Transcreation guidelines for migrant health information materials: a multimodal and participatory framework

Communicative accessibility in health information materials is a key component of health equity for migrant populations who speak languages of lesser diffusion (LLDs). Although translation is commonly used to facilitate access, multilingual health materials often reproduce structures, formats and cultural assumptions designed for native audiences, limiting contextual adequacy and communicative effectiveness. In response, transcreation – an iterative, creative and participatory process producing culturally relevant and functionally adequate messages – offers an effective framework for specialised health communication. This study adopts a cumulative research design combining an integrative review of 27 academic sources (2005–2024), analysis of 448 multilingual health materials produced by Spanish NGOs and public institutions, and a pilot participatory transcreation experience involving cultural mediators and healthcare professionals. Findings confirm the predominance of standardised translation practices and show that collaborative, iterative approaches improve communicative effectiveness. On this basis, the study proposes flexible, equity-oriented transcreation guidelines structured around defined stages, key dimensions and explicit evaluation criteria.