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Company: San Francisco Health Plan
Contact: Scott Paro, Production Specialist
Location: San Francisco, CA
Industry: Nonprofit, B2C
Annual revenue: Confidential
Number of employees: 100

Quick read:

A nonprofit health-plan provider serving lower-income San Francisco residents was designed for and by the residents it served. The health plan said it took "pride in speaking the language" of its local residents—but the community has large Hispanic, Vietnamese and Chinese populations, as well as other ethnic groups. It was therefore important to provide plan information in several languages.

The company hired a translation service with local knowledge, skills in dozens of languages, and medical expertise to translate its materials. It then designed a marketing campaign geared specifically to its multicultural, lower-income audience.

The community has responded in an overwhelmingly positive way, with people walking in off the streets to comment on the great advertising campaigns. Phone inquiries are up significantly, and the campaign is bringing in new members as it reaches a wider non-English speaking audience.

The challenge:

The San Francisco Health Plan (SFHP) is a city-sponsored health plan providing health insurance to more than 50,000 San Franciscans. It was created by the city and county to provide high-quality medical care to the largest possible number of low-income residents, particularly young adults; one of every four city children is insured by SFHP.

Many of its members have limited English skills, and communicating with them has been a challenge. According to the SFHP Web site, 23% of its members speak Chinese, 14% speak Spanish, 3% speak Russian, and 2% speak Vietnamese.

But SFHP was determined to reach members and potential members with simple messages in their own language. "We pride ourselves in saying we are here for you, we speak your language," says Scott Paro, production specialist for SFHP. "We need to continue down that path and gain their respect."

When Paro came aboard three years ago, he inherited a local mom-and-pop shop that did translation. But he wasn't happy with the level of service or expertise.


Paro hired a company called viaLanguage to handle translations. He and the company developed a comprehensive marketing campaign that focused on three factors: translation services, sensitivity to cultural differences, and response to public feedback.

Step #1. Translate marketing materials in various venues at an appropriate reading level

  • Letter to members. Working with viaLanguage, Paro and his team translated a letter to members and potential members. These were lower-income individuals with lower reading levels, so it was important to write materials at no higher than a fifth-grade reading level.

  • Web site translation. The nonprofit's Web site had always been in English; when it was re-launched last spring, Paro knew he wanted it translated in at least Spanish. "Because we serve a low-income population, there was the feeling that that population didn't even have access to technology," Paro explains. "But I didn't believe that was the case, so we translated and re-launched."

  • Outdoor campaigns. Paro and his team created outdoor ad campaigns that they translated into the core member languages. "Now you'll find it (SFHP ads) in bus shelters throughout the city," he says. "You just don't see that throughout San Francisco very much, where the same ad is in English, Spanish and Chinese."

  • "Translation memory." viaLanguage offers a service called translation memory. Every document that is translated is put into the tool, so common phrases are remembered and automatically translated.

    "A common phrase may be, 'your co-payment is $12 every time you see your doctor.' Each time that phrase comes up, it automatically translates," Paro says. The benefit, he notes, is that he doesn't repeatedly have to pay for the translation of that phrase, and he can be certain the phrase is translated the same way every time.

Step #2. Practice cultural sensitivity as much as possible

  • Separate documents were designed for each ethnic group. SFHP decided it was not only confusing for the reader to have more than one language on a specific document but also, potentially, a sign of disrespect. Each language deserves—and receives—its own, separate document.

  • Colors matter! Paro learned that the color of one piece of marketing material—purple—signified death to one sector if his market. This was particularly inappropriate, since the marketing piece was geared toward pregnant women and their prenatal needs.

Step #3. Get local feedback on your campaign

  • Hire multicultural employees. Simply being aware of cultural differences was not enough to ensure that the documents Paro created were sensitive enough to his audiences. So he took steps to help garner sufficient feedback of his campaign, such as hiring a multicultural workforce and then conducting internal focus groups with those employees. SFHP's workers include many of Chinese, Vietnamese, and Hispanic descent.

  • Set up a member advisory committee. Paro has invited a group of SFHP members to come in once a month to advise on campaigns and answer questions. They get a $25 stipend for about two hours of their time.


When the new SFHP Web site launched in Chinese and Spanish, it generated enough visits—before it was even officially announced—that Paro knew he wanted to translate it into other languages as soon as possible. (The top-left corner of the site's homepage offers visitors the chance to view it in English, Spanish, or Chinese.)

The outdoor campaigns have, at times, caused the phones to "ring off the hook," Paro says. The most recent campaign generated 44 phone calls the very morning it was unveiled.

The advisory committee has spoken extremely highly of the new translations, as have community members. And the campaign won a national contest for insurance advertising, besting such larger and better-funded competitors as Blue Cross/Blue Shield and Kaiser Permanente.

Lesson learned:

  • Don't underestimate your community. Paro has learned how valuable feedback is from the community. Even though SFHP employs a culturally diverse group, most are not in the same income level as its members. Sometimes, he says, "We forget what's important to them."

    For example, by asking new members what they liked best about the SFHP program, Paro learned that being able to keep their own doctors, having SFHP in the neighborhood, and having SFHP speak their language were the best marketing points. Now, when people come in off the street to sign up for the plan, he often asks for feedback.

  • Every audience, now matter how narrow, responds to an effective marketing campaign. By separately marketing to lower-income San Francisco residents of Chinese, Hispanic, and Vietnamese descent in their native language, and taking into consideration their cultural concerns, SHFP has been able to effectively serve each audience.

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