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Postma JM, Evans-Agnew R, Capouya J. Mexican-American caregivers' perceptions about asthma management: a photovoice study. J Asthma 2015; 52:593-9. [PMID: 25539397 DOI: 10.3109/02770903.2014.996651] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVE The purpose of this study is to report how photovoice was used to (1) ascertain Mexican-American caregiver perspectives about asthma management, and (2) engage caregivers in dissemination. METHODS Eleven Mexican-American caregivers of children with asthma were recruited and given cameras to photograph what helped or hindered their ability to care for their child. Participants prioritized which images to share, discussed the images with the group, and wrote accompanying titles and captions in four photovoice sessions. Sessions were in Spanish and occurred in a community setting. Participants presented their work to peers and community members. Identified issues were subsequently categorized by investigators according to the four components of asthma care. RESULTS Participants prioritized 32 phototexts, the majority of which (n = 20, 63%) reflected activities associated with environmental control. Caregivers highlighted asthma triggers, and suggested ways to maintain indoor air quality (IAQ) through home cleaning. The need for policies that enforce smoking bans in shared housing and public places was identified as an important strategy to improve outdoor air quality. "Education for a Partnership in Asthma Care" was represented in six (19%) phototexts. Five phototexts (16%) represented "Assessment and Monitoring". Only one phototext (3.13%) primarily represented "Medications". CONCLUSIONS Results support the need for active partnerships between caregivers and providers. Photographs can serve as the basis for reciprocal education between patient and provider, especially in the area of environmental triggers. Provider visits should include assessment, strategies and resources to maximize IAQ. Photovoice facilitates caregivers' ability to advocate for improved asthma management and health equity.
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Affiliation(s)
- Julie Marie Postma
- a Washington State University College of Nursing, Washington State University Puyallup Research and Extension Center , Puyallup , WA , USA
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Paternotte E, van Dulmen S, van der Lee N, Scherpbier AJJA, Scheele F. Factors influencing intercultural doctor-patient communication: a realist review. PATIENT EDUCATION AND COUNSELING 2015; 98:420-45. [PMID: 25535014 DOI: 10.1016/j.pec.2014.11.018] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2014] [Revised: 10/23/2014] [Accepted: 11/17/2014] [Indexed: 05/10/2023]
Abstract
OBJECTIVE Due to migration, doctors see patients from different ethnic backgrounds. This causes challenges for the communication. To develop training programs for doctors in intercultural communication (ICC), it is important to know which barriers and facilitators determine the quality of ICC. This study aimed to provide an overview of the literature and to explore how ICC works. METHODS A systematic search was performed to find literature published before October 2012. The search terms used were cultural, communication, healthcare worker. A realist synthesis allowed us to use an explanatory focus to understand the interplay of communication. RESULTS In total, 145 articles met the inclusion criteria. We found ICC challenges due to language, cultural and social differences, and doctors' assumptions. The mechanisms were described as factors influencing the process of ICC and divided into objectives, core skills and specific skills. The results were synthesized in a framework for the development of training. CONCLUSION The quality of ICC is influenced by the context and by the mechanisms. These mechanisms translate into practical points for training, which seem to have similarities with patient-centered communication. PRACTICE IMPLICATIONS Training for improving ICC can be developed as an extension of the existing training for patient-centered communication.
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Affiliation(s)
- Emma Paternotte
- Department of Healthcare Education, Sint Lucas Andreas hospital, Amsterdam, The Netherlands.
| | - Sandra van Dulmen
- NIVEL (Netherlands Institute for Health Services Research), Utrecht, The Netherlands; Department of Primary and Community Care, Radboud University Medical Centre, Nijmegen, The Netherlands; Faculty of Health Sciences, Buskerud and Vestfold University College, Drammen, Norway.
| | - Nadine van der Lee
- Department of Healthcare Education, Sint Lucas Andreas hospital, Amsterdam, The Netherlands.
| | - Albert J J A Scherpbier
- Institute for Medical Education, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.
| | - Fedde Scheele
- Medical School of Sciences, Vu University Medical Center, Amsterdam, The Netherlands.
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Reel LA, Hicks CB, Ortiz N, Rodriguez A. New resources for audiologists working with Hispanic patients: Spanish translations and cultural training. Am J Audiol 2015; 24:11-22. [PMID: 25569165 DOI: 10.1044/2014_aja-14-0027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2014] [Accepted: 11/21/2014] [Indexed: 11/09/2022] Open
Abstract
PURPOSE Hispanics comprise over 16% of the U.S. population (Humes, Jones, & Ramirez, 2011). Cultural and language differences may negatively affect services audiologists provide to Hispanic patients. The purpose of the current study was to assist monolingual English-speaking audiologists working with Spanish-speaking Hispanic patients by developing appropriate cultural and language instruction materials. METHOD Test descriptions and instructions for hearing and balance tests were developed in English and Spanish. A cultural training module was also created. The first draft of these resources was reviewed by nonaudiologists (bilingual and Spanish monolingual) and audiologists (bilingual and English monolingual). Videos were recorded of the Spanish test instructions read aloud. RESULTS Overall, ratings from audiologists and nonaudiologists indicated the translations were easy to understand, and the wording/dialect was appropriate for the region. Audiologists generally reported the information was consistent with what they use clinically, although variability existed in specific wording used. Reviewers rated the cultural training module as easy to understand, relevant to Spanish-speaking patients, and relevant to audiologists. The materials were revised and edited based on feedback from reviewers. CONCLUSIONS The current study developed materials for monolingual English-speaking audiologists working with Spanish-speaking Hispanic patients. The final translations are provided as online supplemental materials.
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Affiliation(s)
| | | | - Nathan Ortiz
- Texas Tech University Health Sciences Center, Lubbock
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Rodriguez CJ, Allison M, Daviglus ML, Isasi CR, Keller C, Leira EC, Palaniappan L, Piña IL, Ramirez SM, Rodriguez B, Sims M. Status of cardiovascular disease and stroke in Hispanics/Latinos in the United States: a science advisory from the American Heart Association. Circulation 2014; 130:593-625. [PMID: 25098323 PMCID: PMC4577282 DOI: 10.1161/cir.0000000000000071] [Citation(s) in RCA: 262] [Impact Index Per Article: 26.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND AND PURPOSE This American Heart Association (AHA) scientific statement provides a comprehensive overview of current evidence on the burden cardiovascular disease (CVD) among Hispanics in the United States. Hispanics are the largest minority ethnic group in the United States, and their health is vital to the public health of the nation and to achieving the AHA's 2020 goals. This statement describes the CVD epidemiology and related personal beliefs and the social and health issues of US Hispanics, and it identifies potential prevention and treatment opportunities. The intended audience for this statement includes healthcare professionals, researchers, and policy makers. METHODS Writing group members were nominated by the AHA's Manuscript Oversight Committee and represent a broad range of expertise in relation to Hispanic individuals and CVD. The writers used a general framework outlined by the committee chair to produce a comprehensive literature review that summarizes existing evidence, indicate gaps in current knowledge, and formulate recommendations. Only English-language studies were reviewed, with PubMed/MEDLINE as our primary resource, as well as the Cochrane Library Reviews, Centers for Disease Control and Prevention, and the US Census data as secondary resources. Inductive methods and descriptive studies that focused on CVD outcomes incidence, prevalence, treatment response, and risks were included. Because of the wide scope of these topics, members of the writing committee were responsible for drafting individual sections selected by the chair of the writing committee, and the group chair assembled the complete statement. The conclusions of this statement are the views of the authors and do not necessarily represent the official view of the AHA. All members of the writing group had the opportunity to comment on the initial drafts and approved the final version of this document. The manuscript underwent extensive AHA internal peer review before consideration and approval by the AHA Science Advisory and Coordinating Committee. RESULTS This statement documents the status of knowledge regarding CVD among Hispanics and the sociocultural issues that impact all subgroups of Hispanics with regard to cardiovascular health. In this review, whenever possible, we identify the specific Hispanic subgroups examined to avoid generalizations. We identify specific areas for which current evidence was less robust, as well as inconsistencies and evidence gaps that inform the need for further rigorous and interdisciplinary approaches to increase our understanding of the US Hispanic population and its potential impact on the public health and cardiovascular health of the total US population. We provide recommendations specific to the 9 domains outlined by the chair to support the development of these culturally tailored and targeted approaches. CONCLUSIONS Healthcare professionals and researchers need to consider the impact of culture and ethnicity on health behavior and ultimately health outcomes. There is a need to tailor and develop culturally relevant strategies to engage Hispanics in cardiovascular health promotion and cultivate a larger workforce of healthcare providers, researchers, and allies with the focused goal of improving cardiovascular health and reducing CVD among the US Hispanic population.
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Calo WA, Ortiz AP, Colon-Lopez V, Krasny S, Tortolero-Luna G. Factors associated with perceived patient-provider communication quality among Puerto Ricans. J Health Care Poor Underserved 2014; 25:491-502. [PMID: 24858864 PMCID: PMC4154245 DOI: 10.1353/hpu.2014.0074] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Patient-provider communication is an important factor influencing patients' health outcomes. This study examined the relationship between patient-provider communication quality and sociodemographic, health care access, trusted information sources, and health status variables. Data were from a representative sample of 450 Puerto Rican adults who participated in the Health Information National Trends Survey. A composite score rating perceived patient-provider communication quality was created from five items (Cronbach's alpha = 0.87). A multivariate linear regression analysis was conducted. Patient-provider communication ratings were lower among the unemployed (p = 0.049), those who do not trust a lot in the information provided by their providers (p = 0.003), and respondents with higher depressive symptoms scores (p = 0.036). Perceived patient-provider communication quality, however, was higher among respondents who visited their providers five or more times in the last year (p = 0.023). Understanding patient perceptions of provider communication may serve to develop system-level interventions aimed at eliminating communication disparities and improving patients' health outcomes.
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Martínez-Donate AP, Vera-Cala LM, Zhang X, Vedro R, Angulo R, Atkinson T. Prevalence and correlates of breast and cervical cancer screening among a Midwest community sample of low-acculturated Latinas. J Health Care Poor Underserved 2013; 24:1717-38. [PMID: 24185166 PMCID: PMC3959859 DOI: 10.1353/hpu.2013.0165] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
BACKGROUND Low adherence to cervical and breast cancer (CBC) screening recommendations contributes to high CBC mortality among Latinas. PURPOSE To estimate the prevalence of, and factors associated with, last 12-month Pap smear and mammogram receipt among a Midwest community sample of low-acculturated Latinas. METHODS We conducted a cross-sectional study with 278 Latina immigrants in Dane County, Wisconsin. Participants completed a self-administered questionnaire. We estimated multivariate logistic regression models to identify factors associated with CBC screening receipt. RESULTS Rates of last 12-month Pap smear and mammogram receipt were 56.8% and 39.4%, respectively. Age, knowledge of screening recommendations, and having a regular health care provider were independently associated with both Pap smear and mammogram receipt. Having ever used Planned Parenthood and fear of cancer were uniquely correlated with Pap smear and mammogram receipt, respectively. CONCLUSIONS Modifiable individual, structural, and cultural factors contribute to suboptimal rates of CBC screening among low-acculturated Latino immigrants.
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Wallace LS, Chisolm DJ, Abdel-Rasoul M, DeVoe JE. Survey mode matters: adults' self-reported statistical confidence, ability to obtain health information, and perceptions of patient-health-care provider communication. J Health Psychol 2013; 18:1036-45. [PMID: 23349400 DOI: 10.1177/1359105312470125] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This study examined adults' self-reported understanding and formatting preferences of medical statistics, confidence in self-care and ability to obtain health advice or information, and perceptions of patient-health-care provider communication measured through dual survey modes (random digital dial and mail). Even while controlling for sociodemographic characteristics, significant differences in regard to adults' responses to survey variables emerged as a function of survey mode. While the analyses do not allow us to pinpoint the underlying causes of the differences observed, they do suggest that mode of administration should be carefully adjusted for and considered.
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Affiliation(s)
- Lorraine S Wallace
- Department of Family Medicine, The Ohio State University, Columbus, OH 43201, USA.
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Decomposing the Gap in Satisfaction with Provider Communication Between English- and Spanish-Speaking Hispanic Patients. J Immigr Minor Health 2012; 16:195-203. [DOI: 10.1007/s10903-012-9733-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Weinberg AC, Brandeis GH, Bruyere J, Tsui JF, Weiss JP, Rutman MP, Blaivas JG. Reliability and validity of the overactive bladder symptom score in spanish (OABSS-S). Neurourol Urodyn 2012; 31:664-8. [DOI: 10.1002/nau.21235] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2011] [Accepted: 10/03/2011] [Indexed: 11/07/2022]
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Buscher A, Hartman C, Kallen MA, Giordano TP. Validity of self-report measures in assessing antiretroviral adherence of newly diagnosed, HAART-naïve, HIV patients. HIV CLINICAL TRIALS 2012; 12:244-54. [PMID: 22180522 DOI: 10.1310/hct1205-244] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To compare the performance of self-report instruments assessing adherence to antiretroviral therapy (ART) in patients starting ART for the first time and in a predominately Hispanic population. METHODS Of 184 patients in a prospective observational cohort study of newly diagnosed, minority patients of low socioeconomic status, 54 were given Medication Event Monitoring System (MEMS) caps for their boosted protease inhibitor (PI) or non-nucleoside reverse transcriptase inhibitor (NNRTI). They completed a 4-week recall visual analogue scale (VAS), the Adult AIDS Clinical Trial Group (AACTG) 4-day recall instrument, and a 1-month recall qualitative single-item measure every 3 months for up to 18 months in English or Spanish. Electronic pharmacy records recorded refill dates. Spearman correlation coefficients were calculated to compare self-report measures with MEMS data and pharmacy data. RESULTS Of 46 patients with MEMS data, mean adherence was 84.7% (SD 35.6) by MEMS, 84.5% (SD 15.1) by pharmacy, 95.4% (SD 11.9) by VAS, 95.8% (SD 17.2) by AACTG, and 87.6% (SD 28.2) by qualitative single item. The correlation coefficient (CC) of VAS with MEMS was 0.37 (P < .01), and with pharmacy it was 0.34 (P < .01). The CC of the AACTG with MEMS was 0.32 (P < .01), and with pharmacy it was 0.28 (P < .01). The qualitative single item had a CC with MEMS of 0.24 (P < .01) and with pharmacy of 0.32 (P < .01). Spanish-speaking patients' VAS adherence had a CC of 0.40 (P < .01) with MEMS. CONCLUSIONS The VAS, AACTG, and qualitative single-item measures correlated significantly with MEMS and pharmacy data. Our data support self-administration of the VAS, even in Span-ish speakers.
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Affiliation(s)
- April Buscher
- Department of Medicine, Baylor College of Medicine, Houston, Texas, USA
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Lora CM, Gordon EJ, Sharp LK, Fischer MJ, Gerber BS, Lash JP. Progression of CKD in Hispanics: potential roles of health literacy, acculturation, and social support. Am J Kidney Dis 2011; 58:282-90. [PMID: 21787982 DOI: 10.1053/j.ajkd.2011.05.004] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2010] [Accepted: 05/06/2011] [Indexed: 11/11/2022]
Abstract
Hispanics are the fastest growing minority group in the United States, and compared with non-Hispanic whites, they have a higher incidence of end-stage renal disease. Examining novel factors that may explain this disparity in progression of chronic kidney disease (CKD) in Hispanics is urgently needed. Interpersonal and patient-centered characteristics, including health literacy, acculturation, and social support, have been shown to affect health outcomes in patients with other chronic diseases. However, these characteristics have not been well studied in the context of CKD, particularly in relation to disease knowledge, attitudes, and behaviors. In this report, we examine the potential roles of these factors for CKD progression in Hispanics and propose targeted therapeutic interventions.
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Health literacy, language, and ethnicity-related factors in newcomer asthma patients to Canada: a qualitative study. J Immigr Minor Health 2011; 13:315-22. [PMID: 20938742 DOI: 10.1007/s10903-010-9405-x] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The objectives of this study were to investigate how asthma patients from new immigrant groups are being informed and educated about asthma and its management, and to identify barriers to knowledge transfer. Four focus groups (n = 29) from Latino, Chinese, Iranian and Punjabi cultural communities were conducted with asthmatic patients in the Greater Vancouver Area. Our results from the focus group discussions can be summarized in four broad areas (a) perceptions of and ways of coping with asthma, (b) perceptions of whether the healthcare system is culturally competent, (c) perceptions of language barriers in regards to accessing the healthcare system, and (d) perceptions of how to access reliable asthma information. The results of this study highlight the importance of diverse cultural beliefs and practices as factors that should be taken into consideration when tailoring interventions to improve asthma outcomes in vulnerable populations, including patients from ethno-cultural communities.
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Ye J, Shim R. Perceptions of health care communication: examining the role of patients' psychological distress. J Natl Med Assoc 2011; 102:1237-42. [PMID: 21287905 DOI: 10.1016/s0027-9684(15)30779-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE We sought to gain a better understanding of the relationship between patients' serious psychological distress (SPD) and their perception of interactions with health care providers and their ratings of the health care quality. METHODS We analyzed data from 6286 adult respondents to the 2007 Health Information National Trends Survey. We conducted cross-tabulations to compare sociodemographic characteristics between those with SPD and those without SPD. Using odds ratios and 95% confidence intervals from logistic regression models, we assessed the association between psychological status and indicators of perceived health care communication and the overall health care quality after controlling for sociodemographic variables. RESULTS Patients with SPD were less likely to report that their provider "always" paid attention to their feelings and emotions, "always" ensured their understanding of the needed care, and "always" assisted them dealing with uncertain feelings. These distressed patients were also less satisfied with the overall health care quality. CONCLUSIONS Patients' psychological distress is negatively associated with their perceived quality of communication with health providers. Further knowledge on the health care need of patients with SPD would be important in improving health service delivery and optimizing the psychological care of medical patients.
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Affiliation(s)
- Jiali Ye
- National Center for Primary Care, Department of Community Health and Preventive Medicine, Morehouse School of Medicine, 720 Westview Dr, Atlanta, GA 30310, USA.
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Pearson WS, Zhao G, Ford ES. An Analysis of Language as a Barrier to Receiving Influenza Vaccinations among an Elderly Hispanic Population in the United States. Adv Prev Med 2010; 2011:298787. [PMID: 21991435 PMCID: PMC3169338 DOI: 10.4061/2011/298787] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2010] [Accepted: 07/27/2010] [Indexed: 11/20/2022] Open
Abstract
Background. The Hispanic population in the United States is growing, and disparities in the receipt of healthcare services as a result of limited English proficiency have been demonstrated. We set out to determine if Spanish language preference was a barrier to receiving influenza vaccinations among Hispanic persons 65 years and older in the USA. Methods. Differences in the receipt of vaccinations by language preference were tested with both Chi-square analyses and adjusted logistic regression analyses. Results. Findings suggest that elderly Hispanic persons, 65 years of age and older, who prefer to communicate in Spanish instead of English, are significantly less likely to have received influenza vaccinations when compared to their Hispanic counterparts who prefer to communicate in English. Conclusions. Influenza infections can more often be fatal in older persons and may disparately affect minority populations such as Hispanic persons. Therefore, understanding barriers to the receipt of effective preventive health measures is necessary.
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Affiliation(s)
- William S Pearson
- Healthy Aging Program, Division of Adult and Community Health, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA
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Wallace LS, DeVoe JE, Rogers ES, Protheroe J, Rowlands G, Fryer GE. Digging deeper: quality of patient-provider communication across Hispanic subgroups. BMC Health Serv Res 2009; 9:240. [PMID: 20025725 PMCID: PMC2803181 DOI: 10.1186/1472-6963-9-240] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2009] [Accepted: 12/21/2009] [Indexed: 11/10/2022] Open
Abstract
Background Recent research suggests that ethnic subgroup designation plays an important role in health-related disparities among Hispanics. Our objective was to examine the influence of Hispanics' self-reported ethnic subgroup designation on perceptions of their health care providers' communication behaviors. Methods Cross-sectional analysis of the 2005 Medical Expenditure Panel Survey (MEPS). Participants included non-institutionalized Hispanics (n = 5197; US population estimate = 27,070,906), aged ≥18 years, reporting visiting a health care provider within the past 12 months. Six (n = 6) items were used to capture respondents' perceptions of their health care providers' communication behaviors. Results After controlling for socio-demographic covariates, compared to Other Hispanics (reference group), very few differences in perceptions of health care providers communication emerged across ethnic subgroups. Puerto Ricans were more likely to report that their health care provider "always" showed respect for what they had to say (OR = 2.16, 95% CI 1.16-4.03). Both Puerto Ricans (OR = 2.28, 95% CI 1.06-4.92) and Mexicans (OR = 1.88, 95% CI 1.02-3.46) were more likely to indicate that their health care provider "always" spent enough time with them as compared to Other Hispanics. Conclusions We observed very few differences among Hispanics respondents in their perceived quality of interactions with health care providers as a function of their ethnic subgroup designation. While our findings somewhat contradict previous research, they do suggest that other underlying factors may influence the quality of perceived interactions with health care providers.
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Affiliation(s)
- Lorraine S Wallace
- University of Tennessee Graduate School of Medicine, Department of Family Medicine, Knoxville, Tennessee, USA.
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