Health communication is recognised as a powerful tool for improving both individual and public health outcomes. One of its main objectives is to influence and enhance the health status of individuals and the broader public through sharing health-related information. To achieve this objective, the shared health-related information should be lay-friendly. Moreover, there has been a growing emphasis on the significance of health communication for laypeople in recent years. As a consequence, many new patient communication genres designed to convey lay-friendly information have come into existence, and a great amount of related legislation has been passed. Patient Information Leaflet (PIL), which accompanies medicinal products and informs patients about dosage, possible side effects, and other details, is one of these genres that is subject to regulations that require it to be lay-friendly. As a form of written health communication, PIL serves as the most important source of information about a medication that patients have access to.

Despite the importance of PILs and their legal requirements, studies have demonstrated that PILs are not linguistically lay-friendly, and translated PILs tend to be even more linguistically complex than their source texts. Several reasons have been discussed in the literature explaining why translated PILs are not lay-friendly. However, there seemed to be a lack of empirical research looking into the impact of culture in general and cultural references (CRs) in particular on the lay-friendliness of translated PILs, despite the fact that the health communication genres are translated for culturally and linguistically diverse populations, and cultural barriers have been recognised as one of the major non-clinical factors affecting health communication and outcomes. This dissertation sought to work to fill the gap by using a mixed methods research design that consisted of three strands.