Translating the JBI EBP Database

Jef Adriaenssens, RN, MsN, PhD, 
Belgian Evikey Network, Brussels, Belgium    

The Belgian federal government has significantly invested in evidence-based practice (EBP) since the 1990s.  Several institutions were founded and a network between these centres was created. A central database was then set up, together with an electronic decision support system for GPs. Over the last 15 years, EBP database access has been acquired by the government and made accessible to health professionals.  As Belgium is a bilingual country, all information is available in both Dutch and French.  However, up until 2015, the majority of the EBP guidance was focused on GPs, while the other ten officially recognised healthcare disciplines only had sparse information.  As a result, a government study was undertaken to identify relevant EBP databases. 

JBI was selected as the most comprehensive database that could cover nine of the eleven recognised disciplines (GPs, nurses, midwives, dieticians, speech therapists, podologists, occupational therapists, physiotherapists, and psychologists).  Only two disciplines (dentists and pharmacists) reported that content was lacking.  Consequently, negotiations between the government and JBI started to obtain full access to the content of the JBI EBP Database, to translate this content into Dutch and French, and to make it accessible nationwide. An agreement to this effect was signed in 2021. However, that was the easiest part of the job.  The translation and publishing process was (and still is) a tremendous job, with many lessons learned along the way.  

The first obstacle we faced was that all the documents in the JBI EBP database were in PDF format, whereas our central database is written in HTML (more precisely, in JSON).  Conversion from PDF to HTML was difficult, but after much trial-and-error, JBI and our ICT partner collaborated to convert the delivery of JBI content into JSON—a project that is still in progress.  

A second enormous task was the translation work itself.  Every document (in JSON) is being translated into Dutch and French in multiple steps by a translation agency. First, there is a process of machine translation with TRADOS software, where the text is split up into parts and translated. This step is followed by medical proofreading of the TRADOS version.  Next, the approved translations are converted back to JSON and a software tool adds all layout, pictograms and graphics. Subsequently, a group of medical contextualists reads the output once again and considers whether the information is directly applicable to Belgium or whether a contextual note needs to be added. In the last phase, the content is tagged with search terms and published on the central Belgian EBP database.  This process is considerable in light of the 5,000+ documents available on the JBI EBP Database, especially considering that these resources are updated every 1 to 2 years.  Consequently, a very close monitoring system is necessary to track which document is in which phase of the process.  

Over the last one-and-a-half years, about 1,100 documents have been translated into two languages and published on our central EBP database.  We continue to pursue our aim of translating all content on the JBI EBP Database and working through the ongoing technical challenges, while managing updates of the JBI content.  We are committed to this process and continue providing good evidence to our healthcare professionals across nine disciplines. 

Although currently only a portion of the JBI EBP resources have been translated and published on our EBP portal, the reactions of the end users have been encouraging.  The first group that picked up the news was the educational field.  Nursing lecturers stated that the information was very useful to underpin their courses. They also sensitize their students to use the JBI content for tasks and reporting.  In addition, midwifery students reported that they were happy with the expansion of the EBP portal. 

In the next few months, the communication department of the Belgian EBP network will launch a campaign to encourage healthcare professionals to use the EBP portal.  We are aware that this process will take considerable time, but we are confident that within a few years, the majority of Belgian healthcare workers will know and use the JBI content to improve the quality of their practice.

In conclusion, we are proud of what we have achieved already, and we are happy with the results of our collaboration with JBI. Contact has been warm, friendly, timely and accurate. Our project only started about one-and-a-half years ago, but our aim is to continue the collaboration for many years to come to be able to provide EBP resources to health professionals across Belgium, in our native languages.