Unmuted: Equity in Focus — Bridging Language and Health

🎙️ New on the GOSH Podcast's "Unmuted: Equity in Focus" series!

How can language empower women to take charge of their health? In this episode, we speak with Dr. Lesa Dawson, Dr. Reetinder Kaur Brar, and Jessie Kaur Lehail about their groundbreaking project Bridging Language and Health: Creating Culturally Competent, Gender-Sensitive Health Education for Punjabi Women.

Together, they’re redefining what equitable care means—by creating translation frameworks that honour culture, gender, and community voice. 💬✨

🎧 Tune in to hear how this team is ensuring that language is not a barrier to care, but an invitation.

Resources:

CBCNews: https://www.cbc.ca/player/play/video/9.6911282

For more information on the Gynecologic Cancer Initiative, please visit https://gynecancerinitiative.ca/ or email us at info@gynecancerinitiative.ca

Where to learn more about us:
Twitter – @GCI_Cluster
Instagram – @gynecancerinitiative
Facebook – facebook.com/gynecancerinitiative
TikTok – @gci_gosh

Transcript

00:00:02 Intro 

Thanks for listening to the GOSH podcast—The Gynecologic Oncology Sharing Hub. We share real, evidence-based discussions on gynecologic cancers, featuring stories from patients, survivors, researchers, and clinicians. Our podcast is produced and recorded on traditional unceded territories of the Musqueam, Squamish, and Tsleil-Waututh Nations. It is produced by the Gynecologic Cancer Initiative, a BC-wide effort to advance research and care for gynecologic cancers.   

00:00:35 Sabrina 

Hello everyone! Welcome back to another episode in our Unmuted: Equity in Focus series on the GOSH Podcast where we highlight stories, expertise, and community perspectives on equitable gynecologic cancer care. Today we have Dr. Lesa Dawson, Dr. Reetinder Kaur Brar, and Jessie Kaur Lehail who have teamed up to create a Punjabi translation framework to ensure culturally and gender-sensitive translations of English medical materials. Their project Bridging Language and Health: Creating Culturally Competent, Gender-Sensitive Health Education for Punjabi Women advocates for providing accurate, meaningful, and culturally appropriate communication to patients, in order to improve equity in healthcare. 

Reetinder Kaur is a Punjabi language instructor at SFU with master’s degrees in Anthropology (Panjab University, India) and Asian Studies (UBC), and a PhD in Anthropology (Panjab University). She has over 10 years’ experience in qualitative health research, project coordination, and teaching in Canada and India. Her research focuses on South Asian health, organ donation in racialized communities, and gender disparities in kidney donation, with an emphasis on diversity, inclusion, and decolonizing research. She is Project Director with the UBC Kidney Transplant Research Program and pursuing a PhD in Interdisciplinary Studies at UBC. 

Jessie Kaur Lehail is an award-winning social impact and communications leader dedicated to women’s advocacy and health equity. As CEO of the Kaur Collective Foundation, she empowers Sikh women globally through storytelling, faith, health, and food security. She co-created a gender-sensitive translation framework for Punjabi women’s health education and works as a research coordinator with Dr. Lesa Dawson on hereditary ovarian cancer testing. Jessie also leads Shelter Movers Vancouver, serves on the Fraser Health Board of Directors, and is a professional abstract painter with over 15 years’ experience in women’s advocacy. 

Dr. Lesa Dawson is a Gynecologic Oncologist with over 20 years’ experience caring for women with gynecologic cancer or hereditary predisposition (BRCA, RAD51C/D, Lynch Syndrome). She leads the VGH Gynecologic Cancer Prevention and Survivorship Clinic, serving women across BC. Trained in obstetrics, gynecology, oncology, cancer genetics, and clinical epidemiology, her research focuses on survivorship, equity in women’s health, and population-based hereditary cancer testing. She is committed to personalized care for high-risk women and has research funding from SSHRC, MSRF, and CIHR. 

Welcome Jessie, Reetinder, and Lesa! Thank you so much for joining us today. 

00:03:40 Jessie 

 Thank you for having us. 

00:03:42 Lesa 

Thanks. 

00:03:42 Sabrina 

I was thinking we could start with you guys sharing a bit about how you all came to collaborate. 

00:03:50 Jessie 

Oh, for sure. I'm happy to go first. So Reetinder and I have been friends for many years. She was actually my Punjabi teacher. So I was taking a class during COVID, and she was my instructor. And we really, since the time that we met, we've been asking a lot of big questions, things like, why is it hard for Punjabi women to talk about their health? And why do we never really have the right words to describe our health ailments? Our curiosity kind of grew into a larger mission. Dr. Dawson and I have known each other for probably about the same time, but maybe a bit longer. And we actually collectively met together during a South Asian Health Conference during COVID. Again, it was at the tail end of COVID. And we all really got along well together. And over the last couple of years in particular, really have been coming together to ask these harder questions and thought it would be great to formalize something with Lisa through UBC and then through Core Collective Foundation. 

00:05:03 Sabrina 

Beautiful. Sounds like you all have a long, long lasting relationship here. 

00:05:08 Jessie 

We hope so. 

00:05:10 Sabrina 

Would you guys mind telling me a bit or giving me and our listeners a bit of an overview of the objectives of the Bridging Language and Health Project? 

00:05:21 Lesa 

Sure. So, as we got into this, we're coming, all three of us, at it from quite different angles. I'm coming at it as a physician who cares for patients every day in my clinical practice in gynecologic cancer prevention, but also I'm a researcher. And so through my research, we were seeing some disconnects and some inconsistencies in the numbers of people by certain ethnicity that were accessing certain services. And the thing that was relevant to my practice was that there weren't very many South Asian women accessing genetic testing for BRCA. And it's free if you meet certain criteria. So we didn't really know why that was. And that's kind of how I got started. But the project has kind of got two sections, I would say now. The first section is really trying to doing some qualitative work, meaning interviews, focus groups with South Asian women, Punjabi women, and other South Asian identities to see what are the reasons that we think maybe people were less likely to do testing. So that's one project. And we were very lucky to be supported by the Canada Indian Network Society, Dr. Arun Garg. And we received some funding through the UBC Community Engagement Fund, as well as through the SSHRC, the Social Sciences Council. That's project one. Project two really comes at the heart of how Jesse and Ratinder found each other, which was through talking about women's health and communication in Punjabi language. And that second project is the development of its translation framework and in essence, they'll tell you more. But in essence, what we're seeing is that a lot of the things that are generated from the health care system are not being delivered in Punjabi in an accurate or culturally adapted way. So really there's two projects, but they deeply overlap, we believe, but they've washed out to be two super important, super interesting projects. I'll let Reetinder and Jessie explain more about the translation framework. 

00:07:21 Jessie 

Our goal is, like I said, we've been having these conversations, really trying to understand why women aren't really having self-agency over their health and aren't really empowered to speak about health ailments. So number one is our goal is to really name and dismantle barriers that have kept Punjabi women silenced and really understand the complexity of Punjabi language with its variations, whether from script dialects or regional variations, to cultural and family kind of community expectations that keep some health topics, particularly women's health topics, quite taboo. So we really want women to feel familiar and confident with words that they're using to describe their bodies and their health, not just at doctor's offices or health kind of atmospheres, but also in their homes and in their common language. So we're really building and we're at the initial stage, I'd say, in this building of the translation framework. We still have quite a bit of work ahead of us. And really, we're not looking at it as an end product. We're really looking at translation right from the outset. And it's really more than just swapping words and literal translation, but really about creating meaning for Punjabi women. And we're really trying to ensure that the community is directly part of the process whether it's through focus groups, we're realizing we need to create anatomy workshops and maybe even patient partner panels. So really, every resource will be reviewed and adapted by the community so that it's not just correct, but really trusted and usable by the community and the women talking about their bodies. And overall project, as you probably have picked up on, is about agency for Punjabi women. We really want women to use language and context to be able to speak up for themselves. And the framework prioritizes privacy, dignity, and real choice for women so that they're not having to rely on translators, whether that's family members or otherwise to really interpret delicate information. And our vision ultimately is for Punjabi women to not be silent by standards or not really speak up about their health, but really to be active participants in their health journeys and really be empowered to ask questions, talk about family history, challenge stigma in whatever language feels comfortable for them and is close to them. So by using meaning first, culturally sensitive and community-driven approaches, we really want to set a new standard for equity in health education. We're foreseeing this, obviously, for Punjabi speakers, but we would like to have a broader people of color, equity kind of focus for communities who've been left out of conversations before. 

00:10:56 Reetinder 

Yeah, just adding on to what Jesse has already said. So we are noticing a lot of inconsistencies in how Punjabi language translations are done. Most of the translations are word to word, but there are many inaccuracies, use of words that are not culturally appropriate or gender sensitive. So that is the point from where we thought that we should start, having a conversation in the community. So one of our initial goal is to have community support, have this conversation going on in community, but also making sure that we gather data. We have community and patient partner support for this project so that we can create some tangible products such as a dictionary that, give agency to Punjabi women what are the most preferred words, for their body parts, for, body anatomy that are used for, that are preferred by Punjabi women but also they are understandable to them. These are the words, these are the terms, these are the examples and phrases and stories, you know, that Punjabi women most relate to in context of their health. So that is our goal, to obviously, you know, get community's attention and support, but also making sure that what we are talking about in terms of this translation framework is backed by data that is driven by community. And community have a space to really talk about these issues, such as translation and contributing to this data. So this is led by Punjabi women, but also creating space for community women to participate in a research project in partnership with them. 

00:12:54 Sabrina 

Oh, yeah. Big, big goals and very important work. Thank you so much for sharing that overview. I think both of you mentioned script variations and gendered language and how that can really affect comprehension and engagement with health education. Would you mind telling us a bit more about this and how your project really aims to address that? 

00:13:14 Reetinder 

Yeah, so when we had our initial conversation and you have mentioned in my introduction as well that I teach Punjabi at Simon Fraser, I've also been involved with UBC Punjabi program. So one of the things that we noticed is that everybody who's coming into the program, Punjabi program for learning Punjabi language, they don't understand that Punjabi language have two distinct scripts. So it is written very differently, but spoken in a similar manner with geographical variations, of course. So Gurmukhi is the most dominant script that is being used in translations, but also in teaching programs. But many people who are getting into, you know, either teaching programs or, you know, in the translation work, they don't understand that there is an audience for another script as well. So creating audio resources could be really useful in terms of patient educational material. But as far as, you know, any kind of written materials are concerned, we need to acknowledge this limitation that by translating materials into only one script, we are limiting access to this information for readers of, you know, Shahmukhi script, for example. So just for our basic understanding, Punjabi language has two scripts, which are gurmukhi and shahmukhi. And there are many regional variations, which means somebody from one region may be using this word, meaning this, but then somebody from other region may not be understanding this. So one of the role of translator is to use words that are understandable generally, which are like most common words. So those understandings are really important for translators, but also for anybody who's engaging in the translation process, even in healthcare system. The other question you ask is about gendered nature of Punjabi language. So the way Punjabi sentence formation and how Punjabi is spoken, it is spoken differently. So gender is assigned to things, you know. So if I'm referring to you versus if I'm referring to a male, it is constructed differently. So when we use platforms like AI, which are default masculine, they can't really differentiate unless we give them a command that I'm, I want to translate this thing in context of a woman, then they'll understand, but otherwise it's default masculine. So many of the translations that we are seeing right now coming out using AI, that kind of distinction is missing from them. That's why in our framework we'll be proposing that we need community, we need patient partners to look at these translations and ensure that these are correct and these are understandable to the community. 

00:16:16 Sabrina 

Very interesting. Yeah, I think differentiating those two scripts must be incredibly important and sometimes overlooked. So you've also mentioned that a portion of your project includes developing a gender-sensitive translation framework. Could you tell us a bit more about that and what goes into building a framework like that? 

00:16:35 Jessie 

Yeah, absolutely. So I think really the origin is, is we start by asking who's going to be reading the document and how do they talk about their bodies? Are they avoiding certain topics? What power dynamics may shape, who speaks and who stays silent. From there, we foresee involving community reviewers and running anatomy literacy workshops and structuring feedback loops that invite honest critique. And really, this, we feel, will not just think of this as a translation, but as a document that's living and evolving, almost like a relationship. So our translators reflection guide, we hope will help translators really pause and reflect and be transparent about their word choices and the challenges they face because we find there is some gaps between what women are noting and what is showing up in translation. And we find that gap is critical because information isn't being conveyed the way that the patient is actually explaining it. So we're hoping that this review and understanding will create some accountability for translators, but also guide them from their own biases so that they are able to convey accurate information that the patient is noting. It'll prompt them with different questions that they can self-ask to make sure that they're on track. And we're really hoping that it's evergreen and particularly during development. And that'll grow with every conversation and every critique going forward. 

00:18:35 Reetinder 

I'm also adding to this. So basically framework will be like a skeleton. So it'll provide guidance, not only to translators, but to, for example, health communication teams at hospitals, you know, whoever is engaging in the process. So we see that translation right now is one step process somebody hires a translator and tell them to, translate a health education material word by word. So this is, and the translator returns back, the materials and it's trusted that this is okay. Now we are proposing a framework which will be much more detailed, guiding what questions can help communications people can ask to the translator and what questions do translator need to ask them? And what is the space, what is the common space for dialogue? For example, I'm someone who's engaging in English to Punjabi translation of any XYZ patient education materials. So I should be aware that, you know, Punjabi language have distinct script. Who is my audience? What are goals of this translation and making sure that these goals and these ideas are communicated to the translator. And then ensuring that translator also have a space, understanding their audience, who is this, you know, who are they creating this work for, and having multiple meetings, you know, like also having an understanding of whether the translator have experience in translating, any kind of health materials and ensuring that there is some common space, to train them, to help them with vocabulary, like that kind of access, so that kind of communication. So a framework will help guide both the parties of what are the most relevant questions at the beginning, how to, you know, go about the process. And then, as Jesse mentioned, translator will also have an opportunity to reflect on their process. Did anything make them uncomfortable, while they were translating these materials? Did they dilute any information? Did they change any word? Did they act as kind of like cultural mediators within that process, changing certain meanings, certain words, certain things which they felt would be accepted in the community. So what were those things? So there is an opportunity for them to reflect on those things through a translator reflection guide. And then teams can look at those guides and have a discussion and reach at a point. And then involvement of community and patient partners is really important. So giving them a framework on how to do a translation. And this is not going to be a one-step process. This is going to be a multiple-step process that requires funding, that requires time investment, and more sincerity towards this work. So Jesse has already mentioned that making sure that Punjabi women are at the center of this work that's being created for them. 

00:22:03 Sabrina 

Yeah, I think you guys have mentioned many times how important it is to have community engagement in your work. Could you share a bit of an example of how Punjabi speaking women have shaped the materials that you're creating? 

00:22:17 Jessie 

Yeah, so we, when we started this and we started asking questions, we both felt that there wasn't a lot of Punjabi words for women's body parts, and if they were, they were either slang, curse words, or very generalized terms. For example, the word for breast is sometimes a curse word or a slang word that's quite offensive. Otherwise, women are really using the word chest to describe their breasts. And so we're thinking a lot is lost in translation of do they really mean breast or do they mean chest or another body part in the area? So this was confirmed when I completed some of the focus groups for the first project that Dr. Dawson noted on hereditary ovarian cancer testing for South Asian women. And really, within the focus groups, women were admitting they didn't have Punjabi words for basic body parts of their reproductive system. And also, they didn't really know locations of where body parts were. So they couldn't name and recognize pains in their bodies with the associated body parts. That was a culmination of many things. A lot of shame. No one teaching them where body parts were, and really them feeling ashamed to ask where body parts were and how they should describe the pain. So this is concerning for us and really shows how women knowing location, having the words to describe ailments and actually being encouraged to share words and placement so that they can understand their bodies and more so convey to health practitioners where they're having concerns and where they're noticing changes. So this narrow language and really honest admission is leading us to co-design anatomy resources and exercises. And again, returning back to the community, we hope to make sure and come confirm that words make sense to women and they're embracing this language and are comfortable using words that they're self-creating in community and then being able to actually name and place things with their bodies. And we're thinking this courage of shifting these priorities from education at them and really with them instead will be quite liberating for Punjabi women. And we're hoping that they will have the confidence then to start having the conversations that have been really lacking in the community about women knowing where their ailments are, and we're hoping it'll help them, inspire them to share stories and really support one another in conversations about their health and in their bodies. 

00:25:48 Lesa 

In addition to what Reetinder and Jessie are saying, which is so dead on, the other thing, too, to think about is that when we're seeing patients, not just a matter of documents or communication that's written or audio resources. Also, too, we're seeing people in clinic and they may have a healthcare authority translator who may or may not have the appropriate words themselves, but also sometimes, too, the person doing the translating might be a relative. And we need to really think about that, particularly, say, in my field where I work in gynecology and I work in genetics. You know, these are both topics that are quite sensitive. When you're talking about body parts and perhaps the translator is a male relative, that can be very uncomfortable, and people will not necessarily be comfortable to tell you what it is that's really bothering them. Likewise, when you're talking about genetics and things like BRCA mutations and inheritance, you know, if the translator is a relative, they may have their own set of beliefs and values about what needs to be shared, what should be tested, what should be communicated. So this is quite a big topic in terms of delivering evidence-based, well-communicated, empowering health care for women. 

00:27:06 Reetinder 

And now, adding to what Lesa has already said right now, for example, anatomy comprehension exercises, which will be part of developing this framework, would be really powerful. For example, you know, we may think, you know, and our literature also suggests that Punjabi women, you know, have reduced access to these and these healthcare services, or they don't, you know, take benefit of these services, and There are many things that are being said from being conservative, but the lens that this translation framework can provide is, do women really know about their body parts? Do they really understand? For example, if we have these anatomy comprehension exercises and we know that women are not completely aware of the differentiation between uterus and ovaries and fallopian tubes.... And, if we get that data, that'll be so powerful because in many, tests like Pap... I recently got in the mail, like you can, order the kit for yourself, Pap thing. You know, like having the data that do women really understand their body anatomy and can they really do it would be like really powerful data, not only in context of translation, but general Punjabi women's health context. It'll be really, really good, you know, set of data. 

00:28:39 Sabrina 

Yeah. Wow. That's so fascinating and so important for us to actually understand our bodies and be able to describe them in order to access care. You mentioned earlier, Reetinder, while you were describing the framework that you have a translator's reflection guide. I was wondering if you could elaborate on how that works and how it can be used to improve health literacy for Punjabi women. 

00:29:06 Reetinder 

Yeah, so it's a good question. So I do a lot of, you know, translation work myself as well. And when I'm translating a document, I really, you know, I'm also a health researcher. So I always wonder, like, is there a space where I can like note, you know, certain things? There were some difficult words that I came across, you know, for example, I'm reading the English version of patient health materials. And there are certain terms, right? When we had conversations with Lisa as well, and we were like, is it BRAC or BRAC? Like what is it called? Because people are calling it in a different manner. So as a translator, so there are certain things that you want to ask and, you know, you wanna go back to the communications team then ask them, you know, how is this pronounced? What is the meaning? Is there any elaboration that I need to add? You know, those kind of things. So reflection guide will have different sections where they can write down their general questions that they want to go back and make sure that this is correct, but also an opportunity to write any words that made them uncomfortable. So when I'm translating, one of the important things would be for any translator, it's their reflexivity. So how do I contextualize myself in context of this research project? For example, I'm a woman of certain age, I may be married, have kids, my comfort level with certain topics and ideas. Those are like certain important things that I should be reflecting on. So if it's women's health material, who's the translator? If they were male, did they find, if they were comfortable doing that or not comfortable? Or if a woman, is translating the materials, did they feel anything different about it? So this reflection guide will have different sections where they can document some notes. So it's not, you know, it's not very detailed, but like there are like smaller opportunities where they can like note certain things. And then the communications teams could read through it, so this is something for them, and then they can have communication, then they can exchange ideas, and they could reach a consensus with community and patient partner involvement they can address some of the issues that arise. And then, these communication teams will have, over time, they will have a kind of log of these reflection guides, and then they can build on, that these were the words that, that there were some concerns about, then they can address, then we can address the larger issues within that one organization. And that also helps in ensuring consistency in the language. And I would also say that apart from translator's reflection guide, translators must also be given some access to preexisting materials on a topic, because we noted that for words like cervix, there were different terms used. In some materials, it's called cervix. You know, there is transliteration and it's completely written in English as it is, but at other places it's like, you know, mouth of uterus and different terms I use. So there should also be consistency, you know, and then in reflection guide, they can note, oh, I use this word for this one, but the existing word was this, but I felt, you know, like they can provide some detail and explanation that will be a kind of lock for the organization. 

00:32:52 Jessie 

I'll just add on to that. Really, I think Reetinder summarized it really well, but really, the guide is prompting them to consider who's going to use this translation. Will words build trust or might it shut down conversations? Did they themselves feel hesitation about phrases? And if so, why? And really, the process will ingrain some accountability to the translators and challenge really everyone to acknowledge what feels awkward or culturally sticky at times. So there's no discomfort that gets swept under the rug. We're anticipating the end result is translation that's grounded in truth, empathy, and critical self-awareness. And that in itself will be a leap forward for health literacy, we're thinking. 

00:33:46 Reetinder 

Adding one more point to this, so far we see that we don't see a translator's name on any of the translators because they'll get an opportunity to reflect. And we also propose that we should name the translator so that they feel accountable, responsible, but also they get credit for the work that they produce. So I think by some of those ways, there is more accountability in the translation process. 

00:34:13 Sabrina 

Thank you so much for that really in-depth explanation. I think it's very clear the importance of this reflection guide in the work you're doing. Would you guys mind sharing a little bit about-- obviously, this is a huge project that you're undertaking. I was wondering if you could share some of the biggest linguistic and cultural challenges that you face so far in translating women's health materials into Punjabi. 

00:34:38 Lesa 

In clinical care, I think there's a couple of things that I've learned just by caring for people from lots of different backgrounds. And there's some little adjustments that you need to make depending on who the person is, where do they come from, what are their personal circumstances, when are they gonna be comfortable, what are the points or issues at which they will have discomfort. And one of the things I think is really important when you're caring for the South Asian community, I believe, is that the way that people make decisions is different. So when I was in training, we were taught, you know, yes, if there's a whole bunch of family members in a room, that really what you want to do is take that lady and try to get time with her by herself so you can find out what she really wants. And it's really much focused on individual decision-making. What I would say that we need to be thoughtful about is for not just South Asian community, but for some communities, that's not how people make decisions, people make decisions collectively. And we need to really try to thread the needle between respecting the way that decisions are made in families and ensuring that women themselves have agency and autonomy. So it's a bit of a fine line. You know, people are not always going to make the decision for themselves alone. They're always going to consider the people in their community and their family, but they also need to, it's got to be a bit of a balance, I guess, is what I'm trying to say. 

00:36:03 Jessie 

Yeah, definitely agree with your assessment. We are an interdependent community, and we we do make collective decisions. I think also from my angle to add to what you've noted is Punjabi women have been taught that speaking about their body is shameful so really there's the equivalent words for medical concepts and scripts they can differ by region by generation by migration background even and the literal translation that exists now is really failing them. So what they need is meaning-based materials that are respecting their lived realities, destigmatizing health topics, and really helping them to build confidence so that they can share what is happening within them. Because healthy women are healthy families and healthy communities, and we really want that focus to come back to women and women's health to really make sure that families and communities, because of that interdependence, are strong and healthy and are able to name and place where they're having concerns with their health. 

00:37:30 Reetinder 

I work with UBC Kidney Transplant Research Program as well. So we did note in our research projects, in South Asian community, there is collective family decision-making. So definitely Lisa's observation is really right. And I also feel that as we work more in the area of translations, we also must have materials that are family-focused because I think that's something that's lacking because families also need information on certain topics and, you know, get more education. So I think that is an area that's under explored and there are very little materials that are like focused on families and how decisions could be made in context of a health issue. 

00:38:19 Sabrina 

Thank you. I think those are all very insightful reflections. Obviously, there are many prongs to this work that you are doing. I was curious how you plan to assess the impact of this framework overall. 

00:38:36 Reetinder 

Before we kind of respond to this question, the previous one, what are the biggest linguistic and cultural challenges? I wanted to add a few here. So one of the biggest challenges in Punjabi language translation is use of AI. So we are using AI mindlessly and not paying attention to the nuances of language. So that's one of the issues. The other issue is a lot of inaccuracies in translation. So there are many spelling mistakes, use of too many English words. Anything that feels and seems to be very difficult to word is actually like written in Punjabi, but like really translated. For example, words like , which is not understandable to the community. Third issue is that translations are too complex for the audience for whom we are creating. So most of the Punjabi reading audiences from the rural areas of Punjab, India, who are migrating. So when we create translations, we always want to make sure that those are understandable by somebody who has completed grades five or six. So those are quite complex when translators try to do word to word. But on the other hand, as much as like we think that translators should do this and that, we should also be mindful what power do translators really have. So this lies in hands of health communication teams, how much power they actually get to translate it, to actually question and change something. What is that common space for discussion? So that's an important systemic barrier for translators as well. So, those are some of the challenges. The other important challenge could be having conversations with translators in context of their comfort in translating something for their community. So do they really see it as like word to word literal translation as their work? Or do they feel that they have to be a certain way? For example, diluting certain kind of information, not really passing on the information, as Lisa said, in real-life situations. So those are some of the ideas that we need to be having conversations about. 

00:41:13 Sabrina 

Wow, yeah. No, thank you for adding those. Those are very great examples. I want to move on to looking at the impact of your framework. And I was curious if you could explain how you plan to assess the impact overall? 

00:41:31 Jessie 

So it's quite early stages yet. So we want to really make sure that we're noting that. We're actually looking for funding so that we can continue to develop this work. So that is something that we should highlight right away. But the measuring impact part is really both big and small. Things like are more women showing up to health events? Are they getting screening? Do they now say, I understand, and I can go and ask my doctor? Those simple kind of success stories are gonna be big measures of impact for us. We anticipate that we're gonna track downloads of, you know, the reflection guide, workshop participation, our self-reporting of confidence levels. And really, we want to keep our feedback mechanisms really wide open so that we can keep evolving our resources to fit women's real needs. And those are just a few of the initial ways that we're thinking that we can really measure impact. 

00:42:42 Sabrina 

Lovely. So obviously, as you mentioned, you're still at the beginning stages of all of this, but eventually the goal will be able to implement all of this into standard practice, and that can obviously be complex. Do you have any ideas or general overarching plans for implementation of this work? 

00:43:03 Lesa 

I think we have to run, we have to walk before we run, right? So I think, you know, through the process of publishing our findings from our first project, which is those focus groups and interviews about South Asian women's opinions about these things. And I can tell you, having listened and reviewed only a few of the ones that Jesse has done already, the themes that are coming out are crystal clear that women, even very educated women, do not often feel empowered and conversant about their bodies. So I think the first step will be the publication of that project, which we're really proud of. We're really proud of that, and I can't wait to get it in print and share it with others. I think that in terms of the translation framework, a lot will depend on how it rolls out as we go. So, you know, for example, to make a leap and say that, oh, this is going to be implemented everywhere across every health authority is quite far down the road. I think we need to go stepwise. Perhaps we would start with, you know, research projects. Perhaps we would work with one individual healthcare team at a time and test in an iterative fashion, see how we're improving the quality. So it's going to be a long way yet, but I think at the end of it, what we really want is to develop a product that the users, the end users, women themselves, come back and say, I understand that now. I didn't before. 

00:44:27 Speaker 1 

So looking ahead, how do you hope that this work will impact health education for Punjabi women and/or other communities? 

00:44:37 Lesa 

I mean, it's the same thing. I think what Jessie said, which has become our mantra really, is that when women are healthy, when families are healthy, communities thrive. We all know that women really are at the heart of society in many, many ways, not just the care of children, but we really do keep the trains running and keep society rolling. And I think when women are better educated, when women understand their healthcare options, if they access everything that's recommended, for example, in the lifetime prevention schedule, that has lots of downstream benefits for society. So yes, that seems lofty, but you really do do it one community at a time, one woman at a time. And this was an obvious gap that we could see that we know how to, we know how to start to fix. 

00:45:25 Jessie 

Yeah. And I think it's so powerful that this is being developed by Punjabi women for Punjabi women. That's a first of its kind. And we are also users of the health system. We know many women, our mothers, our aunts, our sisters, our friends, and overall, our community. And really, what we want for our community is for women to feel familiar, safe, and empowering to know their bodies, to know their health. And for Reetinder and I, we want this framework to inspire new standards for the Punjabi community. But overall, if this can be done for the Punjabi community, we're thinking it could be done for for many communities that have kind of similar for translation, that's really a checkbox. And we want to be part of building a health system where women's stories are heard and where language is not a barrier to care, but always an invitation. And we want women to have agency and feel empowered to talk about their health and want to have better health for themselves. 

00:46:50 Reetinder 

And I think the data that will be generated out of this project will lead to many other projects and many other communities and will have a lot of scope. So I think this is just the beginning, but it'll lead to a lot of work and create space for more Punjabi women to engage in research, engage with researcher as participants. So there will be a lot of opportunities in terms of health education and there will be a lot of improvement that will happen from this one small project leading to a lot of branches, to a lot of work. 

00:47:26 Sabrina 

Fantastic. Well, thank you to all three of you for coming on and talking about this work. Incredibly impactful, incredibly important. And we're so grateful that you took the time out of your day to share this with all of our listeners today. 

00:47:40 Reetinder 

Thank you for having us. 

00:47:43 Outro 

Thanks for joining us on the GOSH Podcast. To learn more about the Gynecologic Cancer Initiative and our podcast, make sure to check out our website at gynaecancerinitiative.ca.