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Lohr AM, Capetillo GP, Molina L, Goodson M, Smith K, Griffin JM, Wieland ML, Sia IG. Development of a Digital Storytelling Intervention to Increase Breast, Cervical, and Colorectal Cancer Screening in the Hispanic/Latino Community: a Qualitative Evaluation. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2024; 39:160-167. [PMID: 38044415 DOI: 10.1007/s13187-023-02389-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/18/2023] [Indexed: 12/05/2023]
Abstract
Digital storytelling (DST) interventions may be one way to address disparities in cancer screening experienced by the Hispanic/Latino population. Digital stories are short, first-person narratives that include voice-over narration and images. With storytellers' permission, researchers can screen digital stories as a health intervention. Digital stories can inspire viewers to adopt or change their behavior, such as completing cancer screening. Rochester Healthy Community Partnership (a 20-year community-based participatory research partnership) together with eight Hispanic/Latino, Spanish speaking cancer survivors, co-survivors, or recently screened individuals, developed digital stories about breast, cervical, and colorectal cancer screening. Here, we describe our qualitative evaluation of the DST workshop. To understand what the storytellers thought viewers would find relatable in their digital stories, we applied Narrative Theory. We also assessed workshop successes and opportunities for improvement. We used the constant comparative method for data analysis. We learned that the storytellers anticipated their stories would be engaging and that viewers would connect with Hispanic/Latino cultural values. During the workshop, the storytellers felt like they were making an important contribution. The storytellers highlighted specific opportunities for improvement including sharing the stories more quickly after the workshop. Future research is needed to test whether this intervention follows the Narrative Theory causal pathway by persuading viewers to complete recommended cancer screenings.
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Affiliation(s)
- Abby M Lohr
- Center for Clinical and Translational Science, Mayo Clinic, Rochester, MN, USA.
- Division of Community Internal Medicine, Geriatrics, and Palliative Care, Mayo Clinic, Rochester, MN, USA.
| | | | - Luz Molina
- Community Based Research, Mayo Clinic, Rochester, MN, USA
| | - Miriam Goodson
- Community Based Research, Mayo Clinic, Rochester, MN, USA
| | - Kaitlyn Smith
- Community Based Research, Mayo Clinic, Rochester, MN, USA
| | - Joan M Griffin
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA
| | - Mark L Wieland
- Center for Clinical and Translational Science, Mayo Clinic, Rochester, MN, USA
- Division of Community Internal Medicine, Geriatrics, and Palliative Care, Mayo Clinic, Rochester, MN, USA
| | - Irene G Sia
- Center for Clinical and Translational Science, Mayo Clinic, Rochester, MN, USA
- Division of Public Health, Infectious Diseases, and Occupational Medicine, Mayo Clinic, Rochester, MN, USA
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2
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Kostareva U, Soo Hoo CA, Zeng SM, Albright CL, Ceria-Ulep CD, Fontenot HB. Understanding Professional Medical Interpreters' Perspectives on Advancing Accurate and Culturally Informed Patient-Provider Communication for Filipinos in Hawai'i: Qualitative Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:7012. [PMID: 37947568 PMCID: PMC10649552 DOI: 10.3390/ijerph20217012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 09/27/2023] [Accepted: 10/26/2023] [Indexed: 11/12/2023]
Abstract
One in every eight persons in Hawai'i, USA, have limited English proficiency (LEP) and are entitled to free language assistance for federally funded services under Title IV of the Civil Rights Act of 1964. They also have the right to culturally and linguistically appropriate services (CLAS) provided by professional medical interpreters (PMIs). This study's goals were to uncover barriers and facilitators of CLAS from the perspective of PMIs. PMIs for Filipino languages (n = 10) participated in an online survey and semi-structured interviews. Quantitative data were analyzed using descriptive statistics, and qualitative data were analyzed using conventional content analysis. Six themes emerged in the qualitative analysis: (1) cultural and social factors that can influence patient-provider communication; (2) barriers to effective patient-provider communication: patient, healthcare provider, and PMI levels; (3) facilitators of effective patient-provider communication: patient, healthcare provider, and PMI levels; (4) COVID-19 and remote interpreting barriers and facilitators; (5) strengths and weaknesses of in-person and stand-by interpreting appointments; and, (6) recommendations: system and provider levels. Proposed interventions could include advertising language services among Filipino communities and educating them about their language rights, providing additional resources for language assistance, employing more PMIs, training staff/providers, and supporting the use of PMIs versus untrained individuals.
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Affiliation(s)
- Uliana Kostareva
- Nancy Atmospera-Walch School of Nursing, University of Hawai‘i at Mānoa, Honolulu, HI 96822, USA
| | - Carrie A. Soo Hoo
- School of Education, Victoria University of Wellington, Kelburn, Wellington 6012, New Zealand
| | - Suzanne M. Zeng
- Language Services Hawaii, 3747A Waialae Avenue, Honolulu, HI 96816, USA
| | - Cheryl L. Albright
- Nancy Atmospera-Walch School of Nursing, University of Hawai‘i at Mānoa, Honolulu, HI 96822, USA
| | - Clementina D. Ceria-Ulep
- Nancy Atmospera-Walch School of Nursing, University of Hawai‘i at Mānoa, Honolulu, HI 96822, USA
| | - Holly B. Fontenot
- Nancy Atmospera-Walch School of Nursing, University of Hawai‘i at Mānoa, Honolulu, HI 96822, USA
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Yao R, Sykora D, Olson EM, Sanborn D, Himes C, Mohamed AS, Matulis J. Improving colorectal cancer screening disparities among Somali-speaking patients in an Internal Medicine Residency Clinic. BMJ Open Qual 2023; 12:e002391. [PMID: 37797960 PMCID: PMC10551956 DOI: 10.1136/bmjoq-2023-002391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 09/21/2023] [Indexed: 10/07/2023] Open
Abstract
Colorectal cancer (CRC) is the third-most lethal cancer in the USA, and early detection through screening is crucial for improving outcomes. However, significant disparities in access and utilisation of CRC screening exist among patients with limited English proficiency. Our Quality Improvement (QI) team developed and implemented a video, featuring a Somali-speaking physician, created with input from internal medicine (IM) residents, patient education experts and community leaders to increase the rate of CRC screening uptake within a Somali-speaking population receiving primary care within an IM Residency Clinic. The baseline proportion of average-risk Somali-speaking patients who had successfully been screened for CRC was 46.3% (63/134). The proportion of patients agreeable to undergo CRC screening was assessed monthly from the beginning of video implementation (June 2022 to December 2022). We found that this intervention corresponded with a significant increase in willingness to undergo CRC screening from 36.4% to 100% during the early stages of intervention. At the end of our measurement timeframe, the proportion of the original population fully screened for CRC was 50.7% (68/134). Implementation of the video intervention was also assessed and determined to be minimally disruptive to the clinic flow.
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Affiliation(s)
- Rebecca Yao
- Department of Internal Medicine, Mayo Clinic Rochester, Rochester, Minnesota, USA
| | - Daniel Sykora
- Department of Internal Medicine, Mayo Clinic Rochester, Rochester, Minnesota, USA
| | - Emily M Olson
- Department of Medicine, Division of Pulmonary and Critical Care, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - David Sanborn
- Division of Pulmonary Medicine and Critical Care, Mayo Clinic Rochester, Rochester, Minnesota, USA
| | - Carina Himes
- Department of Anesthesiology, Montefiore Medical Center, New York, New York, USA
| | - Ahmed Shafii Mohamed
- Division of Community Internal Medicine, Mayo Clinic Rochester, Rochester, Minnesota, USA
| | - John Matulis
- Division of Community Internal Medicine, Mayo Clinic Rochester, Rochester, Minnesota, USA
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Wieland ML, Njeru JW, Weis JA, Lohr A, Nigon JA, Goodson M, Osman A, Molina L, Ahmed Y, Capetillo GP, Nur O, Sia IG. Rochester Healthy Community Partnership: Then and now. Front Public Health 2023; 10:1090131. [PMID: 36703848 PMCID: PMC9871468 DOI: 10.3389/fpubh.2022.1090131] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 12/21/2022] [Indexed: 01/12/2023] Open
Abstract
Community-engaged research partnerships promote health equity through incorporation of regional contexts to inform partnership dynamics that shape research and interventions that reflect community voice and priorities. Long-term partnerships build trusted relationships and promote capacity building among community and academic partners, but there are many structural barriers to sustaining long-term partnerships. Here we describe lessons learned from sustaining Rochester Healthy Community Partnership (RHCP), an 18-year community-based participatory research (CBPR) partnership in Southeast Minnesota. RHCP collaborates with immigrant and refugee populations to co-create interventions that promote health equity for community health priorities. Challenges to sustainability include a tension between project-based funding and the needs of long-term community-based research infrastructure. These challenges can be met with a focus on shared CBPR principles, operating norms, partnership dynamics, and governance. RHCP began in 2004 through identification of a community health priority, defining the community, and establishment of CBPR principles. It grew through identification of broader community health priorities, capacity building for community and academic partners, and integration of diverse learners. We describe the capacity for RHCP to respond to new societal contexts, the importance of partnership dynamics as a barometer for partnership health, and lessons learned about sustainability of the CBPR partnership.
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Affiliation(s)
- Mark L. Wieland
- Division of Community Internal Medicine, Geriatrics, and Palliative Care, Mayo Clinic, Rochester, MN, United States,Rochester Healthy Community Partnership, Rochester, MN, United States,*Correspondence: Mark L. Wieland ✉
| | - Jane W. Njeru
- Division of Community Internal Medicine, Geriatrics, and Palliative Care, Mayo Clinic, Rochester, MN, United States,Rochester Healthy Community Partnership, Rochester, MN, United States
| | - Jennifer A. Weis
- Rochester Healthy Community Partnership, Rochester, MN, United States,Center for Clinical and Translational Science, Mayo Clinic, Rochester, MN, United States
| | - Abby Lohr
- Division of Community Internal Medicine, Geriatrics, and Palliative Care, Mayo Clinic, Rochester, MN, United States,Rochester Healthy Community Partnership, Rochester, MN, United States
| | - Julie A. Nigon
- Rochester Healthy Community Partnership, Rochester, MN, United States,Hawthorne Education Center, Rochester, MN, United States
| | - Miriam Goodson
- Rochester Healthy Community Partnership, Rochester, MN, United States,Alliance of Chicanos, Hispanics, and Latin Americans, Rochester, MN, United States
| | - Ahmed Osman
- Rochester Healthy Community Partnership, Rochester, MN, United States,Intercultural Mutual Assistance Association, Rochester, MN, United States
| | - Luz Molina
- Rochester Healthy Community Partnership, Rochester, MN, United States,Division of Public Health, Infectious Diseases, and Occupational Medicine, Mayo Clinic, Rochester, MN, United States
| | - Yahye Ahmed
- Rochester Healthy Community Partnership, Rochester, MN, United States,Somali American Social Service Association, Rochester, MN, United States
| | - Graciela Porraz Capetillo
- Rochester Healthy Community Partnership, Rochester, MN, United States,Division of Public Health, Infectious Diseases, and Occupational Medicine, Mayo Clinic, Rochester, MN, United States
| | - Omar Nur
- Rochester Healthy Community Partnership, Rochester, MN, United States,Somali American Social Service Association, Rochester, MN, United States
| | - Irene G. Sia
- Rochester Healthy Community Partnership, Rochester, MN, United States,Division of Public Health, Infectious Diseases, and Occupational Medicine, Mayo Clinic, Rochester, MN, United States
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Soleimani J, Marquez A, Fathma S, Weister TJ, Barwise AK. Detecting professional interpreter use among patients with limited English proficiency: Derivation and validation study. SAGE Open Med 2022; 10:20503121221098146. [PMID: 35600712 PMCID: PMC9118401 DOI: 10.1177/20503121221098146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 04/13/2022] [Indexed: 11/23/2022] Open
Abstract
Objectives: The objective of this derivation and validation study was to develop and validate a search strategy algorithm to detect patients who used professional interpreter services. Methods: We identified all adults who had at least one intensive care unit admission during their hospital stay across the Mayo Clinic Enterprise between 1 January 2015 and 30 June 2020. Three random subsets of 100 patients were extracted from 60,268 patients to develop the search strategy algorithm. Two physician reviewers conducted gold standard manual chart review and any discrepancies were resolved by a third reviewer. These results were compared with the search strategy algorithm each time it was refined. Sensitivity and specificity were calculated during each phase by comparing the search strategy results to the reference gold standard for both derivation cohorts and the final validation cohort. Results: The first search strategy resulted in a sensitivity of 100% and a specificity of 89%. The second revised search strategy achieved a sensitivity of 100% and a specificity of 87%. The final version of the search strategy was applied to the validation subset and sensitivity and specificity were 100% and 89%, respectively. Conclusion: We derived and validated a search strategy algorithm to assess interpreter use among hospitalized patients. Using a search strategy algorithm with high sensitivity and specificity can reduce the time required to abstract data from the electronic medical records compared with manual data abstraction.
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Affiliation(s)
- Jalal Soleimani
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA
- Amelia Barwise, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
| | - Alberto Marquez
- Anesthesia Clinical Research Unit (ACRU), Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA
| | - Sawsan Fathma
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA
| | - Timothy J Weister
- Anesthesia Clinical Research Unit (ACRU), Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA
| | - Amelia K Barwise
- Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, USA
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Strelow B, O'Laughlin D. Barriers to cervical cancer screening among immigrants. JAAPA 2022; 35:23-27. [PMID: 35120364 DOI: 10.1097/01.jaa.0000819564.35151.0a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT For women ages 21 to 65 years who have not had a hysterectomy, the US Preventive Services Task Force (USPSTF) recommends cervical cancer screening with cytology (Pap smear) every 3 years or a combination of cytology and human papillomavirus (HPV) testing every 5 years. However, foreign-born women were less likely to have received a Pap smear compared with US-born women. This article reviews barriers to cervical cancer screening for foreign-born women.
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Affiliation(s)
- Brittany Strelow
- Brittany Strelow is clinical co-director of development in the PA program at the Mayo Clinic School of Health Sciences in Rochester, Minn., and practices in community internal medicine at the Mayo Clinic. Danielle O'Laughlin is clinical skills co-director in the Mayo Clinic PA program and practices in internal medicine at the Mayo Clinic. The authors have disclosed no potential conflicts of interest, financial or otherwise
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Scharf A, Voigt L, Vardhana S, Matsoukas K, Wall LM, Arevalo M, Diamond LC. What Should Clinicians Do When a Patient's Autonomy Undermines Her Being Treated Equitably? AMA J Ethics 2021; 23:E97-108. [PMID: 33635189 DOI: 10.1001/amajethics.2021.97] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Language and cultural barriers can impede communication between patients and clinicians, exacerbating health inequity. Additional complications can arise when family members, intending to protect their loved ones, ask clinicians to lie or not disclose to patients their diagnoses, prognoses, or intervention options. Clinicians must express respect for patients' and families' cultural, religious, and social norms regarding health care decision making, but they might also be ethically troubled by some decisions' effects on patients' health outcomes. This article suggests strategies for clinicians trying to overcome linguistic and cultural barriers to equitable patient care.
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Affiliation(s)
- Amy Scharf
- Member of the ethics committee at Memorial Sloan Kettering Cancer Center in New York City
| | - Louis Voigt
- Associate professor of clinical medicine and anesthesiology at Weill Cornell Medical College in New York City
| | - Santosha Vardhana
- Medical oncologist at Memorial Sloan Kettering Cancer Center in New York City
| | - Konstantina Matsoukas
- Research informationist at the Memorial Sloan Kettering Cancer Center's Medical Library in New York City
| | - Lisa M Wall
- Clinical nurse specialist and ethics consultant at Memorial Sloan Kettering Cancer Center in New York City
| | - Maria Arevalo
- Clinical nurse at Memorial Sloan Kettering Cancer Center in New York City
| | - Lisa C Diamond
- Member of the research faculty of the Memorial Sloan Kettering Cancer Center Immigrant Health and Cancer Disparities Service
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