Culturally Competent Care in the Breast Imaging Clinic: Hispanic/Latino Patients

Appropriate Use of Medical Interpreters in the Breast Imaging Clinic

More than 25 million Americans have limited English-language proficiency (LEP) according to the U.S. Census Bureau. This population experiences challenges accessing health care and is least likely to receive preventive health care, including screening mammogram. In a setting where the breast radiologist does not speak the language of their patient, using certified medical interpreter services is fundamental. Medical interpreter use is associated with improved clinical care and patient satisfaction and can potentially increase adherence to screening mammograms and follow-up in patients with LEP. Title VI of the Civil Rights Act requires interpreter services for patients with LEP who are receiving federal financial assistance. Failure to provide interpretative services when necessary is considered discriminatory and illegal. The use of untrained medical interpreters, including ad hoc interpreters (eg, family, friends, or untrained staff), is associated with more medical errors, violation of confidentiality, and poor health outcomes. Types of medical interpretation services available to address language barriers include in-person interpretation, telephone and video remote interpretation, and qualified bilingual staff. Proper training and certification of medical interpreters is essential to prevent misinterpretations and ensure patient safety. When using an interpreter service, speak to and maintain eye contact with the patient, address the patient directly and seat the interpreter next to or slightly behind the patient, use visual aids whenever possible, and have the patient repeat the information to verify comprehension. Breast radiologists can address disparities in breast cancer screening and treatment by promoting effective communication.

Psychosocial Experiences of Spanish-Speaking Parents of Children With Craniofacial Microsomia

Craniofacial microsomia (CFM) and microtia psychosocial research in the US is primarily with English-speaking participants. Given that 19% of the US is Latino, and there is a higher prevalence of CFM in Latino populations, this study aims to describe psychosocial experiences related to CFM among Spanish-speaking Latino caregivers to better inform health care. Narrative interviews (mean 73±17 min) were completed in Spanish with parents of children with CFM aged 3 to 17 (mean age 10.8±4.8 years). Transcripts were analyzed using quantitative linguistic analyses and reflexive thematic analysis. Participants (N=12) were mostly mothers (83%) who had immigrated to the US and had low socioeconomic status. Based upon analysis of grouped word counts, participants spent approximately half of their narratives discussing the first two years of their child's life. Themes selected based on US Latino sociodemographics and cultural values included the Impact of Language, Healthcare Challenges, Supportive Healthcare Experiences, Caregiver Coping with CFM, Family Roles, and Addressing Social Implications of CFM. Results highlighted that the first years of care are of critical importance to parents and suggest this is an optimal time to focus on education and support services for families. Additional treatment suggestions include providing interpretation and informational materials in Spanish, addressing care barriers, supporting familial and child coping, accounting for the role of extended family, and helping address social concerns. Ongoing research with Latino families can further assist in guiding culturally sensitive CFM health care.

Development and Implementation of a Culturally Informed Spanish Language Yoga Program for Latiné Women With Overweight or Obesity Diagnosed With Cancer: A Single Arm Pilot Study

Background

Given limited yoga research in health disparities populations, we developed and evaluated a 12-week Spanish language yoga program for Latiné women with overweight or obesity affected by cancer. The program aimed to empower participants through culturally tailored yoga practice and opportunities for social connection and support.

Methods

Partnering with a community-based organization, the program was co-created by bilingual (English and Spanish-speaking) yoga instructors, Latiné cancer survivor support professionals, and integrative medicine researchers. The single arm intervention consisted of 12 separate, 60-minute Hatha yoga classes, including physical postures, breathing exercises, culturally relevant poetry, and post-practice socialization opportunities. Measures were administered at baseline, 12-week, and 24-week.

Results

Thirty-five eligible participants enrolled in the program, demonstrating high feasibility and relevance as well as high levels of engagement in home practice. Some participants faced barriers to regular home practice, including family responsibilities and concerns about proper pose execution. Preliminary outcome analyses indicated improvements in sleep disturbance, pain interference, depression, and blood pressure post-intervention, with sustained improvements in depression, anxiety, and blood pressure at 24-week. No significant changes were observed in fatigue, physical function, positive affect, satisfaction with social roles and activities, and weight. Structured post-practice social snack time with yoga instructors (compared with unstructured time with peers) was associated with self-reported improvements in satisfaction with social roles and activities and weight loss.

Conclusion

This yoga program successfully engaged female Latiné cancer survivors with overweight and obesity and serves as a foundational step in empowering this population to improve their health and well-being through culturally tailored yoga practice. Future research should utilize controlled study designs and engage participants from different geographical regions to study the efficacy and sustainability of findings.

Mammography Information Systems: A Survey of Breast Imaging Radiologist Satisfaction and Perspectives

OBJECTIVE

To assess use of mammography information systems (MISs) and explore features associated with breast imaging radiologist satisfaction.

METHODS

A 22-question survey regarding MISs was distributed electronically to the Society of Breast Imaging membership between February 16, 2022 and June 28, 2022. Differences in responses between respondents satisfied and dissatisfied with their MIS were analyzed using Pearson chi-squared test, Fisher exact test, and multivariate logistic regression.

RESULTS

The response rate was 11.4% (228/2007). Most respondents used a commercial MIS (195/228, 85.5%). Most used were Epic (47/228, 21%), MagView (47/228, 21%), and PenRad (37/228, 16%). Only 4.4% (10/228) reported that patient tracking was not integrated with results reporting. The majority (129/226, 57%) reported satisfaction with their MIS. Satisfaction correlated (P < 0.05) with features such as picture archiving and communication system integration, structured reporting, access to physician outcomes metrics, and ability to query data. Less commonly reported features such as non-English language options and recognition of laterality and patient mismatch errors also correlated with satisfaction. Lack of these features correlated with dissatisfaction (P < 0.05). Satisfaction also correlated with adequate training (P < 0.001) and technology support (P < 0.001). On multivariate analysis, longer time using the current MIS was independently associated with satisfaction.

CONCLUSION

Most respondents used a commercial MIS and were satisfied with their system. Satisfied users reported several helpful MIS features and adequate training and support. The survey results could help MIS companies when designing new products and inform radiologists and administrators when considering a new MIS.