I work with a national network of clinicians who provide intensive primary care to underserved pediatric populations via mobile and fixed-site clinics, so I was pleased to discover your practical article, "Patient Education Materials" (October 2001). Our clinicians have created brochures in English and Spanish and lesson plans for clinical and classroom application. Our bilingual health materials for children can be downloaded free from our Web site, http://www.childrenshealthfund.org, and lesson plans and a bilingual parent's guide will soon be available.

Based on my experience, I have several additional suggestions that address the health education needs of culturally diverse populations:

* Hire a translator, and have the translation reviewed by native speakers of the language.

* Establish appropriate reading levels before translation.

* Use reverse translation (translate the document back into English) to identify weak content.

* Be aware that other languages may use more words than English does to describe the same idea.

* Use community resources for a "cultural check." A nurse anthropologist, who critically reviews text and illustrations, is an invaluable resource.

* Field-test the materials with patients and other clinicians before publication.

Kathy Sinnett, FNP