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Learning from global public health experience: Something else to get lost in translation?
ARTICLE IN PRESS Public Health (2007) 121, 161–162
www.elsevierhealth.com/journals/pubh
Editorial
Learning from global public health experience: Something else to get lost in translation? The growing interest in, and understanding of, health literacy is an important area in public health research and practice. As this edition of Public Health shows, understanding the health literacy of the population for which you are caring is a critical factor in effective intervention whether it be for specific communities,1 events2 or diseases.3 Often these studies highlight that care is needed to make sure that things are not ‘‘lost in translation’’ between the public health professional or agency and the public. However, closer consideration of how things can get lost in translation suggests that the public health community may also need to be careful. There is little doubt that public health concerns are now expressed on a global level. In recent years we have been asked to consider our response to multi-country disaster relief following earthquakes and tsunami, to newly emerging communicable diseases such as SARS, or to the possibility of pandemic flu. At the same time we have been called upon to act to limit the resurgence in old public health enemies such as TB. We are already seeking to understand the escalating threat of obesity and how it may be reversed. In all cases the need to learn from the experiences of public health professionals and the systems in which they work is essential. When the lessons have very clear, global impact the learning can be swift and effective. However, there are times when, for whatever reason, it does not seem to work that way. At one level—given the size of the evidence base—it is hardly surprising that things can get lost. It is arguable that without the use of internet based search engines or e-mail reminder services, public health professionals would struggle to keep abreast of all the possible peer-reviewed journals that would be of interest to them. If one adds in the need to be aware of the many international and
national reports and studies that are published by health organisations, charitable foundations and government bodies and agencies, then the task could become a full-time job. However, there are more subtle ways in which research evidence can get ‘‘lost’’. The use of technology to facilitate searching for evidence is a great way of losing it inadvertently. For example, ensuring that the search parameters of your preferred search engine are not set too narrowly is an important lesson. Of course, you may only really be interested in randomised controlled trials, undertaken in the last 10 years, and published in the main bio-medical journal set. Yet when searching for material relevant to your public health practice, this may be less than helpful. Even setting the language filter—whilst helpful in some contexts—may be less so in others. As an English language journal, this edition of Public Health is publishing two papers from Japanese researchers that consider the measurement of deprivation and mortality4 and the health economics of proteinuria.5 Most English-speaking researchers would have excluded these studies from further consideration had they been published in an untranslated Japanese language journal and had appeared on a computer-generated search list. But at least that would have required active exclusion, rather than passive omission. A further way in which material is lost in translation relates to the context in which the research is being undertaken. Almost from the very first lecture on using evidence, students and budding researchers are encouraged to reflect on the appropriateness of any research study to the local context. Our teachers encourage a critical appraisal of the degree to which any research is capable of being transferred from the research setting to another setting. In some cases, this is a
0033-3506/$ - see front matter & 2007 Published by Elsevier Ltd on behalf of The Royal Institute of Public Health. doi:10.1016/j.puhe.2007.01.001
ARTICLE IN PRESS 162 fairly straightforward process. For example, in countries where Forest Onchocerciasis is endemic, the study, which we are publishing in this edition of the journal is highly relevant and likely to be transferable.6 But is the same true for the study on the impact of domestic violence7 in the Lebanese context? Whether such a study achieves its potential for transferable learning will largely depend on whether the searching practitioner considers the subject matter sufficiently important to seek to understand and interpret the context. We live in a shrinking world, where effective public health action requires effective learning from public health systems on a global basis. For that to happen, we recognise that international journals such as Public Health have a key role to play in bringing research evidence from across the world to the attention of our readers. We would encourage all authors to remember the international readership of Public Health and ask them to provide sufficient, contextual detail in their papers to allow interpretation. Equally, we would encourage our readers to be proactive in preventing evidence getting lost in translation.
References 1. Netto G, McCloughan L, Bhatnagar A. Effective heart disease prevention: lessons from a qualitative study of user perspec-
Editorial
2.
3. 4.
5.
6.
7.
tives in Bangladeshi, Indian and Pakistani communities. Public Health, this issue, doi:10.1016/j.puhe.2006.11.001. Kondilis B, Soteriades ES, Falagas ME. Readibility levels of health pamphlets distributed during the Athens 2004 Olympic Games. Public Health, this issue, doi:10.1016/ j.puhe.2006.09.020. Wells DL. Public understanding of toxocariasis. Public Health, this issue, doi:10.1016/j.puhe.2006.10.016. Fukuda Y, Nakamura K, Takano T. Higher mortality in areas of lower socioeconomic position measured by a single index of deprivation in Japan. Public Health, this issue, doi:10.1016/ j.puhe.2006.10.015. Nakamura K, Okamura T, Kanda H, Hayakawa T, Okeyama A, Ueshima H, for the Health Promotion Research Committee of the Shiga National health Insurance Organizations. Medical costs of individuals with proteinuria: a 10-year follow-up study of National Health Insurance in Shiga, Japan. Public Health, this issue, doi:10.1016/j.puhe. 2006.07.024. Opara KN, Fagbemi BO, Atting IA, Oyene UE, Okenu DMN. Status of forest onchocerciasis in the Lower Cross River Basin, Nigeria: Change in clinical and parasitological indices after 6 years of ivermectin intervention. Public Health, this issue, doi:10.1016/j.puhe.2006.09.010 Usta J, Farver JAM, Pashayan N. Domestic violence: The Lebanese experience. Public Health, this issue, doi:10.1016/ j.puhe.2006.09.014.
P. Mackie F. Sim The Royal Institute of Public Health, 28 Portland Place, London, W1B 1DE, UK E-mail address: [email protected]
In this Issue For the March edition of Public Health we consider a very wide range of papers from across the globe. From Japan, we present two papers. The first explores the relationship between mortality and socioeconomic position and how it can be measured, and the second the healthcare costs associated with the management of proteinuria. The public’s understanding of health—often described as health literacy—is increasingly recognised as a key factor in effective public health intervention, and in papers from the UK and from Greece, we explore aspects of such public heath literacy in relation to heart disease interventions, toxcariasis and general information leaflets. The theme of understanding and health is also considered in papers describing aspects of communicable disease amongst schoolteachers in Chandigarh and pregnant women in rural China. Violence remains a public health concern in many places and settings which we explore in two studies: one considering domestic violence in Lebanon and the second relating to children’s views of corporal punishment.
www.elsevierhealth.com/journals/pubh
Editorial
Learning from global public health experience: Something else to get lost in translation? The growing interest in, and understanding of, health literacy is an important area in public health research and practice. As this edition of Public Health shows, understanding the health literacy of the population for which you are caring is a critical factor in effective intervention whether it be for specific communities,1 events2 or diseases.3 Often these studies highlight that care is needed to make sure that things are not ‘‘lost in translation’’ between the public health professional or agency and the public. However, closer consideration of how things can get lost in translation suggests that the public health community may also need to be careful. There is little doubt that public health concerns are now expressed on a global level. In recent years we have been asked to consider our response to multi-country disaster relief following earthquakes and tsunami, to newly emerging communicable diseases such as SARS, or to the possibility of pandemic flu. At the same time we have been called upon to act to limit the resurgence in old public health enemies such as TB. We are already seeking to understand the escalating threat of obesity and how it may be reversed. In all cases the need to learn from the experiences of public health professionals and the systems in which they work is essential. When the lessons have very clear, global impact the learning can be swift and effective. However, there are times when, for whatever reason, it does not seem to work that way. At one level—given the size of the evidence base—it is hardly surprising that things can get lost. It is arguable that without the use of internet based search engines or e-mail reminder services, public health professionals would struggle to keep abreast of all the possible peer-reviewed journals that would be of interest to them. If one adds in the need to be aware of the many international and
national reports and studies that are published by health organisations, charitable foundations and government bodies and agencies, then the task could become a full-time job. However, there are more subtle ways in which research evidence can get ‘‘lost’’. The use of technology to facilitate searching for evidence is a great way of losing it inadvertently. For example, ensuring that the search parameters of your preferred search engine are not set too narrowly is an important lesson. Of course, you may only really be interested in randomised controlled trials, undertaken in the last 10 years, and published in the main bio-medical journal set. Yet when searching for material relevant to your public health practice, this may be less than helpful. Even setting the language filter—whilst helpful in some contexts—may be less so in others. As an English language journal, this edition of Public Health is publishing two papers from Japanese researchers that consider the measurement of deprivation and mortality4 and the health economics of proteinuria.5 Most English-speaking researchers would have excluded these studies from further consideration had they been published in an untranslated Japanese language journal and had appeared on a computer-generated search list. But at least that would have required active exclusion, rather than passive omission. A further way in which material is lost in translation relates to the context in which the research is being undertaken. Almost from the very first lecture on using evidence, students and budding researchers are encouraged to reflect on the appropriateness of any research study to the local context. Our teachers encourage a critical appraisal of the degree to which any research is capable of being transferred from the research setting to another setting. In some cases, this is a
0033-3506/$ - see front matter & 2007 Published by Elsevier Ltd on behalf of The Royal Institute of Public Health. doi:10.1016/j.puhe.2007.01.001
ARTICLE IN PRESS 162 fairly straightforward process. For example, in countries where Forest Onchocerciasis is endemic, the study, which we are publishing in this edition of the journal is highly relevant and likely to be transferable.6 But is the same true for the study on the impact of domestic violence7 in the Lebanese context? Whether such a study achieves its potential for transferable learning will largely depend on whether the searching practitioner considers the subject matter sufficiently important to seek to understand and interpret the context. We live in a shrinking world, where effective public health action requires effective learning from public health systems on a global basis. For that to happen, we recognise that international journals such as Public Health have a key role to play in bringing research evidence from across the world to the attention of our readers. We would encourage all authors to remember the international readership of Public Health and ask them to provide sufficient, contextual detail in their papers to allow interpretation. Equally, we would encourage our readers to be proactive in preventing evidence getting lost in translation.
References 1. Netto G, McCloughan L, Bhatnagar A. Effective heart disease prevention: lessons from a qualitative study of user perspec-
Editorial
2.
3. 4.
5.
6.
7.
tives in Bangladeshi, Indian and Pakistani communities. Public Health, this issue, doi:10.1016/j.puhe.2006.11.001. Kondilis B, Soteriades ES, Falagas ME. Readibility levels of health pamphlets distributed during the Athens 2004 Olympic Games. Public Health, this issue, doi:10.1016/ j.puhe.2006.09.020. Wells DL. Public understanding of toxocariasis. Public Health, this issue, doi:10.1016/j.puhe.2006.10.016. Fukuda Y, Nakamura K, Takano T. Higher mortality in areas of lower socioeconomic position measured by a single index of deprivation in Japan. Public Health, this issue, doi:10.1016/ j.puhe.2006.10.015. Nakamura K, Okamura T, Kanda H, Hayakawa T, Okeyama A, Ueshima H, for the Health Promotion Research Committee of the Shiga National health Insurance Organizations. Medical costs of individuals with proteinuria: a 10-year follow-up study of National Health Insurance in Shiga, Japan. Public Health, this issue, doi:10.1016/j.puhe. 2006.07.024. Opara KN, Fagbemi BO, Atting IA, Oyene UE, Okenu DMN. Status of forest onchocerciasis in the Lower Cross River Basin, Nigeria: Change in clinical and parasitological indices after 6 years of ivermectin intervention. Public Health, this issue, doi:10.1016/j.puhe.2006.09.010 Usta J, Farver JAM, Pashayan N. Domestic violence: The Lebanese experience. Public Health, this issue, doi:10.1016/ j.puhe.2006.09.014.
P. Mackie F. Sim The Royal Institute of Public Health, 28 Portland Place, London, W1B 1DE, UK E-mail address: [email protected]
In this Issue For the March edition of Public Health we consider a very wide range of papers from across the globe. From Japan, we present two papers. The first explores the relationship between mortality and socioeconomic position and how it can be measured, and the second the healthcare costs associated with the management of proteinuria. The public’s understanding of health—often described as health literacy—is increasingly recognised as a key factor in effective public health intervention, and in papers from the UK and from Greece, we explore aspects of such public heath literacy in relation to heart disease interventions, toxcariasis and general information leaflets. The theme of understanding and health is also considered in papers describing aspects of communicable disease amongst schoolteachers in Chandigarh and pregnant women in rural China. Violence remains a public health concern in many places and settings which we explore in two studies: one considering domestic violence in Lebanon and the second relating to children’s views of corporal punishment.