Embedding Cultural Communications in Health Departments 

Organizations that work with refugee, immigrant, and migrant (RIM) communities often face numerous linguistic and cultural challenges when communicating with these communities. These communication gaps were made more apparent during the COVID-19 pandemic across non-English speaking and limited English proficient (LEP) communities. 

Embedding and strengthening a cultural communications infrastructure within a health department helps to transmit timely, consistent, reliable, culturally, and linguistically appropriate information to RIM communities. It is important to have an internal team that is dedicated to standardizing, supporting, and coordinating the cultural communications work at the agency. 

Cultural communications go beyond translations—cultural nuance should be intentionally integrated in the messaging designed for RIM communities. This promising practice describes approaches taken by the Minnesota Department of Health (MDH) to embed cultural communications within the department. 
 

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Fostering an inclusive and supportive environment is important to guide and support cultural communication work and efforts.  

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Elevate the need for cultural communication

Establishing a network of internal and external partners supportive of cultural communications elevates its importance to an organization’s leadership. The Minnesota Department of Health’s (MDH) community liaison staff and network of community partners working with various ethnic communities frequently elevated the importance and need for cultural communications to agency leadership during the COVID-19 response. This was driven by the community need for culturally and linguistically appropriate materials for African immigrant, Asian Pacific Islander, Hispanic/Latine, Indigenous, and African American communities. MDH also participated in the Governor’s Community Response Workgroup where the need was often elevated by staff.   

Partnering with external community organizations and local public health (LPH) departments serving ethnic communities helped MDH gather additional evidence for the need. MDH participated in Twin Cities Metro LPH COVID-19 Outreach and Engagement meetings where resources were shared and discussed around reaching RIM and LEP communities. The Health Equity and Advisory Leadership (HEAL) Council, which was created to address health disparities, supported the initial integration of COVID-19 cultural communications team into the Communications Office in 2022 as a pilot/temporary unit.

Use Feedback

Use existing internal engagement forums to promote feedback for cultural communication work. MDH’s internal LEP Communicators' Workgroup, established prior to COVID-19, is used to share resources and challenges, and to exchange best practices on creating communications materials for LEP communities. This group enriches cultural communications work by harnessing efforts in developing, reviewing, and centralizing resources for the agency through monthly meetings.

  • The Cultural Communications Team supervisor co-leads the LEP Communicators Workgroup, and this new position has helped to prioritize the update of the Translations and Interpretation Standards. 

The Cultural Communications staff joins the MDH COVID-19 Cultural, Faith, and Disabilities (CFD) Collaborative at their bi-weekly meetings. These are ongoing forums established during the pandemic and continue to maintain a post COVID-19 response agenda, discussing ongoing support needed and current activities with CFD communities.

  • The staff also regularly meet with different CFD Collaborative teams such as the African Immigrant, Hispanic/Latine, Asian American, and Pacific Islander Community Liaison Teams to hear the needs of the communities from contract managers and community engagement staff.
  • Result: Feedback during the COVID-19 response was used to create the Cultural Communications Team and is used to continually refine the team’s efforts

Adequate preparation and resources need to be dedicated to effectively support the work and sustain the benefits of embedding and strengthening cultural communications.

Find Funding

MDH includes funding for cultural communications work in other equity related budgets for existing projects within the organization such as translations and community engagement. To sustain a robust internal cultural communications program, it is necessary to develop a separate budget plan for this work to be included in the public health infrastructure. Additionally, standard language and budget projections need to be further developed so staff can routinely include this work as a line item in their proposed budgets.

The Cultural Communications Team is currently supported by several grants around COVID-19 and equity that end in 2024. Minnesota Governor Tim Walz and Lieutenant Governor Peggy Flanagan put forward a proposal budget plan which was passed for the Cultural Communications Team to become part of MDH permanently.

Defining Scope

Language prioritization was based on the highest target populations, health impact, and resources available for the focus populations

MDH looked at data sources and worked with Refugee and International Health staff to decide the top languages for the Cultural Communications Team to cover.

Results

The Cultural Communications Team will do work beyond COVID-19.
 

MDH worked with the Minnesota Association of Professional Employees (MAPE) union to put a plan together for HR to compensate staff who are asked to use their language skills frequently, or on an intermittent basis, for projects that are outside of their normal work. 

The MAPE Multilingual Differential Proposal advances racial, cultural, and linguistic equity, recognizing the value of multilingual staff to the agency and the State of Minnesota. Existing staff with relevant linguistic skills and cultural experience supporting cultural communications work can be compensated in two ways:

  • Staff can be paid $50 per pay period for each qualifying language. This method is used for situations where the language skills are used frequently. 
  • Staff can be paid in .25-hour increments for specific projects, events, or time-limited and intermittent work.

Result: The MAPE proposal has helped increase the capacity of MDH to provide information and materials in additional languages and topic areas by recognizing and rewarding staff for using their languages skills, therefore increasing the pool of staff willing to help

Result: Hmong, Somali, and Spanish were chosen based on the most common non-English languages spoken at home in Minnesota.

  • Choose tasks that maximize the staff’s impact and use their cultural knowledge, not just language skills.
    • The cultural communication specialists provide technical assistance, cultural consults, and trainings to agency staff in addition to reviewing translations, translating, and recording voice overs

Result: The materials created will more likely reach and resonate with the communities in a time-sensitive approach.

MDH has been working closely with CFD communities during COVID-19, and we have been able to use those relationships to build trust with the community and provide opportunities to their members.

MDH removed the education requirement for the cultural communication specialist roles to prioritize cultural and language experiences of potential candidates residing in communities targeted for cultural communications work

MDH had multiple rounds of interviews that included a panel of multilingual staff and internal partners who tested the candidate’s abilities to translate written materials in real-time from English to another language, from another language to English, and to read non-English material out loud.

The Cultural Communications Team has access to LinkedIn Learning where they can participate in trainings ranging from a broad variety of topics such as cultural competency, public speaking, and much more.

For example, the Spanish cultural communications specialist meets regularly with Latine/Hispanic leaders

The Cultural Communications Team is part of the broader MDH Communications Team.

Improvement
  • Use internal and external feedback to continually improve processes.
  • Determine the effectiveness and reach of the material through analytics.
  • Gather metrics and report to leadership on outcomes.
     
Assurance
  • Use quality assessment tools to review and evaluate the integrity, accuracy, neutrality, and appropriateness of translated material from state vendors. Refer to annex for translation tool kit; tool kit for making written material clear and effective; and detailed guidelines for translation. 
  • Create and update internal toolkits, checklists, and other resources for quality assurance of work and to guide and strengthen the capacity of the agency. 
  • Include a community review when requesting translations. If the vendor does not provide that service, then contract with the community.