Author: Aiman Alrawabdeh, MScBME, (2025)
Primary advisor: Robert Murphy, MD
DHI Translational Project, McWilliams School of Biomedical Informatics at UTHealth Houston
ABSTRACT
In Jordan, where the healthcare system primarily operates in English, Arabic-speaking patients encounter significant challenges in understanding laboratory test names and results, including Hemoglobin A1c (HbA1c), an essential diagnostic indicator for diabetes management. The lack of multilingual access to medical information limits health literacy and patient autonomy, increasing dependence on healthcare staff for translation assistance. This translational informatics project addressed these challenges by developing and implementing an Arabic translation process for the HbA1c lab test name and results. HbA1c was selected as it is a standard lab test among patients with diabetes in Jordan; nearly 30% of Jordanians had type 2 diabetes in 2020 (Awad et al., 2020).
The project was guided by Sittig and Singh’s Eight-Dimensional Model for Health Information Technology (Sittig & Singh, 2010), which provided a 360-degree overview and addressed this healthcare improvement initiative's technical and social dimensions. The intervention had two parts: translating the HbA1c name and results into Arabic and making those results available to Arabic-speaking patients who had undergone HbA1c testing. The first part, the translation process, incorporated standardized medical terminologies to attain clinical accuracy, linguistic relevance, and interoperability. A combination of Arabization, Arabicization, and descriptive translation methods (Alasbahy & Shamsi, 2023; Al-Shbiel, 2017; Høy, 2022) was applied to produce culturally appropriate, patient-friendly translations. A scientific committee of clinicians and linguistic experts completed, reviewed, and validated the translations; a series of Plan-Do-Study-Act (PDSA) cycles (Agency for Healthcare Research and Quality, 2024) allowed for iterative refinement of translated content. The second part of the intervention provided the translated test name and results to patients via hard copy, a patient portal, a mobile app, and digital download. Additionally, English or Arabic results were provided, by patient request, to their physician.
A mixed-methods approach was employed to evaluate the intervention’s impact. Quantitative metrics included login frequencies for the patient portal and mobile app, translation and explanation assistance requests, and time spent per patient consultation. Qualitative insights were gathered through patient feedback and observations of user behavior. Results revealed a 12.3% increase in engagement with online tools, an 89.4% reduction in translation requests, and an 84% reduction in lab staff time spent translating or explaining results for patients. Furthermore, 91.2% of patients reported comprehension of their results and clarity regarding the next steps in managing their care, reflecting enhanced health literacy. Despite the success of the translation initiative, certain limitations were noted that should be considered when planning for broader implementation and generalization.
In conclusion, this project demonstrated a scalable, structured approach to improving patient comprehension and decreasing reliance on lab staff by translating the name and results of a common lab test into Arabic. The methodology and translation process used in this study have the potential to be a model for similar initiatives in other Arabic-speaking countries. Future efforts should develop national policies to create and implement standardized Arabic medical terminology across healthcare systems in Jordan. Additionally, a national standardized and governed repository of Arabic medical terminology should be developed to advance equitable access to multilingual health information.