participative” in the research process for a variety of reasons:(4)

Special Considerations in Interpretation

Finding the right balance with an interpreter is not always easy.  “Concepts of health and illness are socially constructed,”(5) and although the interpreter and the researcher can communicate in the same language, there may be vast cultural differences that lead to each party understanding the same concept or interaction in very different ways.  In addition, there are several potential issues that may come about as a result of the omnipresent nature of interpreters throughout the research process.

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Footnotes

(1) Marshall, P. A.  “Ethical Challenges in Study Design and Informed Consent for Health Research in Resource-Poor Settings”  Special Topics in Social, Economic and Behavioral Research No. 5, pp. 12.  Accessed on 2/17/09.

(2) Pitchforth, E. and van Teijlingen, E.  “International Public Health Research Involving Interpreters: A Case Study From Bangladesh” BMC Public Health, Vol. 5, No. 71. 2005. Accessed 2/17/09.

(3)  Pitchforth, E. and van Teijlingen, E.  “International Public Health Research Involving Interpreters: A Case Study From Bangladesh” BMC Public Health, Vol. 5, No. 71. 2005. Accessed 2/17/09.

(4) Pitchforth, E. and van Teijlingen, E.  “International Public Health Research Involving Interpreters: A Case Study From Bangladesh” BMC Public Health, Vol. 5, No. 71. 2005. Accessed 2/17/09.

(5) Pitchforth, E. and van Teijlingen, E.  “International Public Health Research Involving Interpreters: A Case Study From Bangladesh” BMC Public Health, Vol. 5, No. 71. 2005. Accessed 2/17/09.

(6)  Pitchforth, E. and van Teijlingen, E.  “International Public Health Research Involving Interpreters: A Case Study From Bangladesh” BMC Public Health, Vol. 5, No. 71. 2005. Accessed 2/17/09.

(7) Marshall, P. A.  “Ethical Challenges in Study Design and Informed Consent for Health Research in Resource-Poor Settings”  Special Topics in Social, Economic and Behavioral Research No. 5.  Accessed on 2/17/09.

(8) Erinosho, Olayiwola, ed.  “Ethics for Public Health Research in Africa” Proceedings of an International Workshop in collaboration with the Special Programme for Research and Training in Tropical Diseases (TDR) of the World Health Organisation, with the support of the Federal Ministry of Health, Abuja, Nigeria, April 21-23, 2008. pp. 37.  Accessed 2/17/09.