Juntos: A Model for Language Congruent Care to Better Serve Spanish-Speaking Patients with COVID-19.
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ABSTRACT:
SUBMITTER: Alvarez-Arango S
PROVIDER: S-EPMC8742298 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:IntroductionThe COVID-19 pandemic has disproportionately affected Hispanics in the United States, who make up 18% of US inhabitants but 29% of COVID-19 cases as of June 2021. Recent studies have attributed higher COVID-19 infection, hospitalization, and death rates among Hispanics to social determinants of health. Given that the majority of US Hispanics are bilingual or Spanish-dominant, it is imperative for health care providers to be prepared to discuss COVID-19 prevention and treatment in Spanish.MethodsWe developed an interactive workshop aimed at increasing health professionals' confidence in discussing COVID-19 prevention, risk factors, and treatments with Spanish-speaking patients. Learners were expected to have an intermediate level or higher proficiency in medical Spanish. The workshop consisted of a PowerPoint presentation and English/Spanish scripts to facilitate interactive learning. The workshop was evaluated using a postworkshop questionnaire to assess learners' perceived confidence in communicating with Spanish-speaking patients.ResultsThe workshop was implemented with 70 participants, who had diverse ethnoracial identities and professional roles, at five different medical schools. Fifty-three participants completed the postworkshop questionnaire. More than 50% reported near complete to complete confidence in meeting the three learning objectives.DiscussionWith Hispanics being the largest non-White ethnoracial group in the US and being disproportionally affected by COVID-19, it is essential for health professionals to access training tools that allow them to practice medical Spanish. This module can uniquely aid in the preparation of health professionals caring for Spanish-speaking patients who present with COVID-19 symptoms.
| S-EPMC9001760 | biostudies-literature
Project description:Purpose The purpose of this study was to examine the diagnostic accuracy of traditional measures of phonological ability developed for monolingual English-speaking children with their bilingual peers in both English and Spanish. We predicted that a composite measure, derived from a combination of English and Spanish phonological measures, would result in higher diagnostic accuracy than examining the individual phonological measures of bilingual children separately by language. Method Sixty-six children, ages 3;3-6;3 (years;months), participated in this study: 29 typically developing bilingual Spanish-English-speaking children (x = 5;3), five bilingual Spanish-English-speaking children with speech sound disorders (x = 4;6), 26 typically developing monolingual English-speaking children (x = 4;8), and six monolingual English-speaking children with speech sound disorders (x = 4;9). Children were recorded producing single words using the Assessments of English and Spanish Phonology, and productions were phonetically transcribed and analyzed using the Logical International Phonetics Program. Overall consonants correct-revised; accuracy of early-, middle-, and late-developing sounds; and percent occurrence of phonological error patterns in both English and Spanish were calculated. Receiver operating characteristic curves and support vector machine models were applied to observe diagnostic accuracy, separately and combined, for each speaker group and each language. Results Findings indicated the combination of measures improved diagnostic accuracy within both the English and Spanish of bilingual children and significantly increased accuracy when measures from both languages of bilingual children were combined. Combining measures for the productions of monolingual English-speaking children did not increase diagnostic accuracy. Conclusion To prevent misdiagnosis of speech sound disorders in bilingual preschoolers, the composite phonological abilities of bilingual children need to be assessed across both gross and discrete measures of phonological ability. Supplemental Material https://doi.org/10.23641/asha.16632604.
| S-EPMC9132055 | biostudies-literature
Project description:Effective communication with primary care physicians is important yet incompletely understood for Spanish-speaking parents. We predicted lower satisfaction among Spanish-speaking compared to English-speaking Latino and non-Latino parents.Cross-sectional analysis at 2-month well visits within the Greenlight study at 4 pediatric resident clinics. Parents reported satisfaction with 14 physician communication items using the validated Communication Assessment Tool (CAT). High satisfaction was defined as "excellent" on each CAT item. Mean estimations compared satisfaction for communication items among Spanish- and English-speaking Latinos and non-Latinos. We used generalized linear regression modeling, adjusted for parent age, education, income, and clinic site. Among Spanish-speaking parents, we compared visits conducted in Spanish with and without an interpreter, and in English.Compared to English-speaking Latino (n = 127) and non-Latino parents (n = 432), fewer Spanish-speaking parents (n = 303) reported satisfaction with 14 communication items. No significant differences were found between English-speaking Latinos and non-Latinos. Greatest differences were found in the use of a greeting that made the parent comfortable (59.4% of Spanish-speaking Latinos endorsing "excellent" vs 77.5% English-speaking Latinos, P < .01) and discussing follow-up (62.5% of Spanish-speaking Latinos vs 79.8% English-speaking Latinos, P < .01). After adjusting for parent age, education, income, and study site, Spanish-speaking Latinos were still less likely to report high satisfaction with these communication items. Satisfaction was not different among Spanish-speaking parents when the physician spoke Spanish versus used an interpreter.Satisfaction with physician communication was associated with language but not ethnicity. Spanish-speaking parents less frequently report satisfaction with communication, and innovative solutions to enhance communication quality are needed.
| S-EPMC5524514 | biostudies-literature
Project description:Purpose The purpose of this study was to find morphological markers with good diagnostic accuracy to identify developmental language disorders (DLD) in Spanish-English bilingual children. Method The participants in this study included 66 Spanish-English bilingual children between the ages of 4;0 and 6;11 (years;months) with (n = 33) and without DLD (n = 33). We employed a comprehensive production task in Spanish to elicit morphological structures that have been previously found to be problematic for Spanish-speaking children with DLD. These structures included elements of nominal morphology (articles, direct object pronouns, adjectives, and plurals) and verbal morphology (verbs and the subjunctive mood). Logistic regression was used in this study to find a set of grammatical structures that most accurately predicted group membership. Results Spanish-English bilingual children with and without DLD significantly differed from each other in their accurate production of articles, clitics, adjectives, verbs, and the subjunctive mood. Clitics, verbs, and the subjunctive mood in isolation had adequate diagnostic accuracy. A combination of verb and subjective mood accuracy best predicted group membership in this study (sensitivity of 85% and specificity of 91%). Conclusion In addition to clitics, verbs, and the subjunctive mood, both elements of verbal morphology should be considered grammatical markers of DLD in Spanish-English bilingual children. Supplemental Material https://doi.org/10.23641/asha.13641320.
| S-EPMC8711715 | biostudies-literature
Project description:BackgroundThe COVID-19 pandemic has created an urgent need to rapidly disseminate health information, especially to those with cancer, because they face higher morbidity and mortality rates. At the same time, the pandemic's disproportionate impact on Latinx populations underscores the need for information to reach Spanish speakers. However, the equity of COVID-19 information communicated through institutions' online media to Spanish-speaking cancer patients is unknown.ObjectiveWe conducted a multimodal, mixed method document review study to evaluate the equity of online information about COVID-19 and cancer available to English- and Spanish-speaking populations from seven health care institutions in North Texas, where one in five adults is Spanish-speaking. Our focus was less on the "digital divide," which conveys disparities in access to computers and the internet based on the race/ethnicity, education, and income of at-risk populations; rather, our study asks the following question: to what extent is online content useful and culturally appropriate in meeting Spanish speakers' information needs?MethodsWe reviewed 50 websites (33 English and 17 Spanish) over a period of 1 week in the middle of May 2020. We sampled seven institutions' main oncology and COVID web pages, and both internal (institutional) and external (noninstitutional) linked content. We conducted several analyses for each sampled page, including (1) thematic content analysis, (2) literacy level analysis using Readability Studio software, (3) coding using the Patient Education and Materials Assessment Tool (PEMAT), and (4) descriptive analysis of video and diversity content.ResultsThe themes most frequently addressed on English and Spanish websites differed. While "resources/FAQs" were frequently cited themes on both websites, English websites more frequently addressed "news/updates" and "cancer+COVID," and Spanish websites addressed "protection" and "COVID data." Spanish websites had on average a lower literacy level (11th grade) than English websites (13th grade), although still far above the recommended guideline of 6th to 8th grade. The PEMAT's overall average accessibility score was the same for English (n=33 pages) and Spanish pages (n=17 pages) at 82%. Among the Dallas-Fort Worth organizations, the average accessibility of Spanish pages (n=7) was slightly lower than that of English pages (n=19) (77% vs 81%), due mostly to the discrepancy in English-only videos and visual aids. Of the 50 websites, 12 (24%) had embedded videos; however, 100% of videos were in English, including one on a Spanish website.ConclusionsWe identified an uneven response among the seven health care institutions for providing equitable information to Spanish-speaking Dallas-Fort Worth residents concerned about COVID and cancer. Spanish speakers lack equal access in both diversity of content about COVID-19 and access to other websites, leaving an already vulnerable cancer patient population at greater risk. We recommend several specific actions to enhance content and navigability for Spanish speakers.
| S-EPMC8409500 | biostudies-literature
Project description:Background: Social distancing restrictions imposed due to the Novel Coronavirus 2019 (COVID-19) pandemic resulted in a rapid shift in the delivery of psychological interventions from in-person to telehealth. Much of the research on this transition has been conducted with English-speaking mental health providers, leaving a gap in understanding related to how this shift has impacted Spanish-speaking treatment providers. Methods: Fifty non-U.S. Spanish-speaking therapists completed a survey related to their use of telecommunication modalities; client population characteristics; professional, ethical, and legal/regulatory issues; and telehealth training and practice. Participants completed the survey at one time point and retrospectively described their use of telehealth both pre-pandemic and during the pandemic. Results: Most of the 50 Spanish-speaking therapists surveyed reported using telepsychology 58% before COVID-19 versus 84% during the COVID-19 pandemic (χ2 = 5.76, p < 0.05). Compared with pre-pandemic, the number of hours therapists spent using telepsychology per week increased significantly for early adopter therapists (those who began using telehealth before the pandemic began) (Z = -3.18, p = 0.001) and also for late adopter therapists who only began using telehealth during the pandemic (Z = -3.74, p < 0.001). Many therapists reported equity issues. Most participants also reported ethical and regulatory concerns regarding security/confidentiality or Health Insurance Porability and Accountability Act. Conclusions: The rapid adoption of technology to deliver therapy during COVID-19 has spurred growing pains for Spanish-speaking therapists and their underserved clients, and more research is needed to better understand and improve the therapists' adoption of these technologies with diverse patient populations.
| S-EPMC8380799 | biostudies-literature
Project description:The COVID-19 pandemic has brought new urgency to a longstanding problem: the US health system is not well-equipped to accommodate the country's large limited English proficient (LEP) population in times of national emergency. We examined the landscape of Spanish-language COVID-19 website information compared to information in English provided by health departments of the top 10 cities by population in the USA. For each city, coders evaluated three score measures (amount of information, presentation quality, and ease of navigation) for six content types (general information, symptoms, testing, prevention, vaccines, and live statistics) across six delivery modes (print resources, website text, videos, external links, data visualization, and media toolkits). We then calculated a grand average, combining all cities' values per score measure for each content type-delivery mode combination, to understand the landscape of Spanish-language information across the country. Overall, we found that, for all cities combined, nearly all content types and delivery modes in Spanish were inferior or non-existent compared to English resources. Our findings also showed much variability and spread concerning content type and delivery mode of information. Finally, our findings uncovered three main clusters of content type and delivery mode combinations for Spanish-language information, ranging from similar to worse, compared to information in English. Our findings suggest that COVID-19 information was not equivalently provided in Spanish, despite federal guidance regarding language access during times of national emergency. These results can inform ongoing and future emergency communication plans for Spanish-preferring LEP and other LEP populations in the USA.
| S-EPMC9559270 | biostudies-literature
Project description:COVID-19 vaccine misinformation is a global threat, and digital and social media support its spread. Addressing Spanish-language vaccine misinformation is critical. In 2021, we began a project to increase vaccine confidence and uptake in the United States by assessing and opposing Spanish-language COVID-19 vaccine misinformation circulating in the United States. Analysts identified trending Spanish-language vaccine misinformation each week, and trained journalists provided communications guidance for addressing the misinformation, which we delivered to community organizations via a weekly newsletter. We identified thematic and geographic trends and highlighted lessons learned to inform future efforts to monitor Spanish-language vaccine misinformation. We collected publicly available Spanish- and English-language COVID-19 vaccine misinformation across various media sources (eg, Twitter, Facebook, news, blogs). Analysts identified top trending vaccine misinformation in the Spanish query and compared it with vaccine misinformation in the English query. Analysts examined misinformation to identify its geographic source and dominant conversation themes. From September 2021 through March 2022, analysts flagged 109 pieces of trending Spanish-language COVID-19 vaccine misinformation. Through this work, we found that Spanish-language vaccine misinformation is easily identifiable. Linguistic networks are not distinct, and vaccine misinformation often circulates across English and Spanish queries. Several websites have outsized influence in promoting Spanish-language vaccine misinformation, suggesting that it may be important to focus on a handful of hyperinfluential accounts and websites. Efforts to address Spanish-language vaccine misinformation must incorporate collaboration with local communities and emphasize community building and empowerment. Ultimately, addressing Spanish-language vaccine misinformation is not an issue of data access and knowledge of how to monitor it; it is an issue of prioritization.
| S-EPMC10140774 | biostudies-literature
Project description:BackgroundScientific studies from North America and Europe tend to predominate the internet and benefit English-speaking users. Meanwhile, the COVID-19 death rate was high at the onset of the pandemic in Spanish-speaking countries, and information about nearby Caribbean countries was rarely highlighted. Given the rise in social media use in these regions, the web-based dissemination of scientific information related to COVID-19 must be thoroughly examined.ObjectiveThis study aimed to provide a multidimensional analysis of peer-reviewed information circulation related to COVID-19 in Spanish-speaking and Caribbean regions.MethodsCOVID-19-related, peer-reviewed resources shared by web-based accounts located in Spanish-speaking and Caribbean regions were identified through the Altmetric website, and their information was collected. A multidimensional model was used to examine these resources, considering time, individuality, place, activity, and relations. Time was operationalized as the 6 dates of data collection, individuality as the knowledge area and accessibility level, place as the publication venue and affiliation countries, activity as the Altmetric score and number of mentions in the selected regions, and relations as coauthorship between countries and types of social media users who disseminated COVID-19-related information.ResultsThe highest information circulation peaks in Spanish-speaking countries were from April 2020 to August 2020 and from December 2020 to April 2021, whereas the highest peaks in Caribbean regions were from December 2019 to April 2020. Regarding Spanish-speaking regions, at the onset of the pandemic, scientific expertise was concentrated on a few peer-reviewed sources written in English. The top scientific journals mentioned were from English-speaking, westernized regions, whereas the top scientific authorships were from China. The most mentioned scientific resources were about breakthrough findings in the medical and health sciences area, written in highly technical language. The top relationships were self-loops in China, whereas international collaborations were between China and the United States. Argentina had high closeness and betweenness, and Spain had high closeness. On the basis of social media data, a combination of media outlets; educational institutions; and expert associations, particularly from Panama, influenced the diffusion of peer-reviewed information.ConclusionsWe determined the diffusion patterns of peer-reviewed resources in Spanish-speaking countries and Caribbean territories. This study aimed to advance the management and analysis of web-based public data from non-white people to improve public health communication in their regions.
| S-EPMC10448908 | biostudies-literature
Project description:BackgroundAlthough it is known that mortality due to COVID-19 increases progressively with age, the probability of dying from this serious infection among the oldest-old population is little known, and controversial data are found in literature.MethodsWe examine the mortality by year and month of birth of Belgians who had turned 100 during the current COVID-19 pandemic and whose birth fell on the years around the end the First World War and the outbreak of the H1N1 "Spanish flu" pandemic.FindingsThe COVID-19 mortality of the "older" centenarians is significantly lower than that of "younger" centenarians, and this difference between the two groups reaches a maximum on August 1, 1918 as the discriminating cut-off date of birth. Having excluded the plausible impact of the end of WWI it becomes clear that this date corresponds to the time of reporting the first victims of the Spanish flu pandemic in Belgium.InterpretationIn this study, the striking temporal coincidence between the outbreak of the Spanish flu epidemic and the birth of the cohorts characterized by greater fragility towards COVID-19 in 2020 strongly suggests a link between exposure to 1918 H1N1 pandemic influenza and resistance towards 2020 SARS-Cov-2. It can be speculated that the lifetime persistence of cross-reactive immune mechanisms has enabled centenarians exposed to the Spanish flu to overcome the threat of COVID-19 a century later.
| S-EPMC8507269 | biostudies-literature