1
|
Nash K, Macniven R, Clague L, Coates H, Fitzpatrick M, Gunasekera H, Gwynne K, Halvorsen L, Harkus S, Holt L, Lumby N, Neal K, Orr N, Pellicano E, Rambaldini B, McMahon C. Ear and hearing care programs for First Nations children: a scoping review. BMC Health Serv Res 2023; 23:380. [PMID: 37076841 PMCID: PMC10116763 DOI: 10.1186/s12913-023-09338-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 03/24/2023] [Indexed: 04/21/2023] Open
Abstract
BACKGROUND Ear and hearing care programs are critical to early detection and management of otitis media (or middle ear disease). Otitis media and associated hearing loss disproportionately impacts First Nations children. This affects speech and language development, social and cognitive development and, in turn, education and life outcomes. This scoping review aimed to better understand how ear and hearing care programs for First Nations children in high-income colonial-settler countries aimed to reduce the burden of otitis media and increase equitable access to care. Specifically, the review aimed to chart program strategies, map the focus of each program against 4 parts of a care pathway (prevention, detection, diagnosis/management, rehabilitation), and to identify the factors that indicated the longer-term sustainability and success of programs. METHOD A database search was conducted in March 2021 using Medline, Embase, Global Health, APA PsycInfo, CINAHL, Web of Science Core Collection, Scopus, and Academic Search Premier. Programs were eligible or inclusion if they had either been developed or run at any time between January 2010 to March 2021. Search terms encompassed terms such as First Nations children, ear and hearing care, and health programs, initiatives, campaigns, and services. RESULTS Twenty-seven articles met the criteria to be included in the review and described a total of twenty-one ear and hearing care programs. Programs employed strategies to: (i) connect patients to specialist services, (ii) improve cultural safety of services, and (iii) increase access to ear and hearing care services. However, program evaluation measures were limited to outputs or the evaluation of service-level outcome, rather than patient-based outcomes. Factors which contributed to program sustainability included funding and community involvement although these were limited in many cases. CONCLUSION The result of this study highlighted that programs primarily operate at two points along the care pathway-detection and diagnosis/management, presumably where the greatest need lies. Targeted strategies were used to address these, some which were limited in their approach. The success of many programs are evaluated as outputs, and many programs rely on funding sources which can potentially limit longer-term sustainability. Finally, the involvement of First Nations people and communities typically only occurred during implementation rather than across the development of the program. Future programs should be embedded within a connected system of care and tied to existing policies and funding streams to ensure long term viability. Programs should be governed and evaluated by First Nations communities to further ensure programs are sustainable and are designed to meet community needs.
Collapse
Affiliation(s)
- Kai Nash
- The Djurali Centre for Aboriginal and Torres Strait Islander Health Research and Education, Sydney, Australia.
| | - Rona Macniven
- School of Population Health, University of New South Wales, Sydney, Australia
| | - Liesa Clague
- Thurru Indigenous Unit, College of Medicine, Health and Wellbeing, University of Newcastle, Newcastle, Australia
| | - Harvey Coates
- The University of Western Australia, Perth, Australia
| | | | | | - Kylie Gwynne
- The Djurali Centre for Aboriginal and Torres Strait Islander Health Research and Education, Sydney, Australia
| | - Luke Halvorsen
- The Djurali Centre for Aboriginal and Torres Strait Islander Health Research and Education, Sydney, Australia
| | | | - Leanne Holt
- Department of Indigenous Studies, Macquarie University, Sydney, Australia
| | - Noeleen Lumby
- The Djurali Centre for Aboriginal and Torres Strait Islander Health Research and Education, Sydney, Australia
| | | | - Neil Orr
- The Djurali Centre for Aboriginal and Torres Strait Islander Health Research and Education, Sydney, Australia
| | | | - Boe Rambaldini
- The Djurali Centre for Aboriginal and Torres Strait Islander Health Research and Education, Sydney, Australia
| | - Catherine McMahon
- The Djurali Centre for Aboriginal and Torres Strait Islander Health Research and Education, Sydney, Australia
| |
Collapse
|
2
|
Burgess A, Hawkins J, Kostovski C, Kennedy M, Penkala S, Duncanson K. Aboriginal people’s perceptions of patient-reported outcome measures in the assessment of diabetes health-related quality of life†. Aust J Prim Health 2022; 29:165-174. [PMID: 37079465 DOI: 10.1071/py22150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 10/19/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND Patient-reported outcome measures (PROMs) provide clinicians and consumers a platform to inform and improve healthcare planning and management. Aboriginal people experience disproportionately high rates of chronic diseases, including type 2 diabetes. Treatment and management require holistic approaches that draw on culturally relevant resources and assessment tools. This study explored perceptions of Aboriginal people about two diabetes management-related PROMs (PROMIS-29, PAID Scale). METHODS Twenty-nine Aboriginal people living with diabetes in the Shoalhaven discussed two PROMs in one of four focus groups or at an individual interview. Preliminary data coding was conducted by clinician researchers, with thematic analysis overseen by Aboriginal co-researchers. Subsequent individual interviews with participants were undertaken to seek further feedback and articulate what is needed to improve methods of evaluating Aboriginal people's self-reported quality of life and diabetes management. RESULTS The PROMs did not capture information or knowledge that Aboriginal people considered relevant to their diabetes-related health care. Participants' recommendations included adapting survey materials to be more culturally sensitive; for example, by improving the alignment of measures with common day-to-day activities. This study also describes a genuine collaborative, Aboriginal community-guided approach to evaluate 'fit-for-purpose' diabetes management tools. CONCLUSIONS Appropriate evaluation methods are paramount to address the disproportionate burden of diabetes experienced by Aboriginal peoples and overcome inverse diabetes care. Our learnings will contribute to development of tools, resources or methods that capture culturally tailored outcome measures. Study findings are relevant to clinicians and researchers using and/or developing Patient Reported Measures, particularly in relation to the practicality of tools for First Nations peoples.
Collapse
Affiliation(s)
- Alicia Burgess
- University of Newcastle, School of Medicine and Public Health, Callaghan, NSW, Australia; and Illawarra Shoalhaven Local Health District, High Risk Foot Service, Wollongong, NSW, Australia; and NSW Health Education and Training Institute, Rural Research Capacity Building Program, St Leonards, NSW, Australia
| | - Jessica Hawkins
- Illawarra Shoalhaven Local Health District, High Risk Foot Service, Wollongong, NSW, Australia; and NSW Health Education and Training Institute, Rural Research Capacity Building Program, St Leonards, NSW, Australia
| | - Catherine Kostovski
- Illawarra Shoalhaven Local Health District, Aboriginal Chronic Care Unit, Warrawong, NSW, Australia
| | - Michelle Kennedy
- University of Newcastle, School of Medicine and Public Health, Callaghan, NSW, Australia; and Hunter Medical Research Institute, Equity in Health and Wellbeing Research Program, Newcastle, NSW, Australia
| | - Stefania Penkala
- Western Sydney University, School of Health Sciences, Sydney, NSW, Australia; and Western Sydney University, Translational Health Research Institute, Sydney, NSW, Australia
| | - Kerith Duncanson
- NSW Health Education and Training Institute, Rural Research Capacity Building Program, St Leonards, NSW, Australia; and University of Newcastle, Centre of Research Excellence in Digestive Health, Callaghan, NSW, Australia; and Hunter Medical Research Institute, Immune Health Program, Newcastle, NSW, Australia
| |
Collapse
|
3
|
Affiliation(s)
- Tom Gardiner
- London North West University Healthcare NHS Trust, London, UK
| | | | | | - Mala Rao
- Department of Primary Care and Public Health, Imperial College London, London, UK
| | - Shamini Gnani
- Department of Primary Care and Public Health, Imperial College London, London, UK
| |
Collapse
|
4
|
Dushenkov A, Rozaklis L, Kalabalik-Hoganson J, Kim D. Insights from a capstone workshop: An investigation of soon-to-be pharmacists' readiness to provide culturally competent pharmaceutical care. Curr Pharm Teach Learn 2020; 12:834-842. [PMID: 32540045 DOI: 10.1016/j.cptl.2020.02.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 01/23/2020] [Accepted: 02/26/2020] [Indexed: 06/11/2023]
Abstract
INTRODUCTION This study investigated readiness of soon-to-be pharmacists to provide culturally sensitive patient-centered care through administration of a capstone workshop. METHODS The workshop was delivered in 2017 and 2018 and consisted of a pre-survey, a didactic lecture followed by group discussions of Worlds Apart cases, and a post-survey. The surveys contained knowledge questions and perception statements. Results were analyzed using descriptive and inferential statistics. Group questions were aligned to constructs from Campinha-Bacote's Model of Cultural Competence. The percentage of groups with correct answers was calculated. RESULTS Both cohorts significantly increased their knowledge by the end of the workshop (p = 0.007, 2017; p < 0.001, 2018). Significant increases in respondent agreement to perception statements were also observed post-workshop. The percent of correct group responses varied by construct within the cultural aspect, between the aspects for each year, and between years. The evaluation of overall cultural readiness yielded the lowest results. CONCLUSION This research revealed the necessity and value of the capstone workshop. Significant improvements in meeting cultural competence standards were observed upon completion of the exercise. Alignment of group discussion questions to Campinha-Bacote's Model of Cultural Competence constructs was useful in augmentation of assessment armamentarium as it unearthed gaps in cultural competences of pharmacy graduates. Further multi-institutional research aimed to generalize the findings of this study is highly desired.
Collapse
Affiliation(s)
- Anna Dushenkov
- FDU School of Pharmacy and Health Sciences, 230 Park Av, M-SP1-01, Florham Park, NJ 07932, United States.
| | - Lillian Rozaklis
- FDU School of Pharmacy and Health Sciences, 230 Park Av, M-SP1-01, Florham Park, NJ 07932, United States
| | - Julie Kalabalik-Hoganson
- FDU School of Pharmacy and Health Sciences, 230 Park Av, M-SP1-01, Florham Park, NJ 07932, United States
| | - Dongmi Kim
- FDU School of Pharmacy and Health Sciences, 230 Park Av, M-SP1-01, Florham Park, NJ 07932, United States
| |
Collapse
|
5
|
Kong AC, Ramjan L, Sousa MS, Gwynne K, Goulding J, Jones N, Srinivas R, Rambaldini B, Moir R, George A. The oral health of Indigenous pregnant women: A mixed-methods systematic review. Women Birth 2020; 33:311-322. [PMID: 31501053 DOI: 10.1016/j.wombi.2019.08.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 08/19/2019] [Accepted: 08/19/2019] [Indexed: 11/20/2022]
Abstract
BACKGROUND Western models of care to improve the oral health of pregnant women have been successfully implemented in the healthcare setting across various developed countries. Even though Indigenous women experience poorer pregnancy and birth outcomes compared to other women, these models have not been developed with Indigenous communities to address the oral health needs of Indigenous pregnant women. This review aimed to understand the oral health knowledge, practices, attitudes and challenges of Indigenous pregnant women globally. METHODS A comprehensive search including six electronic databases and grey literature up to September 2018 was undertaken (PROSPERO Registration Number: 111402). Quantitative and qualitative evidence exploring at least one of the four oral health domains relating to Indigenous pregnant women worldwide, including women pregnant with an Indigenous child, were retrieved. RESULTS Eleven publications related to nine studies were included. Indigenous pregnant women's attitudes, practices and challenges relating to their oral health were influenced by socioeconomic and psychosocial factors, and their healthcare context. Availability of dental services varied depending on the healthcare model, whether services were public or private, and whether services met their needs. Although there was little evidence related to oral health knowledge, the literature suggests some misconceptions within this population. CONCLUSIONS The availability of culturally appropriate dental services that fulfilled the needs of Indigenous pregnant women varied between developed countries. This review highlighted the need for community-tailored dental services and a care coordinator to provide both education and assistance to those navigating services.
Collapse
Affiliation(s)
- Ariana C Kong
- Centre for Oral Health Outcomes and Research Translation (COHORT), School of Nursing and Midwifery, Western Sydney University/South Western Sydney Local Health District / Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia.
| | - Lucie Ramjan
- Centre for Oral Health Outcomes and Research Translation (COHORT), School of Nursing and Midwifery, Western Sydney University/South Western Sydney Local Health District / Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia.
| | - Mariana S Sousa
- Centre for Oral Health Outcomes and Research Translation (COHORT), School of Nursing and Midwifery, Western Sydney University/South Western Sydney Local Health District / Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia.
| | - Kylie Gwynne
- Poche Centre for Indigenous Health, University of Sydney, Camperdown 2050, Australia.
| | - Joanne Goulding
- Primary and Community Health, South Western Sydney Local Health District, NSW, Australia.
| | - Nathan Jones
- Aboriginal Health Unit, South Western Sydney Local Health District, NSW, Australia.
| | - Ravi Srinivas
- Centre for Oral Health Outcomes and Research Translation (COHORT), School of Nursing and Midwifery, Western Sydney University/South Western Sydney Local Health District / Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia; Oral Health Services, South Western Sydney Local Health District, Australia; School of Dentistry, Faculty of Medicine and Health, University of Sydney, Camperdown 2050, Australia.
| | - Boe Rambaldini
- Poche Centre for Indigenous Health, University of Sydney, Camperdown 2050, Australia.
| | - Rachael Moir
- Poche Centre for Indigenous Health, University of Sydney, Camperdown 2050, Australia.
| | - Ajesh George
- Centre for Oral Health Outcomes and Research Translation (COHORT), School of Nursing and Midwifery, Western Sydney University/South Western Sydney Local Health District / Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia; School of Dentistry, Faculty of Medicine and Health, University of Sydney, Camperdown 2050, Australia; Translational Health Research Institute, Campbelltown, NSW, Australia.
| |
Collapse
|
6
|
Okamoto L, Riklon S, Masaki K, Bell C, Tamai A, Maskarinec GG. Evolving Palliative Care Practices among Marshall Islanders in Hawai'i: Generational Comparisons. Hawaii J Health Soc Welf 2020; 79:82-88. [PMID: 32596684 PMCID: PMC7311949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Little is known about Marshallese palliative care practices. We explored traditional and contemporary Marshallese palliative care practices and examined generational differences. We performed three focus groups in 2011-2012 among Marshall Islanders in Hawai'i. A native speaking interpreter assisted group facilitators. Data were analyzed using classical thematic triangulation methods to identify specific Marshallese palliative care practices, the effect of economic and social challenges in Hawai'i, and generational differences comparing young and old. Nineteen persons (10 men and 9 women, youth aged 17-27 years, and elders as defined in Marshallese culture, aged 46-79) participated. A "good death" was defined as "peaceful and pain free," occurring from natural causes. Factors associated with a "good death" included gathering of family to absolve conflicts, and proper and timely cultural practices. Factors associated with "bad deaths" included young age, active suffering, accidents, suicides, "black magic/curses," or lack of timely or proper burial. Comparing generational differences, older Marshallese had differing opinions regarding preferred place of death, burial site, cultural practice preservation, artificial prolongation of life, and cremation. Barriers included mortuary fees, cost of transporting bodies, United States (US) government policies, and wait times for death certificates. Many cultural factors contribute to "good" or "bad" deaths. Attitudes toward palliative care practices differ by generation. Having previously documented different approaches by Yapese, a generalized "one size fits all" approach to Micronesians is inappropriate. Overcoming identified barriers may facilitate practices necessary for a good death in Micronesian populations in their home nations and as they migrate to communities throughout the US.
Collapse
Affiliation(s)
- Lauren Okamoto
- The John A. Hartford Foundation Center of Excellence in Geriatrics, Department of Geriatric Medicine, John A. Burns School of Medicine, University of Hawai‘i, Honolulu, HI (LO, KM, CB)
| | - Sheldon Riklon
- University of Arkansas for Medical Sciences, Northwest Arkansas Campus, Fayetteville, AR (SK)
| | - Kamal Masaki
- The John A. Hartford Foundation Center of Excellence in Geriatrics, Department of Geriatric Medicine, John A. Burns School of Medicine, University of Hawai‘i, Honolulu, HI (LO, KM, CB)
| | - Christina Bell
- The John A. Hartford Foundation Center of Excellence in Geriatrics, Department of Geriatric Medicine, John A. Burns School of Medicine, University of Hawai‘i, Honolulu, HI (LO, KM, CB)
| | - Anna Tamai
- Japan Association for Development of Community Medicine, Taito Hospital, TaitoKu, Tokyo, Japan (AT)
| | - Gregory G. Maskarinec
- Office of Global Health and International Medicine, John A. Burns School of Medicine, University of Hawai‘i, Honolulu, HI (GGM)
| |
Collapse
|
7
|
Dzierżanowski T, Gradalski T, Kozlowski M. Palliative Performance Scale: cross cultural adaptation and psychometric validation for Polish hospice setting. BMC Palliat Care 2020; 19:52. [PMID: 32321494 PMCID: PMC7178730 DOI: 10.1186/s12904-020-00563-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Accepted: 04/16/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Measuring functional status in palliative care may help clinicians to assess a patient's prognosis, recommend adequate therapy, avoid futile or aggressive medical care, consider hospice referral, and evaluate provided rehabilitation outcomes. An optimized, widely used, and validated tool is preferable. The Palliative Performance Scale Version 2 (PPSv2) is currently one of the most commonly used performance scales in palliative settings. The aim of this study is the psychometric validation process of a Polish translation of this tool (PPSv2-Polish). METHODS Two hundred patients admitted to a free-standing hospice were evaluated twice, on the first and third day, for test-retest reliability. In the first evaluation, two different care providers independently evaluated the same patient to establish inter-rater reliability values. PPSv2-Polish was evaluated simultaneously with the Karnofsky Performance Score (KPS), Eastern Cooperative Oncology Group (ECOG) Performance Status (ECOG PS), and Barthel Activities of Daily Living (ADL) Index, to determine its construct validity. RESULTS A high level of full agreement between test and retest was seen (63%), and a good intra-class correlation coefficient of 0.85 (P < 0.0001) was achieved. Excellent agreement between raters was observed when using PPSv2-Polish (Cohen's kappa 0.91; P < 0.0001). Satisfactory correlations with the KPS and good correlations with ECOG PS and Barthel ADL were noticed. Persons who had shorter prognoses and were predominantly bedridden also had lower scores measured by the PPSv2-Polish, KPS and Barthel ADL. A strong correlation of 0.77 between PPSv2-Polish scores and survival time was noted (P < 0.0001). Moderate survival correlations were seen between KPS, ECOG PS, and Barthel ADL of 0.41; - 0.62; and 0.58, respectively (P < 0.0001). CONCLUSION PPSv2-Polish is a valid and reliable tool measuring performance status in a hospice population and can be used in daily clinical practice in palliative care and research.
Collapse
Affiliation(s)
- Tomasz Dzierżanowski
- Laboratory of Palliative Medicine, Department of Social Medicine and Public Health, Medical University of Warsaw, Warsaw, Poland
| | - Tomasz Gradalski
- St Lazarus Hospice, 31-831 Krakow, Fatimska, 17, Krakow, Poland.
| | - Michael Kozlowski
- Clinic of Pain Treatment and Palliative Care, Chair of Internal Medicine and Geriatrics, Jagiellonian University Medical College, Krakow, Poland
| |
Collapse
|
8
|
Samayoa C, Santoyo-Olsson J, Escalera C, Stewart AL, Ortiz C, Márquez-Magaña L, Urias A, Gonzalez N, Cervantes SA, Torres-Nguyen A, Parada-Ampudia L, Nápoles AM. Participant-Centered Strategies for Overcoming Barriers to Biospecimen Collection among Spanish-Speaking Latina Breast Cancer Survivors. Cancer Epidemiol Biomarkers Prev 2020; 29:606-615. [PMID: 32132128 PMCID: PMC7062229 DOI: 10.1158/1055-9965.epi-19-0942] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 11/12/2019] [Accepted: 01/07/2020] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Latinos are underrepresented in biomedical research, particularly biomarker research, yet they constitute the nation's largest ethnic/racial minority. Optimal methods for obtaining biospecimens for biomarker research among Latinos need to be identified. To minimize barriers and enhance participation, this study developed and tested tailored strategies for collecting biomarkers of chronic stress and premature aging among Spanish-speaking Latina breast cancer survivors. METHODS This study used a community-based participatory approach and selected hair and saliva as noninvasive biospecimens to assess telomere length, the cortisol awakening response (CAR), and hair cortisol concentration. We developed bilingual multimedia instructional materials, and community health workers assisted in collections. Telephone surveys assessed willingness to participate in future studies, barriers to sample collection, and recommendations for improving the strategies. RESULTS A total of 103 participants were recruited over 18 months from two rural sites in California, and 88 were retained at 6-month follow-up. At baseline, rates of donating salivary DNA for telomere length measurement, saliva for CAR analysis, and hair for cortisol concentration were 98%, 89%, and 52%, respectively. At follow-up, rates were 83%, 76%, and 55%, respectively. The majority of participants reported being very willing to provide hair (72%) or saliva (74%) for future studies. CONCLUSIONS Our results support the feasibility of including minorities in biomedical research. We report excellent rates of saliva collection when community partners are engaged in the process, and when patient-centered and culturally tailored recruitment methods are implemented. IMPACT The development of methods to facilitate the inclusion of minorities in biomedical research is critical to eliminate racial/ethnic health disparities.
Collapse
Affiliation(s)
- Cathy Samayoa
- Health Equity Research Lab, Department of Biology, San Francisco State University, San Francisco, California.
| | - Jasmine Santoyo-Olsson
- Division of General Internal Medicine, Department of Medicine, University of California San Francisco, San Francisco, California
| | - Cristian Escalera
- National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland
| | - Anita L Stewart
- Institute for Health & Aging, University of California San Francisco, San Francisco, California
- Center for Aging in Diverse Communities, University of California San Francisco, San Francisco, California
| | - Carmen Ortiz
- Círculo de Vida Cancer Support and Resource Center, San Francisco, California
| | - Leticia Márquez-Magaña
- Health Equity Research Lab, Department of Biology, San Francisco State University, San Francisco, California
| | - Aday Urias
- Cancer Resource Center of the Desert, El Centro, California
| | | | - Silvia A Cervantes
- Community Outreach Department, Kaweah Delta Health District, Visalia, California
| | - Alma Torres-Nguyen
- Community Outreach Department, Kaweah Delta Health District, Visalia, California
| | - Lorenia Parada-Ampudia
- WomenCARE/Entre Nosotras, Family Service Agency of the Central Coast, Soquel, California
| | - Anna M Nápoles
- National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland
| |
Collapse
|
9
|
Minnican C, O’Toole G. Exploring the incidence of culturally responsive communication in Australian healthcare: the first rapid review on this concept. BMC Health Serv Res 2020; 20:20. [PMID: 31910837 PMCID: PMC6947994 DOI: 10.1186/s12913-019-4859-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 12/22/2019] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Increasing diversity in Australia requires healthcare practitioners to consider the cultural, linguistic, religious, sexual and racial/ethnic characteristics of service users as integral components of healthcare delivery. This highlights the need for culturally appropriate communication and care. Indeed the Australian Government in various policies mandates culturally responsive communication. Therefore this paper aims to provide a brief overview of Australian healthcare literature exploring the components; prevalence and effects of this style of communication in healthcare. METHODS A rapid review was conducted using the knowledge to action evidence summary approach. Articles included in the review were those reporting on the components, prevalence and outcomes of culturally responsive communication in Australian healthcare, published in English between 2008 and 2018. Articles were reviewed using reliable critical appraisal procedures. RESULTS Twenty- six articles were included in the final review (23 qualitative studies; 2 systematic reviews; 1 mixed methods study). The literature indicates knowledge of the positive effects of culturally responsive communication in healthcare. It also highlights the disparity between the perceptions of healthcare practitioners and services users over the existence and components of culturally responsive communication in healthcare. The review identified a limited use of this style of communication, but rather a focus on barriers to culturally appropriate care, lacking an awareness of the importance of culturally responsive communication in this care. CONCLUSION While literature suggests the importance and positive effects of culturally responsive communication, evidence suggests inconsistent implementation of this style of communication within Australian healthcare settings. This has implications for the outcomes of healthcare for the diverse population in Australia.
Collapse
Affiliation(s)
| | - Gjyn O’Toole
- Discipline of Occupational Therapy, School of Health Sciences, Faculty of Health and Medicine, The University of Newcastle, Callaghan, 2308 Australia
| |
Collapse
|
10
|
Scott TN, Gil-Rivas V, Cachelin FM. The need for cultural adaptations to health interventions for African American women: A qualitative analysis. Cultur Divers Ethnic Minor Psychol 2019; 25:331-341. [PMID: 30272472 DOI: 10.1037/cdp0000228] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
OBJECTIVE Binge eating disorder (BED) is associated with obesity and psychological distress. Although rates in African American (AA) and White women are similar, AA women report more severity of symptoms and higher frequency of binge eating episodes. However, few AA women seek help due to a lack of acknowledgment of sociocultural influences that shape experiences and behaviors related to BED in currently available interventions. Culturally adapted interventions are an important way to acknowledge these sociocultural factors and produce expected outcomes within a specific group. This qualitative study begins the process of culturally adapting evidence-based treatment for AA women to reduce BED. METHOD Sixteen AA women with BED participated in focus groups to determine the need for adaptations to an evidence-based intervention. Thematic content analysis was used to analyze data from focus groups. RESULTS The unique experiences of AA women including lack of awareness of BED, cultural deviation from the "thin ideal," influence of family on eating practices, social meanings of food, role of religion, binge eating as coping, skepticism about weight standards, and the importance of motivation to change are highlighted. CONCLUSION This research adds to the current discourse on the importance of culturally adapting interventions for more targeted use and helps to expand what is known about AA women with BED and associated obesity. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
Collapse
Affiliation(s)
| | - Virginia Gil-Rivas
- Department of Psychological Science and Health Psychology PhD Program, University of North Carolina Charlotte
| | - Fary M Cachelin
- Department of Psychological Science and Health Psychology PhD Program, University of North Carolina Charlotte
| |
Collapse
|
11
|
Degnan A, Baker S, Edge D, Nottidge W, Noke M, Press CJ, Husain N, Rathod S, Drake RJ. The nature and efficacy of culturally-adapted psychosocial interventions for schizophrenia: a systematic review and meta-analysis. Psychol Med 2018; 48:714-727. [PMID: 28830574 DOI: 10.1017/s0033291717002264] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND Evidence-based psychosocial treatments for schizophrenia founded on Western belief systems and values may not be efficacious in different cultures without adaptation. This systematic review analyses the nature and outcomes of culturally-adapted psychosocial interventions in schizophrenia, examining how interventions have been adapted, their efficacy and what features drive heterogeneity in outcome. METHOD Articles identified by searching electronic databases from inception to 3 March 2016, reference lists and previous reviews were independently screened by two authors for eligible controlled trials. Data on the nature of adaptations was analysed inductively using thematic analyses. Meta-analyses were conducted using random effects models to calculate effect sizes (Hedges' g) for symptoms. RESULTS Forty-six studies with 7828 participants were included, seven adapted for minority populations. Cultural adaptations were grouped into nine themes: language, concepts and illness models, family, communication, content, cultural norms and practices, context and delivery, therapeutic alliance, and treatment goals. Meta-analyses showed significant post-treatment effects in favour of adapted interventions for total symptom severity (n = 2345, g: -0.23, 95% confidence interval (CI) -0.36 to -0.09), positive (n = 1152, g: -0.56, 95% CI -0.86 to -0.26), negative (n = 855, g: -0.39, 95% CI -0.63 to -0.15), and general (n = 525, g: -0.75, CI -1.21 to -0.29) symptoms. CONCLUSIONS The adaptation process can be described within a framework that serves as a benchmark for development or assessment of future adaptations. Culturally adapted interventions were more efficacious than usual treatment in proportion to the degree of adaptation. There is insufficient evidence to show that adapted interventions are better than non-adapted interventions. Features of context, intervention and design influenced efficacy. Investigating whether adaptation improves efficacy, most importantly amongst ethnic minorities, requires better designed trials with comparisons against unadapted interventions.
Collapse
Affiliation(s)
- A Degnan
- Division of Psychology & Mental Health, Faculty of Biology,Medicine & Health, The University of Manchester,Manchester,UK
| | - S Baker
- Division of Psychology & Mental Health, Faculty of Biology,Medicine & Health, The University of Manchester,Manchester,UK
| | - D Edge
- Division of Psychology & Mental Health, Faculty of Biology,Medicine & Health, The University of Manchester,Manchester,UK
| | - W Nottidge
- Division of Psychology & Mental Health, Faculty of Biology,Medicine & Health, The University of Manchester,Manchester,UK
| | - M Noke
- Division of Psychology & Mental Health, Faculty of Biology,Medicine & Health, The University of Manchester,Manchester,UK
| | - C J Press
- Division of Psychology & Mental Health, Faculty of Biology,Medicine & Health, The University of Manchester,Manchester,UK
| | - N Husain
- Division of Psychology & Mental Health, Faculty of Biology,Medicine & Health, The University of Manchester,Manchester,UK
| | - S Rathod
- Southern Health NHS Foundation Trust, Clinical Trials Facility, Tom Rudd Unit, Moorgreen Hospital,West End, Southampton,UK
| | - R J Drake
- Division of Psychology & Mental Health, Faculty of Biology,Medicine & Health, The University of Manchester,Manchester,UK
| |
Collapse
|
12
|
Razum O, Reiss K, Breckenkamp J, Kaufner L, Brenne S, Bozorgmehr K, Borde T, David M. Comparing provision and appropriateness of health care between immigrants and non-immigrants in Germany using the example of neuraxial anaesthesia during labour: cross-sectional study. BMJ Open 2017; 7:e015913. [PMID: 28827247 PMCID: PMC5629712 DOI: 10.1136/bmjopen-2017-015913] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE Research on health services for immigrants has mostly been concerned with access barriers but rarely with appropriateness and responsiveness of care. We assessed whether appropriateness and responsiveness of care depend on migration status, using provision of neuraxial anaesthesia (NA) during labour as indicator. In relation to their migration status, we analysed whether (1) women undergoing elective or secondary/urgent secondary caesarean sections (ESCS) appropriately receive NA (instead of general anaesthesia), (2) women delivering vaginally appropriately receive NA and (3) women objecting to NA, for example, for religious reasons, may deliver vaginally without receiving NA (provider responsiveness). DESIGN Cross-sectional study. SETTING Three obstetric hospitals in Berlin, Germany. METHODS Questionnaire survey covering 6391 women with migration history (first and second generations) and non-immigrant women giving birth; data linkage with routine obstetric data. We assessed the effects of migrant status, German language proficiency, religion and education on the provision of NA (primary outcome) after adjusting for other maternal and obstetric parameters. RESULTS The chance of receiving NA for elective/ESCS was independent of migrant status after controlling for confounding variables (adjusted OR (aOR) 0.93, 95% CI 0.65 to 1.33). In vaginal deliveries, first (but not second) generation women (aOR 0.79, 95% CI 0.65 to 0.95), women with low German language skills (aOR 0.77, 95% CI 0.58 to 0.99) and women with low educational attainment (aOR 0.62, 95% CI 0.47 to 0.82) had lower chances of receiving NA; there was no evidence of overprovision among women with strong affinity to Islam (aOR 0.77, 95% CI 0.63 to 0.94). CONCLUSIONS We found evidence for underprovision of care among first-generation immigrants, among women with low German language proficiency and particularly among all women with low educational attainment, irrespective of migration status. There was no evidence for overprovision of care to immigrant women, either inappropriately (general anaesthesia for ESCS) or because of low provider responsiveness (no opt-out for NA in vaginal delivery).
Collapse
Affiliation(s)
- Oliver Razum
- Department of Epidemiology and International Public Health, Bielefeld University, Bielefeld, Germany
| | - Katharina Reiss
- Department of Epidemiology and International Public Health, Bielefeld University, Bielefeld, Germany
- Healthy Start - Young Family Network, Federal Centre for Nutrition at Federal Office for Agriculture and Food, Bonn, Germany
| | - Jürgen Breckenkamp
- Department of Epidemiology and International Public Health, Bielefeld University, Bielefeld, Germany
| | - Lutz Kaufner
- Department of Anaesthesiology and Operative Intensive Care Medicine (CCM, CVK), Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Silke Brenne
- Department of Gynaecology, Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin, Berlin, Germany
- Alice Salomon Hochschule Berlin, Berlin, Germany
| | - Kayvan Bozorgmehr
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany
| | - Theda Borde
- Alice Salomon Hochschule Berlin, Berlin, Germany
| | - Matthias David
- Department of Gynaecology, Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin, Berlin, Germany
| |
Collapse
|
13
|
McIntyre C, Harris MG, Baxter AJ, Leske S, Diminic S, Gone JP, Hunter E, Whiteford H. Assessing service use for mental health by Indigenous populations in Australia, Canada, New Zealand and the United States of America: a rapid review of population surveys. Health Res Policy Syst 2017; 15:67. [PMID: 28778208 PMCID: PMC5544983 DOI: 10.1186/s12961-017-0233-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Accepted: 07/18/2017] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Indigenous people in Australia, Canada, New Zealand and the United States of America experience disproportionately poor mental health compared to their non-Indigenous counterparts. To optimally allocate resources, health planners require information about the services Indigenous people use for mental health, their unmet treatment needs and the barriers to care. We reviewed population surveys of Indigenous people to determine whether the information needed to guide service development is being collected. METHODS We sought national- or state-level epidemiological surveys of Indigenous populations conducted in each of the four selected countries since 1990 that asked about service use for mental health. Surveys were identified from literature reviews and web searches. We developed a framework for categorising the content of each survey. Using this framework, we compared the service use content of the surveys of Indigenous people to each other and to general population mental health surveys. We focused on identifying gaps in information coverage and topics that may require Indigenous-specific questions or response options. RESULTS Nine surveys met our inclusion criteria. More than half of these included questions about health professionals consulted, barriers to care, perceived need for care, medications taken, number, duration, location and payment of health professional visits or use of support services or self-management. Less than half included questions about interventions received, hospital admissions or treatment dropout. Indigenous-specific content was most common in questions regarding use of support services or self-management, types of health professionals consulted, barriers to care and interventions received. CONCLUSIONS Epidemiological surveys measuring service use for mental health among Indigenous populations have been less comprehensive and less standardised than surveys of the general population, despite having assessed similar content. To better understand the gaps in mental health service systems for Indigenous people, systematically-collected subjective and objective indicators of the quality of care being delivered are needed.
Collapse
Affiliation(s)
- Cecily McIntyre
- School of Public Health, The University of Queensland, Herston, Queensland Australia
- Yale University, New Haven, CT United States of America
| | - Meredith G. Harris
- School of Public Health, The University of Queensland, Herston, Queensland Australia
- Queensland Centre for Mental Health Research, The Park – Centre for Mental Health, Wacol, Queensland Australia
| | - Amanda J. Baxter
- School of Public Health, The University of Queensland, Herston, Queensland Australia
- Queensland Centre for Mental Health Research, The Park – Centre for Mental Health, Wacol, Queensland Australia
| | - Stuart Leske
- School of Public Health, The University of Queensland, Herston, Queensland Australia
| | - Sandra Diminic
- School of Public Health, The University of Queensland, Herston, Queensland Australia
- Queensland Centre for Mental Health Research, The Park – Centre for Mental Health, Wacol, Queensland Australia
| | - Joseph P. Gone
- Department of Psychology, University of Michigan, Ann Arbor, MI United States of America
| | - Ernest Hunter
- Remote Area Mental Health Service, Queensland Health, Cairns, Queensland Australia
| | - Harvey Whiteford
- School of Public Health, The University of Queensland, Herston, Queensland Australia
- Queensland Centre for Mental Health Research, The Park – Centre for Mental Health, Wacol, Queensland Australia
| |
Collapse
|
14
|
Nicolau P, Del Amo E, Carreras R. Primary gynecological care in multicultural areas. Med Clin (Barc) 2017; 149:37-38. [PMID: 28396136 DOI: 10.1016/j.medcli.2017.02.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Accepted: 02/23/2017] [Indexed: 11/17/2022]
Affiliation(s)
- Pau Nicolau
- Servicio de Ginecología y Obstetricia, CAP Raval Drassanes, Hospital del Mar, Barcelona, España.
| | - Elisabeth Del Amo
- Servicio de Ginecología y Obstetricia, CAP Raval Drassanes, Hospital del Mar, Barcelona, España; Departamento Pediatría, Obstetricia y Ginecología, Medicina Preventiva, Universitat Autònoma de Barcelona, Barcelona, España
| | - Ramón Carreras
- Servicio de Ginecología y Obstetricia, CAP Raval Drassanes, Hospital del Mar, Barcelona, España; Departamento Pediatría, Obstetricia y Ginecología, Medicina Preventiva, Universitat Autònoma de Barcelona, Barcelona, España
| |
Collapse
|
15
|
Nicholas D, Fleming-Carroll B, Durrant M, Hellmann J. Examining pediatric care for newly immigrated families: Perspectives of health care providers. Soc Work Health Care 2017; 56:335-351. [PMID: 28323553 DOI: 10.1080/00981389.2017.1292985] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Respect for the ethnicity and cultural background of families are important components of health care delivery. However, the needs of new immigrants in pediatric care systems remain under-addressed in the literature. This study utilized a qualitative approach of interpretive description to elicit the pediatric health care experiences and needs of new immigrants to Canada, from the perspective of health care providers who worked extensively with newcomers. Two focus groups of multidisciplinary health care providers were conducted in a tertiary-level pediatric hospital. Results identify that the needs of new immigrant families are often insufficiently met by existing pediatric care practices. Needs include subsistence requirements such as income, transportation, and family understanding about the complex processes of health care in the new society. Newly immigrated families reportedly experience emotional adjustment and social support struggles and needs. Information and support to navigate the health care system are warranted. These formidable challenges invite proactive approaches, including navigation and resource finding supports as well as culturally responsive family-centered care.
Collapse
Affiliation(s)
- David Nicholas
- a Faculty of Social Work , University of Calgary, Central and Northern Alberta Region , Edmonton , Alberta , Canada
| | - Bonnie Fleming-Carroll
- b The Hospital for Sick Children, Lawrence S. Bloomberg Faculty of Nursing , University of Toronto , Toronto , Ontario , Canada
| | - Michele Durrant
- b The Hospital for Sick Children, Lawrence S. Bloomberg Faculty of Nursing , University of Toronto , Toronto , Ontario , Canada
| | - Jonathan Hellmann
- c The Hospital for Sick Children, Department of Pediatrics , University of Toronto , Toronto , Ontario , Canada
| |
Collapse
|
16
|
Morgan S, Thomson A, O'Mara P, Tapley A, Henderson K, van Driel M, Scott J, Spike N, McArthur L, Magin P. Identification of Aboriginal and Torres Strait Islander status by general practice registrars: Confidence and associations. Aust Fam Physician 2016; 45:677-682. [PMID: 27606373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND Identification of Aboriginal and Torres Strait Islander status in healthcare settings is essential for the delivery of culturally appropriate care. Under-identification is common and practitioner confidence is a known barrier. OBJECTIVE The objective of this research was to document the self-reported confidence of general practice registrars in identifying the Aboriginal and Torres Strait Islander status of their patients, and associations of this confidence. METHODS This research used cross-sectional analysis of survey and patient encounter data of general practice registrars training across five Australian states. RESULTS Of the 698 registrars (97.5% response rate) who participated in the study, 74.5% had a high level of confidence in identifying a patient's Aboriginal and Torres Strait Islander status. Older and more senior registrars had significantly greater confidence. There was also a significant association with the registrars' training provider. DISCUSSION More than a quarter of registrars reported low confidence for this basic consultation skill. Our findings will inform general prac-tice vocational training and continuing professional development, and reinforce the importance of a comprehensive, system-wide approach to the identification of patients' Aboriginal or Torres Strait Islander status.
Collapse
Affiliation(s)
- Simon Morgan
- MBBS, MPH, FRACGP, General Practitioner and Medical Educator, General Practice Training - Valley to Coast, Newcastle, NSW
| | | | | | | | | | | | | | | | | | | |
Collapse
|
17
|
Amstutz-Szalay S. Physician Knowledge of Chagas Disease in Hispanic Immigrants Living in Appalachian Ohio. J Racial Ethn Health Disparities 2016; 4:523-528. [PMID: 27324820 DOI: 10.1007/s40615-016-0254-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Revised: 06/01/2016] [Accepted: 06/06/2016] [Indexed: 11/27/2022]
Abstract
Studies have indicated that US physicians may not consider Chagas disease when diagnosing immigrant patients from Chagas-endemic areas. The purpose of this study was to evaluate physician knowledge of Chagas disease in six Appalachian Ohio counties. Physician knowledge was assessed by self-administrated survey (n = 105). Over 80 % of physicians reported that their current knowledge of Chagas disease was limited or very limited, and 50 % reported never considering Chagas disease diagnosis for their at-risk patients. Nearly 70 % of physicians were unaware of the percentage of chronic Chagas patients that develop clinical disease, and 36 % could not correctly identify the disease course. In addition, over 30 % of physicians reported that no services were available within their practice to assist Spanish-speaking patients with limited English proficiency. A lack of physician awareness of Chagas disease, coupled with a lack of translation services, may create a barrier to care by decreasing the likelihood of identification of patients at risk for Chagas disease. The results of this study support the need for interventions to ensure proper diagnosis and treatment of Chagas disease in Hispanic immigrants in rural Appalachian Ohio.
Collapse
Affiliation(s)
- Shelley Amstutz-Szalay
- Department of Biology, Muskingum University, 163 Stormont Street, New Concord, OH, 43762, USA.
| |
Collapse
|
18
|
Bayram C, Ryan R, Harrison C, Gardiner J, Bailes MJ, Obeyesekere N, Miller G, Britt H. Consultations conducted in languages other than English in Australian general practice. Aust Fam Physician 2016; 45:9-13. [PMID: 27051980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
This study sought to determine the need for, and use of, professional interpreters in general practice. This is a sub-study of the Bettering the Evaluation and Care of Health (BEACH) program - a continuous, national, cross-sectional survey of Australian general practitioner (GP) activity. Data were provided by 206 randomly sampled GPs between December 2013 and March 2014. Of 6074 patients sampled, there were 986 (16.2%; 95% confidence interval [CI]: 13.2-19.3) who reported speaking a language other than English (LOTE) at home. Five per cent of all GP consultations involved communicating in a LOTE. Of these, 1% involved professional interpreters, 82.3% were conducted by multilingual GPs who spoke the patient's language, and 17.7% involved a family member or friend. GPs thought a professional interpreter would/may have improved the quality of 27.8% of these consultations. Our study suggests that GPs see the opportunity to improve the quality of LOTE consultations by using professional interpreters to replace family member/friend interpreters.
Collapse
Affiliation(s)
- Clare Bayram
- BAppSc (HIM) (Hons), PhD, Research Fellow and Project Manager, BEACH Program, Family Medicine Research Centre, University of Sydney, Sydney, NSW
| | | | | | | | | | | | | | | |
Collapse
|
19
|
Langley AK, Gonzalez A, Sugar CA, Solis D, Jaycox L. Bounce back: Effectiveness of an elementary school-based intervention for multicultural children exposed to traumatic events. J Consult Clin Psychol 2015; 83:853-65. [PMID: 26302251 PMCID: PMC4573344 DOI: 10.1037/ccp0000051] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To evaluate the feasibility and acceptability of a school-based intervention for diverse children exposed to a range of traumatic events, and to examine its effectiveness in improving symptoms of posttraumatic stress, depression, and anxiety. METHOD Participants were 74 schoolchildren (Grades 1-5) and their primary caregivers. All participating students endorsed clinically significant posttraumatic stress symptoms. School clinicians were trained to deliver Bounce Back, a 10-session cognitive-behavioral group intervention. Children were randomized to immediate or delayed (3-month waitlist) intervention. Parent- and child-report of posttraumatic stress and depression, and child report of anxiety symptoms, were assessed at baseline, 3 months, and 6 months. RESULTS Bounce Back was implemented with excellent clinician fidelity. Compared with children in the delayed condition, children who received Bounce Back immediately demonstrated significantly greater improvements in parent- and child-reported posttraumatic stress and child-reported anxiety symptoms over the 3-month intervention. Upon receipt of the intervention, the delayed intervention group demonstrated significant improvements in parent- and child-reported posttraumatic stress, depression, and anxiety symptoms. The immediate treatment group maintained or showed continued gains in all symptom domains over the 3-month follow-up period (6-month assessment). CONCLUSIONS Findings support the feasibility, acceptability, and effectiveness of the Bounce Back intervention as delivered by school-based clinicians for children with traumatic stress. Implications are discussed.
Collapse
Affiliation(s)
- Audra K Langley
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles
| | - Araceli Gonzalez
- Department of Psychology, California State University, Long Beach
| | - Catherine A Sugar
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles
| | - Diana Solis
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles
| | | |
Collapse
|
20
|
Abstract
Cognitive behavioral therapy (CBT) is an effective intervention for reducing substance use. However, because CBT trials have included predominantly White samples caution must be used when generalizing these effects to Blacks and Hispanics. This meta-analysis compared the impact of CBT in reducing substance use between studies with a predominantly non-Hispanic White sample (hereafter NHW studies) and studies with a predominantly Black and/or Hispanic sample (hereafter BH studies). From 322 manuscripts identified in the literature, 16 met criteria for inclusion. Effect sizes between CBT and comparison group at posttest had similar effects on substance abuse across NHW and BH studies. However, when comparing pre-posttest effect sizes from groups receiving CBT between NHW and BH studies, CBT's impact was significantly stronger in NHW studies. T-test comparisons indicated reduced retention/engagement in BH studies, albeit failing to reach statistical significance. Results highlight the need for further research testing CBT's impact on substance use among Blacks and Hispanics.
Collapse
Affiliation(s)
- Liliane Cambraia Windsor
- Rutgers: The State University of New Jersey, School of Social Work, 360 Martin Luther King Jr. Blvd, Hill Hall, Room 401, Newark, NJ 07104 - USA
| | - Alexis Jemal
- Rutgers: The State University of New Jersey, School of Social Work, 360 Martin Luther King Jr. Blvd, Hill Hall, Room 401, Newark, NJ 07104 - USA
| | - Edward Alessi
- Rutgers: The State University of New Jersey, School of Social Work, 360 Martin Luther King Jr. Blvd, Hill Hall, Room 401, Newark, NJ 07104 - USA
| |
Collapse
|
21
|
Abstract
PURPOSE The purpose is to provide an overview of a 20-year research program aimed at testing diabetes self-management education interventions culturally tailored for Mexican Americans residing in an impoverished rural community on the Texas-Mexico border. METHODS The research program involved focus group interviews to obtain community input, pilot testing to refine instruments and interventions, and community-based randomized controlled trials to examine intervention effects. Here the authors summarize lessons learned related to the (1) overall effects of culturally tailored diabetes self-management education; (2) impact of culture on study design, intervention development, health outcomes, and community acceptance; (3) benefits of and findings from multiple focus groups held over time in the community; and (4) personal and cultural motivators for behavioral change that were evident among study participants. RESULTS Postintervention reductions in A1C ranged from 1.4 to 1.7 percentage points. Individuals who attended ≥ 50% of intervention sessions achieved a 6-percentage point reduction in A1C. Intervention teams included bilingual Mexican American nurses, dietitians, and promotoras, all recruited from the local community. Focus group interviews indicated that a traditional promotora model was not acceptable to the participants who wanted knowledgeable health professionals, or perceived authority figures, to lead intervention sessions while promotoras provided logistical support. Free glucometers and strips, family participation, and interpersonal dynamics within intervention groups motivated individuals to make healthier lifestyle choices. CONCLUSIONS Culturally tailored diabetes interventions are effective in improving the health of socially disadvantaged minorities who bear a disproportional burden of type 2 diabetes, and these interventions are cost-effective.
Collapse
Affiliation(s)
- Sharon A Brown
- School of Nursing, The University of Texas at Austin, Austin, Texas, USA (Dr Brown)
| | - Craig L Hanis
- Human Genetics Center, School of Public Health, The University of Texas Health Science Center at Houston, Houston, Texas, USA (Dr Hanis)
| |
Collapse
|