Adapting and translating the “Hep B Story” App the right way: a transferable toolkit to develop health resources with, and for, Aboriginal people

Background: In 2014 The Menzies hep B team released the first hepatitis B educational app in an Aboriginal language, the “Hep B Story”, addressing the need for chronic hepatitis B information in a patient’s first language. In 2018 the “Hep B Story” was assessed and adapted prior to translation into a further 10 Aboriginal languages. Whilst we initially thought the task would be simple, this was not so. The translation process developed iteratively and evolved into a model that may be applied when creating any health resource in Aboriginal languages. Methods: The adaptation and translation of the “Hep B Story” process involved ten key steps: 1. Focus groups with language speakers to assess cultural suitability of content. 2. Adaptation of content or images as required. 3. Forward and back translation of script using translators. 4. Translations checked for content accuracy. 5. Queries discussed and corrected with translators. 6. Voiceovers recorded. 7. Revised versions of the app produced. 8. Revised versions of the app reviewed by focus group members and translators. 9. Final edits and corrections made and reviewed. 10. Finalisation and publication of the new language version. Results: The process of adaptation and translation appears straightforward, and in planning the project, we naively allowed 12 months to complete 10 language translations, in reality it took five years. Forming consultation groups, finding translators to write in language, and removing barriers to work was not easy, while simultaneously dealing with the remoteness of Australia’s Northern Territory. The consultation process for each language group resulted in extensive chronic hepatitis B education community wide, with many participants sharing the story with their family and encouraging them to get a hepatitis B check-up. Conclusions: With more than 100 people involved in the project and thousands of kilometres travelled across the Northern Territory we produced not only an education tool for many Aboriginal people in their preferred language but developed a model for working with translators to develop health resources for different cultural and linguistic groups across the Northern Territory.