Lost in translation: advancing intervention adaptation for populations with non-dominant language preference in high diversity settings

Abstract As the population of individuals with non-dominant language preference (NDLP) continues to grow, the field of implementation science has yet to fully address the unique barriers that this population faces in accessing evidence-based interventions (EBIs). Traditional models of cultural adapt...

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Main Authors: Kirsten Austad, Erika G. Cordova-Ramos, Alicia Fernandez, Mari-Lynn Drainoni
Format: Article
Language:English
Published: BMC 2025-05-01
Series:Implementation Science Communications
Subjects:
Online Access:https://doi.org/10.1186/s43058-025-00753-6
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author Kirsten Austad
Erika G. Cordova-Ramos
Alicia Fernandez
Mari-Lynn Drainoni
author_facet Kirsten Austad
Erika G. Cordova-Ramos
Alicia Fernandez
Mari-Lynn Drainoni
author_sort Kirsten Austad
collection DOAJ
description Abstract As the population of individuals with non-dominant language preference (NDLP) continues to grow, the field of implementation science has yet to fully address the unique barriers that this population faces in accessing evidence-based interventions (EBIs). Traditional models of cultural adaptation have been designed primarily for single linguistic or ethnic groups, focusing on aligning interventions with specific cultural values, beliefs, and practices. While effective within narrowly defined populations, this approach is not scalable to high-diversity settings where multiple NDLP groups are served simultaneously. In this Commentary, we argue for a reconceptualization of how implementation science approaches language barriers, advocating for all implementation efforts to consider language as a core determinant of success. We highlight how two relatively recent tools developed within implementation science—the Core Function and Form Framework and causal pathway diagrams—can advance EBI adaptation for populations with NDLP. We propose a highly scalable approach that systematically assesses the linguistic, cultural, and social needs of each individual and uses these data to guide individualized tailoring of an intervention, building on the emerging model of “personalized adaptation.” We highlight the need to innovate methods to ensure an individualized approach to EBI adaptation is feasible, scalable, and led by communities, with input from end-users. By harnessing the wisdom of the fields of implementation science and cultural adaptation, interventions can be adapted to the linguistic, cultural, and social needs of populations with NDLP to bring us closer to health equity in a diverse world.
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spelling doaj-art-1bd3f954350b42bd8a0a6f80aca0e1d92025-08-20T02:00:07ZengBMCImplementation Science Communications2662-22112025-05-01611810.1186/s43058-025-00753-6Lost in translation: advancing intervention adaptation for populations with non-dominant language preference in high diversity settingsKirsten Austad0Erika G. Cordova-Ramos1Alicia Fernandez2Mari-Lynn Drainoni3Department of Family Medicine, Boston Medical Center and Boston University Chobanian & Avedisian School of MedicineEvans Center for Implementation and Improvement Sciences, Department of Medicine, Boston University Chobanian & Avedisian School of MedicineDepartment of Medicine, University of California San FranciscoEvans Center for Implementation and Improvement Sciences, Department of Medicine, Boston University Chobanian & Avedisian School of MedicineAbstract As the population of individuals with non-dominant language preference (NDLP) continues to grow, the field of implementation science has yet to fully address the unique barriers that this population faces in accessing evidence-based interventions (EBIs). Traditional models of cultural adaptation have been designed primarily for single linguistic or ethnic groups, focusing on aligning interventions with specific cultural values, beliefs, and practices. While effective within narrowly defined populations, this approach is not scalable to high-diversity settings where multiple NDLP groups are served simultaneously. In this Commentary, we argue for a reconceptualization of how implementation science approaches language barriers, advocating for all implementation efforts to consider language as a core determinant of success. We highlight how two relatively recent tools developed within implementation science—the Core Function and Form Framework and causal pathway diagrams—can advance EBI adaptation for populations with NDLP. We propose a highly scalable approach that systematically assesses the linguistic, cultural, and social needs of each individual and uses these data to guide individualized tailoring of an intervention, building on the emerging model of “personalized adaptation.” We highlight the need to innovate methods to ensure an individualized approach to EBI adaptation is feasible, scalable, and led by communities, with input from end-users. By harnessing the wisdom of the fields of implementation science and cultural adaptation, interventions can be adapted to the linguistic, cultural, and social needs of populations with NDLP to bring us closer to health equity in a diverse world.https://doi.org/10.1186/s43058-025-00753-6Intervention adaptationNon-dominant language preferenceCultural adaptationLimited English proficiency
spellingShingle Kirsten Austad
Erika G. Cordova-Ramos
Alicia Fernandez
Mari-Lynn Drainoni
Lost in translation: advancing intervention adaptation for populations with non-dominant language preference in high diversity settings
Implementation Science Communications
Intervention adaptation
Non-dominant language preference
Cultural adaptation
Limited English proficiency
title Lost in translation: advancing intervention adaptation for populations with non-dominant language preference in high diversity settings
title_full Lost in translation: advancing intervention adaptation for populations with non-dominant language preference in high diversity settings
title_fullStr Lost in translation: advancing intervention adaptation for populations with non-dominant language preference in high diversity settings
title_full_unstemmed Lost in translation: advancing intervention adaptation for populations with non-dominant language preference in high diversity settings
title_short Lost in translation: advancing intervention adaptation for populations with non-dominant language preference in high diversity settings
title_sort lost in translation advancing intervention adaptation for populations with non dominant language preference in high diversity settings
topic Intervention adaptation
Non-dominant language preference
Cultural adaptation
Limited English proficiency
url https://doi.org/10.1186/s43058-025-00753-6
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AT aliciafernandez lostintranslationadvancinginterventionadaptationforpopulationswithnondominantlanguagepreferenceinhighdiversitysettings
AT marilynndrainoni lostintranslationadvancinginterventionadaptationforpopulationswithnondominantlanguagepreferenceinhighdiversitysettings