title: Barriers beyond words: cancer, culture, and translation in a community of Russian speakers.
abstract: BACKGROUND
  Language and culture relate in complex ways. Addressing this complexity in the context of language translation is a challenge when caring for patients with limited English proficiency (LEP).
  
  
  OBJECTIVE
  To examine processes of care related to language, culture and translation in an LEP population is the objective of this study.
  
  
  METHODS
  We used community based participatory research to examine the experiences of Russian-speaking cancer patients in San Francisco, California. A Russian Cancer Information Taskforce (RCIT), including community-based organizations, local government, and clinics, participated in all phases of the study.
  
  
  METHODS
  A purposeful sample of 74 individuals were the participants of the study.
  
  
  METHODS
  The RCIT shaped research themes and facilitated access to participants. Methods were focus groups, individual interviews, and participant observation. RCIT reviewed data and provided guidance in interpreting results.
  
  
  RESULTS
  Four themes emerged. (1) Local Russian-language resources were seen as inadequate and relatively unavailable compared to other non-English languages; (2) a taboo about the word "cancer" led to language "games" surrounding disclosure; (3) this taboo, and other dynamics of care, reflected expectations that Russian speakers derived from experiences in their countries of origin; (4) using interpreters as cultural brokers or establishing support groups for Russian speakers could help address barriers.
  
  
  CONCLUSIONS
  The language barriers experienced by this LEP population reflect cultural and linguistic issues. Providers should consider partnering with trained interpreters to address the intertwining of language and culture.
authors.affiliation: Institute for Health Policy Studies, University of California San Francisco, UCSF Box 0936, San Francisco, CA 94143, USA. Daniel.Dohan@ucsf.edu
authors.forename: Daniel
authors.initials: D
authors.lastname: Dohan
authors.forename: Marya
authors.initials: M
authors.lastname: Levintova
mesh_terms: D003144:Communication Barriers; D054521:Cultural Competency; D003469:Culture; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007407:Interviews as Topic; D009369:Neoplasms / Q000175:diagnosis / Q000208:ethnology* / Q000628:therapy; D011369:Professional-Patient Relations; D036301:Qualitative Research; D012426:Russia / Q000208:ethnology; D012495:San Francisco / Q000453:epidemiology; D014175:Translating