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Kidy F, McCarthy N, Seers K. From symptom onset to treatment initiation: protocol for a narrative study exploring the journey of older adults with tuberculosis in the English Midlands, UK. BMJ Open 2023; 13:e070933. [PMID: 37977875 PMCID: PMC10660672 DOI: 10.1136/bmjopen-2022-070933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 10/18/2023] [Indexed: 11/19/2023] Open
Abstract
INTRODUCTION Time from symptom onset to treatment initiation in tuberculosis (TB) remains stubbornly prolonged despite reductions in disease incidence. Delays may contribute to increased morbidity, mortality, onward spread of disease and poor patient experiences. Most delays occur prior to hospital referral. The average primary care healthcare provider in England is unlikely to see TB on a regular basis. Little is known about primary care diagnostic and referral challenges.Adults aged 65 years or older are more likely to experience delays. However, little is known about their journey from symptom onset to treatment initiation. METHODS AND ANALYSIS We will carry out a narrative study including adults aged 65 years or older, living in the English Midlands and receiving treatment for active TB. Twelve English and 12 Urdu or Punjabi speakers will be recruited from TB clinics and interviewed. Their primary care records will be accessed, and the primary care story and secondary care letters will be extracted. Each of the data sources will be analysed using dialogical narrative analysis. Data will be triangulated within participants and across the data set. ETHICS AND DISSEMINATION This study received approval from the Health Research Authority and the Research Ethics Committee in April 2022. Risk management and equity considerations have been made a priority. Findings will be disseminated through publication in open access peer-reviewed journals, presentations to policy makers, primary healthcare and secondary healthcare professionals, and through public facing materials developed in conjunction with patients, members of the pubic, TB services and charities.
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Affiliation(s)
- Farah Kidy
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Noel McCarthy
- Population Health Medicine, Public Health & Primary Care, Trinity College Dublin, Dublin, Ireland
| | - Kate Seers
- Warwick Research in Nursing, Warwick Medical School, University of Warwick, Coventry, UK
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Wong HTH, Wang P, Sun Y, Newman CE, Vujcich D, Vaughan C, O'Connor CC, Jin D, Ogilvie E, Zhang Y, Mao L, Carter A. Is sex lost in translation? Linguistic and conceptual issues in the translation of sexual and reproductive health surveys. CULTURE, HEALTH & SEXUALITY 2023; 25:1-17. [PMID: 34941479 DOI: 10.1080/13691058.2021.2016975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 12/07/2021] [Indexed: 06/14/2023]
Abstract
Translated questionnaires are increasingly used in population health research. Nevertheless, translation is often not conducted with the same rigour as the process of survey development in the original language. This has serious limitations and may introduce bias in question relevance and meaning. This article describes and reflects on the process of translating a large and complex sexual and reproductive health survey from English into Simplified Chinese. We interrogated assumptions embedded in taken-for-granted translation practice to locate the sociocultural origins of these assumptions. We discuss how terminology and expression related to sexual and reproductive health may lose their conceptual or linguistic significance during translation in three different ways. Firstly, meanings can be lost in the negotiation of meanings associated with linguacultural and geographical variations of terminology. Secondly, meanings can be lost in the clash between everyday and professional sexual and reproductive health discourses. Thirdly, meanings can be lost due to the design of the source questionnaire and the intended mode of survey administration. We discuss ways to help overcome the unavoidable translation challenges that arise in the process of translating English sexual and reproductive health surveys for migrants from non-English speaking backgrounds.
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Affiliation(s)
- Horas T H Wong
- The Kirby Institute, UNSW Sydney, Sydney, NSW, Australia
- Centre for Social Research in Health, UNSW Sydney, Sydney, NSW, Australia
| | - Pan Wang
- School of Humanities and Languages, UNSW Sydney, Sydney, NSW, Australia
| | - Yingli Sun
- School of Humanities and Languages, UNSW Sydney, Sydney, NSW, Australia
| | - Christy E Newman
- Centre for Social Research in Health, UNSW Sydney, Sydney, NSW, Australia
- Australian Human Rights Institute, UNSW Sydney, Sydney, NSW, Australia
| | - Daniel Vujcich
- Curtin School of Population Health, Curtin University, Perth, WA, Australia
| | - Cathy Vaughan
- Gender and Women's Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | | | - Defeng Jin
- Centre for Social Research in Health, UNSW Sydney, Sydney, NSW, Australia
| | - Erin Ogilvie
- The Kirby Institute, UNSW Sydney, Sydney, NSW, Australia
| | - Ye Zhang
- The Kirby Institute, UNSW Sydney, Sydney, NSW, Australia
| | - Limin Mao
- Centre for Social Research in Health, UNSW Sydney, Sydney, NSW, Australia
| | - Allison Carter
- The Kirby Institute, UNSW Sydney, Sydney, NSW, Australia
- Australian Human Rights Institute, UNSW Sydney, Sydney, NSW, Australia
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
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Anderson ML, Riker T, Wilkins AM. Application of the truth and reconciliation model to meaningfully engage deaf sign language users in the research process. CULTURAL DIVERSITY & ETHNIC MINORITY PSYCHOLOGY 2023; 29:15-23. [PMID: 34197145 PMCID: PMC8720115 DOI: 10.1037/cdp0000445] [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] [Indexed: 06/13/2023]
Abstract
OBJECTIVES One of the most underrepresented public health populations is the U.S. Deaf community-a minority group of 500,000 + individuals who communicate using American Sign Language (ASL). Research on Deaf health outcomes is significantly lacking due to inaccessible research procedures and mistrust of researchers that stems from historical mistreatment of Deaf people (i.e., Audism). METHODS Following the Truth and Reconciliation Model, we hosted three Deaf community forums between October and November 2016 across New England. We invited attendees to share their experiences in the research world and make recommendations about how researchers can better include Deaf people in their studies. A select group of hearing researchers served as representatives of the research community and to issue a formal apology on behalf of this community. RESULTS Forum attendees (n = 22; 5% racial/ethnic minority; 59% female) emphasized the following themes: Research conducted within general population samples is not an activity in which Deaf people can or will be included; a general mistrust of hearing people, including hearing researchers; researchers' frequent failure to communicate study results back to the Deaf community or the community-at-large; and a tendency of researchers to directly benefit from data provided by Deaf participants, without making any subsequent efforts to return to the community to give back or provide useful intervention. CONCLUSIONS Many injustices and forms of mistreatment are still ongoing; therefore, we recognize that our team's efforts to foster an open dialogue between the research community and the Deaf community must be an ongoing, iterative practice. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
| | - Timothy Riker
- Implementation Science & Practice Advances Research Center (iSPARC)
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Alsubhi M, Epton T, Goldthorpe J, Peters S. A qualitative investigation of the health behaviours of young children from refugee families using photo elicitation interviews. Health Psychol Behav Med 2022; 10:1086-1109. [PMID: 36388870 PMCID: PMC9645284 DOI: 10.1080/21642850.2022.2141245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Objectives To explore the experiences and perspectives of refugee parents regarding health behaviour changes among their children (i.e. changes in diet, levels of physical activity) and the impact of these changes on the health of their children aged 2–12 years. Design A qualitative approach using semi-structured interviews supported by photo-elicitation. Methods Parents of 2–12 years old children who had relocated to the UK within the past three or more years were recruited from two refugee organisations in the UK. Semi-structured face-to-face interviews and photo-elicitation were used to stimulate face-to-face in-depth discussions with participants. Data were analysed using an inductive and latent thematic analysis approach. Results Twenty-seven parent refugees were recruited. Participants were primarily mothers (85%) and from Syria (70%). Other countries of origin were Sudan, Eritrea, Iraq, Kuwait, Libya and Tunisia. Twenty-six interviews were conducted in Arabic and one in English. The analysis identified three themes: (1) Reflection on acculturation, (2) Changed parental role, and (3) Environmental barriers to being healthy. Participants described facing substantial changes to their lifestyle and personal context, including a restricted living space, restricted neighbourhood/community and inclement weather. These differences in the environment required parents to adjust their roles, and practices around their own and their child’s eating habits. These changes influenced refugee children’s health behaviours. Of particular concern to parents were increased sedentary behaviour and consumption of unhealthy snacks. Conclusions Multiple factors were identified relating to changes in family circumstances and environments that influenced refugee children’s health behaviours. Targeting these behaviours in tailored interventions may help improve refugee children’s health.
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Affiliation(s)
- Maha Alsubhi
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biological, Medical and Health Sciences, Manchester Centre for Health Psychology, University of Manchester, Manchester, UK
| | - Tracy Epton
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biological, Medical and Health Sciences, Manchester Centre for Health Psychology, University of Manchester, Manchester, UK
| | - Joanna Goldthorpe
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biological, Medical and Health Sciences, Manchester Centre for Health Psychology, University of Manchester, Manchester, UK
| | - Sarah Peters
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biological, Medical and Health Sciences, Manchester Centre for Health Psychology, University of Manchester, Manchester, UK
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Tang Yan C, Bachour A, Pérez CJ, Ansaldo LP, Santiago D, Jin Y, Li Z, Mok YS, Weng Y, Martinez LS. Partnering with immigrant families to promote language justice and equity in education. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2022; 70:433-457. [PMID: 35621207 DOI: 10.1002/ajcp.12604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 04/01/2022] [Accepted: 04/15/2022] [Indexed: 06/15/2023]
Abstract
Despite US federal legislation mandates institutions to provide meaningful access and participation to students and families in educational settings, culturally and linguistically diverse (CLD) families and caregivers of children in special education experience cultural and linguistic barriers. A Community Advisory Team (CAT) of parents, advocates, community interpreters and translators, researchers, and teachers explored CLD families' experiences and advocacy efforts. Critical bifocality and circuits of dispossession, privilege, and resistance informed the documentation of inequities and resistance to understand the linkages of structural arrangements of power. Focus groups with families (n = 21) speakers of Spanish, Portuguese, and Cantonese were conducted. Findings indicate perceived discrimination, poor and inadequate interpretation and translation services impact children's access to special education services, hinder family's communication with schools and reduce the perceptions of schools as trustworthy institutions. Families advocate relentlessly for their children and recommend schools listen to families and hire culturally and linguistically competent interpreters and translators. Community psychologists can make significant contributions to promote language justice in education settings through participatory approaches to inquiry that value CLD families' knowledge and expertise.
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Affiliation(s)
| | - Angélica Bachour
- Parent Advocate, Community Interpreter and Translator, CAT Member, Chelsea, Massachusetts, USA
| | - Consuelo J Pérez
- Artist, Parent Advocate, Community Interpreter and Translator, CAT Member, Somerville, Massachusetts, USA
| | - Loreto P Ansaldo
- MST, CI, Community Interpreter and Translator, Teacher, CAT Member, Boston, Massachusetts, USA
| | - Diana Santiago
- Esq., Senior Attorney, Massachusetts Advocates for Children (MAC), CAT Member, Boston, Massachusetts, USA
| | - Yichen Jin
- Boston University School of Social Work, Boston, Massachusetts, USA
| | - Zihui Li
- Parent Educator, Community Interpreter and Translator, Quincy, Massachusetts, USA
| | - Yu S Mok
- Community Interpreter and Translator, Malden, Massachusetts, USA
| | - Yanyi Weng
- MSW, LCSW, Social Worker, Boston, Massachusetts, USA
| | - Linda S Martinez
- Boston University School of Social Work, Boston, Massachusetts, USA
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Cuoco A, Arcadi P, Figura MC, Piervisani L, Alvaro R, Vellone E, Durante A. Designing and conducting qualitative research across countries and cultures: challenges for inclusiveness and rigour. Eur J Cardiovasc Nurs 2022; 21:873-879. [PMID: 35869622 DOI: 10.1093/eurjcn/zvac067] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 07/14/2022] [Accepted: 07/18/2022] [Indexed: 12/29/2022]
Abstract
Qualitative research is fundamental to understanding the nature and complexity of human phenomena. While cultural and psychometric validations exist for quantitative tools, the same cannot be said of qualitative ones. There are other many challenges when conducting a multinational qualitative study, which includes different cultural and linguistic 'biases'. This paper presents some key issues that researchers may encounter when designing and developing multinational and multicultural qualitative studies, and also provides some strategies to overcome difficulties and ensure rigour.
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Affiliation(s)
- Angela Cuoco
- Biomedicine and Prevention Department, University of Rome 'Tor Vergata', via Montpellier 1, 00133 Rome, Italy
| | - Paola Arcadi
- Biomedicine and Prevention Department, University of Rome 'Tor Vergata', via Montpellier 1, 00133 Rome, Italy
| | - Maria Chiara Figura
- Biomedicine and Prevention Department, University of Rome 'Tor Vergata', via Montpellier 1, 00133 Rome, Italy
| | - Loredana Piervisani
- Biomedicine and Prevention Department, University of Rome 'Tor Vergata', via Montpellier 1, 00133 Rome, Italy
| | - Rosaria Alvaro
- Biomedicine and Prevention Department, University of Rome 'Tor Vergata', via Montpellier 1, 00133 Rome, Italy
| | - Ercole Vellone
- Biomedicine and Prevention Department, University of Rome 'Tor Vergata', via Montpellier 1, 00133 Rome, Italy
| | - Angela Durante
- Predeparmental Nursing Unit, University of La Rioja, Calle Duquesa de la Victoria 88, 26004 Logroño, Spain
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Chinese University Students' Perspectives on Help-Seeking and Mental Health Counseling. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148259. [PMID: 35886103 PMCID: PMC9323838 DOI: 10.3390/ijerph19148259] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 07/02/2022] [Accepted: 07/04/2022] [Indexed: 01/27/2023]
Abstract
Psychological distress and mental illness have become increasingly pervasive among Chinese university students. However, many university students who need mental health treatment or psychological support do not actively seek help from professional counselors or service providers, which could lead to poor mental health outcomes. To promote help-seeking, we undertook a qualitative study to understand Chinese university students' perspectives on help-seeking and mental health counseling. We conducted 13 focus group interviews with students in six universities in Jinan, China, and altogether 91 (62%) female students, and 56 (38%) male students participated in the study. Our results indicate that students' misconception and distrust of on-campus counseling, stigma of mental illness, low mental health literacy, and hard-to-access mental health services are the major barriers that impede students help-seeking behaviors. Internal struggles and systematic and organizational barriers are identified to shed light on future work to promote mental health literacy among Chinese university students.
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8
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Universal health coverage and public-private arrangements within Sri Lanka's mixed system: Perspectives from women seeking healthcare. Soc Sci Med 2022; 296:114777. [DOI: 10.1016/j.socscimed.2022.114777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 01/10/2022] [Accepted: 02/01/2022] [Indexed: 11/21/2022]
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McDiarmid S, Durbeej N, Sarkadi A, Osman F. Schools' and teachers' roles and challenges in supporting the mental wellbeing of refugee youths: a qualitative study with Swedish teachers. Int J Qual Stud Health Well-being 2021; 17:2007568. [PMID: 34847828 PMCID: PMC8648014 DOI: 10.1080/17482631.2021.2007568] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
PURPOSE Resettled refugee youths are increasingly entering host-country school systems and are at risk of poor mental wellbeing. Schools and teachers are often expected to provide psychosocial support to youths with refugee backgrounds, but the teachers' views on this expectation are poorly understood. We investigated the question: What do Swedish teachers believe is the role of (1) schools and (2) teachers in supporting refugee youths' mental wellbeing? METHOD Four semi-structured focus groups were conducted with 30 Swedish educators from five schools. Interview transcripts were analysed and themes reflecting the key concepts were constructed using reflexive thematic analysis. RESULTS Seven themes were constructed. Three addressed the role of schools in supporting refugee youths' mental wellbeing: Promoting Belonging, Offering Refuge, and Instilling Civic Literacy. Four addressed the role of teachers: Building Relationships with Students, Maintaining a Non-therapeutic Relationship, Connecting to Professionals, and Instructing in the Classroom. CONCLUSION Teachers believe that both schools and teachers play an important role in supporting refugee youths' mental wellbeing and each contributes in unique ways. However, schools and teachers are not always successful in supporting refugee youth and teachers reported facing challenges such as unclear roles and a lack of resources.
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Affiliation(s)
- Serena McDiarmid
- Department of Psychology, University of Waterloo, Waterloo, Canada
| | - Natalie Durbeej
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Anna Sarkadi
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Fatumo Osman
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.,Department of Health and Welfare, Dalarna University, Falun, Sweden
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10
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Younas A, Fàbregues S, Durante A, Ali P. Providing English and native language quotes in qualitative research: A call to action. Nurs Open 2021; 9:168-174. [PMID: 34725950 PMCID: PMC8685880 DOI: 10.1002/nop2.1115] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 09/28/2021] [Accepted: 10/14/2021] [Indexed: 11/16/2022] Open
Abstract
Background When publishing qualitative research in international journals, researchers studying non‐English‐speaking participants provide quotes in English language. This is an issue of increasing concern given the need to be rigorous to represent a diversity of participants within their context, beyond how language (alone) situates them. Aim To argue for providing English and native language quotes in qualitative research reports. Design Discussion. Methods This paper is based on the literature on use of quotes and translation in qualitative research and authors’ experiences of publishing qualitative research. Results Provision of native and English language quotes may allow for greater transparency of findings, thereby reflecting that the researchers adequately captured the socially and culturally dependent experiences of participants. Conclusions Presentation of findings with eloquent quotes serves as the gateway into the sociocultural experiences of individuals. We argued against the norm of providing translated quotes in qualitative reports and build a case for the provision of native as well as English language quotes to promote cross‐cultural understanding.
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Affiliation(s)
- Ahtisham Younas
- Swat College of Nursing, Swat, Pakistan.,Memorial University of Newfoundland, St. John's, NL, Canada
| | - Sergi Fàbregues
- Department of Psychology and Education, Universitat Oberta de Catalunya, Barcelona, Spain
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Problematic Insiderness in Migration Research: Refugee Researcher Researching Other Refugees. JOURNAL OF INTERNATIONAL MIGRATION AND INTEGRATION 2021. [DOI: 10.1007/s12134-020-00785-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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12
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Petersen I, Kemp CG, Rao D, Wagenaar BH, Sherr K, Grant M, Bachmann M, Barnabas RV, Mntambo N, Gigaba S, Van Rensburg A, Luvuno Z, Amarreh I, Fairall L, Hongo NN, Bhana A. Implementation and Scale-Up of Integrated Depression Care in South Africa: An Observational Implementation Research Protocol. Psychiatr Serv 2021; 72:1065-1075. [PMID: 33691487 PMCID: PMC8410621 DOI: 10.1176/appi.ps.202000014] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
BACKGROUND People with chronic general medical conditions who have comorbid depression experience poorer health outcomes. This problem has received scant attention in low- and middle-income countries. The aim of the ongoing study reported here is to refine and promote the scale-up of an evidence-based task-sharing collaborative care model, the Mental Health Integration (MhINT) program, to treat patients with comorbid depression and chronic disease in primary health care settings in South Africa. METHODS Adopting a learning-health-systems approach, this study uses an onsite, iterative observational implementation science design. Stage 1 comprises assessment of the original MhINT model under real-world conditions in an urban subdistrict in KwaZulu-Natal, South Africa, to inform refinement of the model and its implementation strategies. Stage 2 comprises assessment of the refined model across urban, semiurban, and rural contexts. In both stages, population-level effects are assessed by using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) evaluation framework with various sources of data, including secondary data collection and a patient cohort study (N=550). The Consolidated Framework for Implementation Research is used to understand contextual determinants of implementation success involving quantitative and qualitative interviews (stage 1, N=78; stage 2, N=282). RESULTS The study results will help refine intervention components and implementation strategies to enable scale-up of the MhINT model for depression in South Africa. NEXT STEPS Next steps include strengthening ongoing engagements with policy makers and managers, providing technical support for implementation, and building the capacity of policy makers and managers in implementation science to promote wider dissemination and sustainment of the intervention.
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Affiliation(s)
- Inge Petersen
- Centre for Rural Health, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa (Petersen, Grant, Gigaba, Van Rensburg, Luvuno, Bhana); Department of Global Health (Kemp, Rao, Wagenaar, Sherr, Barnabas), Department of Psychiatry and Behavioral Sciences (Rao), Department of Epidemiology (Wagenaar), University of Washington, Seattle; Norwich Medical School, University of East Anglia, Norwich, Norfolk, United Kingdom (Bachmann); School of Applied Human Sciences, University of KwaZulu-Natal, Durban, South Africa (Mntambo, Gigaba); Center for Global Mental Health Research, National Institute of Mental Health, Bethesda, Maryland (Amarreh); Knowledge Translation Unit, University of Cape Town, Cape Town, South Africa, and King's Global Health Institute, King's College London, London (Fairall); Mental Health and Substance Abuse Directorate, KwaZulu-Natal Department of Health, Natalia, Pietermaritzburg, South Africa (Hongo); Health Systems Research Unit, South African Medical Research Council, Durban, South Africa (Bhana)
| | - Christopher G Kemp
- Centre for Rural Health, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa (Petersen, Grant, Gigaba, Van Rensburg, Luvuno, Bhana); Department of Global Health (Kemp, Rao, Wagenaar, Sherr, Barnabas), Department of Psychiatry and Behavioral Sciences (Rao), Department of Epidemiology (Wagenaar), University of Washington, Seattle; Norwich Medical School, University of East Anglia, Norwich, Norfolk, United Kingdom (Bachmann); School of Applied Human Sciences, University of KwaZulu-Natal, Durban, South Africa (Mntambo, Gigaba); Center for Global Mental Health Research, National Institute of Mental Health, Bethesda, Maryland (Amarreh); Knowledge Translation Unit, University of Cape Town, Cape Town, South Africa, and King's Global Health Institute, King's College London, London (Fairall); Mental Health and Substance Abuse Directorate, KwaZulu-Natal Department of Health, Natalia, Pietermaritzburg, South Africa (Hongo); Health Systems Research Unit, South African Medical Research Council, Durban, South Africa (Bhana)
| | - Deepa Rao
- Centre for Rural Health, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa (Petersen, Grant, Gigaba, Van Rensburg, Luvuno, Bhana); Department of Global Health (Kemp, Rao, Wagenaar, Sherr, Barnabas), Department of Psychiatry and Behavioral Sciences (Rao), Department of Epidemiology (Wagenaar), University of Washington, Seattle; Norwich Medical School, University of East Anglia, Norwich, Norfolk, United Kingdom (Bachmann); School of Applied Human Sciences, University of KwaZulu-Natal, Durban, South Africa (Mntambo, Gigaba); Center for Global Mental Health Research, National Institute of Mental Health, Bethesda, Maryland (Amarreh); Knowledge Translation Unit, University of Cape Town, Cape Town, South Africa, and King's Global Health Institute, King's College London, London (Fairall); Mental Health and Substance Abuse Directorate, KwaZulu-Natal Department of Health, Natalia, Pietermaritzburg, South Africa (Hongo); Health Systems Research Unit, South African Medical Research Council, Durban, South Africa (Bhana)
| | - Bradley H Wagenaar
- Centre for Rural Health, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa (Petersen, Grant, Gigaba, Van Rensburg, Luvuno, Bhana); Department of Global Health (Kemp, Rao, Wagenaar, Sherr, Barnabas), Department of Psychiatry and Behavioral Sciences (Rao), Department of Epidemiology (Wagenaar), University of Washington, Seattle; Norwich Medical School, University of East Anglia, Norwich, Norfolk, United Kingdom (Bachmann); School of Applied Human Sciences, University of KwaZulu-Natal, Durban, South Africa (Mntambo, Gigaba); Center for Global Mental Health Research, National Institute of Mental Health, Bethesda, Maryland (Amarreh); Knowledge Translation Unit, University of Cape Town, Cape Town, South Africa, and King's Global Health Institute, King's College London, London (Fairall); Mental Health and Substance Abuse Directorate, KwaZulu-Natal Department of Health, Natalia, Pietermaritzburg, South Africa (Hongo); Health Systems Research Unit, South African Medical Research Council, Durban, South Africa (Bhana)
| | - Kenneth Sherr
- Centre for Rural Health, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa (Petersen, Grant, Gigaba, Van Rensburg, Luvuno, Bhana); Department of Global Health (Kemp, Rao, Wagenaar, Sherr, Barnabas), Department of Psychiatry and Behavioral Sciences (Rao), Department of Epidemiology (Wagenaar), University of Washington, Seattle; Norwich Medical School, University of East Anglia, Norwich, Norfolk, United Kingdom (Bachmann); School of Applied Human Sciences, University of KwaZulu-Natal, Durban, South Africa (Mntambo, Gigaba); Center for Global Mental Health Research, National Institute of Mental Health, Bethesda, Maryland (Amarreh); Knowledge Translation Unit, University of Cape Town, Cape Town, South Africa, and King's Global Health Institute, King's College London, London (Fairall); Mental Health and Substance Abuse Directorate, KwaZulu-Natal Department of Health, Natalia, Pietermaritzburg, South Africa (Hongo); Health Systems Research Unit, South African Medical Research Council, Durban, South Africa (Bhana)
| | - Merridy Grant
- Centre for Rural Health, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa (Petersen, Grant, Gigaba, Van Rensburg, Luvuno, Bhana); Department of Global Health (Kemp, Rao, Wagenaar, Sherr, Barnabas), Department of Psychiatry and Behavioral Sciences (Rao), Department of Epidemiology (Wagenaar), University of Washington, Seattle; Norwich Medical School, University of East Anglia, Norwich, Norfolk, United Kingdom (Bachmann); School of Applied Human Sciences, University of KwaZulu-Natal, Durban, South Africa (Mntambo, Gigaba); Center for Global Mental Health Research, National Institute of Mental Health, Bethesda, Maryland (Amarreh); Knowledge Translation Unit, University of Cape Town, Cape Town, South Africa, and King's Global Health Institute, King's College London, London (Fairall); Mental Health and Substance Abuse Directorate, KwaZulu-Natal Department of Health, Natalia, Pietermaritzburg, South Africa (Hongo); Health Systems Research Unit, South African Medical Research Council, Durban, South Africa (Bhana)
| | - Max Bachmann
- Centre for Rural Health, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa (Petersen, Grant, Gigaba, Van Rensburg, Luvuno, Bhana); Department of Global Health (Kemp, Rao, Wagenaar, Sherr, Barnabas), Department of Psychiatry and Behavioral Sciences (Rao), Department of Epidemiology (Wagenaar), University of Washington, Seattle; Norwich Medical School, University of East Anglia, Norwich, Norfolk, United Kingdom (Bachmann); School of Applied Human Sciences, University of KwaZulu-Natal, Durban, South Africa (Mntambo, Gigaba); Center for Global Mental Health Research, National Institute of Mental Health, Bethesda, Maryland (Amarreh); Knowledge Translation Unit, University of Cape Town, Cape Town, South Africa, and King's Global Health Institute, King's College London, London (Fairall); Mental Health and Substance Abuse Directorate, KwaZulu-Natal Department of Health, Natalia, Pietermaritzburg, South Africa (Hongo); Health Systems Research Unit, South African Medical Research Council, Durban, South Africa (Bhana)
| | - Ruanne V Barnabas
- Centre for Rural Health, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa (Petersen, Grant, Gigaba, Van Rensburg, Luvuno, Bhana); Department of Global Health (Kemp, Rao, Wagenaar, Sherr, Barnabas), Department of Psychiatry and Behavioral Sciences (Rao), Department of Epidemiology (Wagenaar), University of Washington, Seattle; Norwich Medical School, University of East Anglia, Norwich, Norfolk, United Kingdom (Bachmann); School of Applied Human Sciences, University of KwaZulu-Natal, Durban, South Africa (Mntambo, Gigaba); Center for Global Mental Health Research, National Institute of Mental Health, Bethesda, Maryland (Amarreh); Knowledge Translation Unit, University of Cape Town, Cape Town, South Africa, and King's Global Health Institute, King's College London, London (Fairall); Mental Health and Substance Abuse Directorate, KwaZulu-Natal Department of Health, Natalia, Pietermaritzburg, South Africa (Hongo); Health Systems Research Unit, South African Medical Research Council, Durban, South Africa (Bhana)
| | - Ntokozo Mntambo
- Centre for Rural Health, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa (Petersen, Grant, Gigaba, Van Rensburg, Luvuno, Bhana); Department of Global Health (Kemp, Rao, Wagenaar, Sherr, Barnabas), Department of Psychiatry and Behavioral Sciences (Rao), Department of Epidemiology (Wagenaar), University of Washington, Seattle; Norwich Medical School, University of East Anglia, Norwich, Norfolk, United Kingdom (Bachmann); School of Applied Human Sciences, University of KwaZulu-Natal, Durban, South Africa (Mntambo, Gigaba); Center for Global Mental Health Research, National Institute of Mental Health, Bethesda, Maryland (Amarreh); Knowledge Translation Unit, University of Cape Town, Cape Town, South Africa, and King's Global Health Institute, King's College London, London (Fairall); Mental Health and Substance Abuse Directorate, KwaZulu-Natal Department of Health, Natalia, Pietermaritzburg, South Africa (Hongo); Health Systems Research Unit, South African Medical Research Council, Durban, South Africa (Bhana)
| | - Sithabisile Gigaba
- Centre for Rural Health, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa (Petersen, Grant, Gigaba, Van Rensburg, Luvuno, Bhana); Department of Global Health (Kemp, Rao, Wagenaar, Sherr, Barnabas), Department of Psychiatry and Behavioral Sciences (Rao), Department of Epidemiology (Wagenaar), University of Washington, Seattle; Norwich Medical School, University of East Anglia, Norwich, Norfolk, United Kingdom (Bachmann); School of Applied Human Sciences, University of KwaZulu-Natal, Durban, South Africa (Mntambo, Gigaba); Center for Global Mental Health Research, National Institute of Mental Health, Bethesda, Maryland (Amarreh); Knowledge Translation Unit, University of Cape Town, Cape Town, South Africa, and King's Global Health Institute, King's College London, London (Fairall); Mental Health and Substance Abuse Directorate, KwaZulu-Natal Department of Health, Natalia, Pietermaritzburg, South Africa (Hongo); Health Systems Research Unit, South African Medical Research Council, Durban, South Africa (Bhana)
| | - André Van Rensburg
- Centre for Rural Health, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa (Petersen, Grant, Gigaba, Van Rensburg, Luvuno, Bhana); Department of Global Health (Kemp, Rao, Wagenaar, Sherr, Barnabas), Department of Psychiatry and Behavioral Sciences (Rao), Department of Epidemiology (Wagenaar), University of Washington, Seattle; Norwich Medical School, University of East Anglia, Norwich, Norfolk, United Kingdom (Bachmann); School of Applied Human Sciences, University of KwaZulu-Natal, Durban, South Africa (Mntambo, Gigaba); Center for Global Mental Health Research, National Institute of Mental Health, Bethesda, Maryland (Amarreh); Knowledge Translation Unit, University of Cape Town, Cape Town, South Africa, and King's Global Health Institute, King's College London, London (Fairall); Mental Health and Substance Abuse Directorate, KwaZulu-Natal Department of Health, Natalia, Pietermaritzburg, South Africa (Hongo); Health Systems Research Unit, South African Medical Research Council, Durban, South Africa (Bhana)
| | - Zamasomi Luvuno
- Centre for Rural Health, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa (Petersen, Grant, Gigaba, Van Rensburg, Luvuno, Bhana); Department of Global Health (Kemp, Rao, Wagenaar, Sherr, Barnabas), Department of Psychiatry and Behavioral Sciences (Rao), Department of Epidemiology (Wagenaar), University of Washington, Seattle; Norwich Medical School, University of East Anglia, Norwich, Norfolk, United Kingdom (Bachmann); School of Applied Human Sciences, University of KwaZulu-Natal, Durban, South Africa (Mntambo, Gigaba); Center for Global Mental Health Research, National Institute of Mental Health, Bethesda, Maryland (Amarreh); Knowledge Translation Unit, University of Cape Town, Cape Town, South Africa, and King's Global Health Institute, King's College London, London (Fairall); Mental Health and Substance Abuse Directorate, KwaZulu-Natal Department of Health, Natalia, Pietermaritzburg, South Africa (Hongo); Health Systems Research Unit, South African Medical Research Council, Durban, South Africa (Bhana)
| | - Ishmael Amarreh
- Centre for Rural Health, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa (Petersen, Grant, Gigaba, Van Rensburg, Luvuno, Bhana); Department of Global Health (Kemp, Rao, Wagenaar, Sherr, Barnabas), Department of Psychiatry and Behavioral Sciences (Rao), Department of Epidemiology (Wagenaar), University of Washington, Seattle; Norwich Medical School, University of East Anglia, Norwich, Norfolk, United Kingdom (Bachmann); School of Applied Human Sciences, University of KwaZulu-Natal, Durban, South Africa (Mntambo, Gigaba); Center for Global Mental Health Research, National Institute of Mental Health, Bethesda, Maryland (Amarreh); Knowledge Translation Unit, University of Cape Town, Cape Town, South Africa, and King's Global Health Institute, King's College London, London (Fairall); Mental Health and Substance Abuse Directorate, KwaZulu-Natal Department of Health, Natalia, Pietermaritzburg, South Africa (Hongo); Health Systems Research Unit, South African Medical Research Council, Durban, South Africa (Bhana)
| | - Lara Fairall
- Centre for Rural Health, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa (Petersen, Grant, Gigaba, Van Rensburg, Luvuno, Bhana); Department of Global Health (Kemp, Rao, Wagenaar, Sherr, Barnabas), Department of Psychiatry and Behavioral Sciences (Rao), Department of Epidemiology (Wagenaar), University of Washington, Seattle; Norwich Medical School, University of East Anglia, Norwich, Norfolk, United Kingdom (Bachmann); School of Applied Human Sciences, University of KwaZulu-Natal, Durban, South Africa (Mntambo, Gigaba); Center for Global Mental Health Research, National Institute of Mental Health, Bethesda, Maryland (Amarreh); Knowledge Translation Unit, University of Cape Town, Cape Town, South Africa, and King's Global Health Institute, King's College London, London (Fairall); Mental Health and Substance Abuse Directorate, KwaZulu-Natal Department of Health, Natalia, Pietermaritzburg, South Africa (Hongo); Health Systems Research Unit, South African Medical Research Council, Durban, South Africa (Bhana)
| | - Nikiwe N Hongo
- Centre for Rural Health, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa (Petersen, Grant, Gigaba, Van Rensburg, Luvuno, Bhana); Department of Global Health (Kemp, Rao, Wagenaar, Sherr, Barnabas), Department of Psychiatry and Behavioral Sciences (Rao), Department of Epidemiology (Wagenaar), University of Washington, Seattle; Norwich Medical School, University of East Anglia, Norwich, Norfolk, United Kingdom (Bachmann); School of Applied Human Sciences, University of KwaZulu-Natal, Durban, South Africa (Mntambo, Gigaba); Center for Global Mental Health Research, National Institute of Mental Health, Bethesda, Maryland (Amarreh); Knowledge Translation Unit, University of Cape Town, Cape Town, South Africa, and King's Global Health Institute, King's College London, London (Fairall); Mental Health and Substance Abuse Directorate, KwaZulu-Natal Department of Health, Natalia, Pietermaritzburg, South Africa (Hongo); Health Systems Research Unit, South African Medical Research Council, Durban, South Africa (Bhana)
| | - Arvin Bhana
- Centre for Rural Health, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa (Petersen, Grant, Gigaba, Van Rensburg, Luvuno, Bhana); Department of Global Health (Kemp, Rao, Wagenaar, Sherr, Barnabas), Department of Psychiatry and Behavioral Sciences (Rao), Department of Epidemiology (Wagenaar), University of Washington, Seattle; Norwich Medical School, University of East Anglia, Norwich, Norfolk, United Kingdom (Bachmann); School of Applied Human Sciences, University of KwaZulu-Natal, Durban, South Africa (Mntambo, Gigaba); Center for Global Mental Health Research, National Institute of Mental Health, Bethesda, Maryland (Amarreh); Knowledge Translation Unit, University of Cape Town, Cape Town, South Africa, and King's Global Health Institute, King's College London, London (Fairall); Mental Health and Substance Abuse Directorate, KwaZulu-Natal Department of Health, Natalia, Pietermaritzburg, South Africa (Hongo); Health Systems Research Unit, South African Medical Research Council, Durban, South Africa (Bhana)
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Abstract
The purpose of this article is to propose essential components of culturally tailored interventions through analyzing practical issues in 3 studies that tested culturally tailored interventions among Asian American women. Practical issues in the studies were analyzed using a content analysis according to the evaluation criteria for rigor in cross-cultural research. Seven essential components of culturally tailored interventions were identified through the analysis: (a) respecting cultural uniqueness; (b) understanding cultural contexts; (c) using cultural examples; (d) having flexibility; (e) adopting multiple languages; (f) having bilingual and/or culturally matched research team members; and (g) engaging community consultants and research participants. Key words: Asian, culture, intervention, issue, rigor.
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LeMasters K, Dussault J, Barrington C, Bengtson A, Gaynes B, Go V, Hosseinipour MC, Kulisewa K, Kutengule A, Meltzer-Brody S, Midiani D, Mphonda S, Udedi M, Pence B. "Pain in my heart": Understanding perinatal depression among women living with HIV in Malawi. PLoS One 2020; 15:e0227935. [PMID: 32502150 PMCID: PMC7274419 DOI: 10.1371/journal.pone.0227935] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Accepted: 05/23/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Perinatal depression (PND) can interfere with HIV care engagement and outcomes. We examined experiences of PND among women living with HIV (WLWH) in Malawi. METHODS We screened 73 WLWH presenting for perinatal care in Lilongwe, Malawi using the Edinburgh Postnatal Depression Scale (EPDS). We conducted qualitative interviews with 24 women experiencing PND and analyzed data using inductive and deductive coding and narrative analysis. RESULTS Women experienced a double burden of physical and mental illness, expressed as pain in one's heart. Receiving an HIV diagnosis unexpectedly during antenatal care was a key contributor to developing PND. This development was influenced by stigmatization and social support. CONCLUSIONS These findings highlight the need to recognize the mental health implications of routine screening for HIV and to routinely screen and treat PND among WLWH. Culturally appropriate mental health interventions are needed in settings with a high HIV burden.
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Affiliation(s)
- Katherine LeMasters
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- Carolina Population Center, Chapel Hill, North Carolina, United States of America
| | - Josée Dussault
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Clare Barrington
- Carolina Population Center, Chapel Hill, North Carolina, United States of America
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Angela Bengtson
- Department of Epidemiology, Brown School of Public Health, Brown University, Providence, Rhode Island, United States of America
| | - Bradley Gaynes
- Department of Psychiatry, UNC School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Vivian Go
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Mina C. Hosseinipour
- UNC-Project Malawi, Lilongwe, Malawi
- Department of Medicine, UNC School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | | | | | - Samantha Meltzer-Brody
- Department of Psychiatry, UNC School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | | | | | - Michael Udedi
- College of Medicine, University of Malawi, Lilongwe, Malawi
- Ministry of Health, Lilongwe, Malawi
| | - Brian Pence
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
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15
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Akiba CF, Zimba CC, Thom A, Matewere M, Go V, Pence B, Gaynes BN, Masiye J. The role of patient-provider communication: a qualitative study of patient attitudes regarding co-occurring depression and chronic diseases in Malawi. BMC Psychiatry 2020; 20:243. [PMID: 32429877 PMCID: PMC7236218 DOI: 10.1186/s12888-020-02657-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Accepted: 05/11/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Globally, depression is a leading cause of morbidity and mortality particularly in Low and Middle-Income Countries (LMICs). The burden of non-communicable diseases (NCDs) are also increasing in LMICs, the conditions frequently co-occur and exacerbate NCD outcomes. Depression interventions alone are not effective at improving NCD outcomes, resulting in wide-reaching calls for integrated services. Integrated services are in a nascent phase in LMICs in general and in Malawi in particular. This manuscript serves to clarify Malawian patients' attitudes and perceptions towards depression integration into routine NCD services. METHODS Ten District Hospitals were selected for data collection and 2 participants were interviewed from each site (N = 20). An iterative approach to concept-driven coding was applied to facilitate the formation of similarities, differences, and connections between codes. RESULTS While patients infrequently described moderate depression as a medical condition, and held various attitudes regarding treatments, they agreed on the appropriateness of integrated services. Patients' respect for their providers led them to support integration. Patients discussed how medical knowledge is highly regarded, revealing a power dynamic with their providers. Patients further acknowledged the importance of a provider's communication in shaping a patient's feelings about depression. CONCLUSIONS Training and interventions that facilitate providers' abilities to transfer their medical knowledge, use strategies to channel their power, and engage patients in a meaningful and collaborative relationship will be key to successfully integrating depression treatment into Malawian NCD clinics. TRIAL REGISTRATION This work served as part of formative data collection for National Institute of Mental Health (NIMH) Trail NCT03711786 registered on 10th October, 2018.
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Affiliation(s)
- Christopher F Akiba
- Department of Health Behavior, University of North Carolina at Chapel Hill, Gillings School of Global Public Health, 363 Rosenau Hall, CB# 7440, Chapel Hill, NC, 27599, USA.
| | - Chifundo C Zimba
- University of North Carolina Project Malawi, Tidziwe Center, 100 Mzimba Road, Private Bag A, /104, Lilongwe, Malawi
| | - Annie Thom
- University of North Carolina Project Malawi, Tidziwe Center, 100 Mzimba Road, Private Bag A, /104, Lilongwe, Malawi
| | - Maureen Matewere
- University of North Carolina Project Malawi, Tidziwe Center, 100 Mzimba Road, Private Bag A, /104, Lilongwe, Malawi
| | - Vivian Go
- Department of Health Behavior, University of North Carolina at Chapel Hill, Gillings School of Global Public Health, 363 Rosenau Hall, CB# 7440, Chapel Hill, NC, 27599, USA
| | - Brian Pence
- Department of Epidemiology, University of North Carolina at Chapel Hill, Gillings School of Global Public Health, 2103C McGavran-Greenberg Hall, CB #7435, Chapel Hill, NC, 27599, USA
| | - Bradley N Gaynes
- Department of Psychiatry, University of North Carolina at Chapel Hill, School of Medicine, 101 Manning Drive, Chapel Hill, NC, 27514, USA
| | - Jones Masiye
- Malawi Ministry of Health and Population, Non-communicable Diseases and Mental Health Clinical Services, P.O Box 30377, Lilongwe, 3, Malawi
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de Wet A, Dowling T, Swartz L, Lesch A, Kagee A, Kafaar Z, Hassan NR, Newman PA. Complexities in the process of translating research documents in cross-cultural settings. Glob Public Health 2020; 15:818-827. [PMID: 31994442 DOI: 10.1080/17441692.2020.1718736] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
In multilingual societies, where researchers and participants often do not speak the same language, research is a challenge as a mismatch of understanding between researchers, research instruments and participants often occurs. Reporting on the translation process is crucial because of the potential implications for the validity of the data that follow from it. We aimed to report on the complexities of such a translation process and many considerations that came to our attention. Methodologically, we used a detailed case study to demonstrate that the complexity of translation might be underestimated by researchers who may neglect to report on the challenges that they experience to benefit the wider research community. We emphasise that translating documents, particularly between languages that are not cognate, requires time and financial resources that researchers often do not anticipate or plan for. By discussing what happened to texts that were translated, and how we as researchers were challenged by considerations that were primarily linguistic but also straddled cultural and socio-political domains, we hope to encourage a deeper understanding of the translation task. We conclude that consideration of these complexities is necessary if the aim is the development of translated documents which complement the researchers' goals.
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Affiliation(s)
- Anneliese de Wet
- Department of Psychology, Stellenbosch University, Stellenbosch, South Africa
| | - Tessa Dowling
- African Languages, School of Languages & Literatures, University of Cape Town, Cape Town, South Africa
| | - Leslie Swartz
- Department of Psychology, Stellenbosch University, Stellenbosch, South Africa
| | - Anthea Lesch
- Department of Psychology, Stellenbosch University, Stellenbosch, South Africa
| | - Ashraf Kagee
- Department of Psychology, Stellenbosch University, Stellenbosch, South Africa
| | - Zuhayr Kafaar
- Department of Psychology, Stellenbosch University, Stellenbosch, South Africa
| | - Neil R Hassan
- Department of Psychology, Stellenbosch University, Stellenbosch, South Africa
| | - Peter A Newman
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
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Anderson ML, Riker T, Hakulin S, Meehan J, Gagne K, Higgins T, Stout E, Pici-D’Ottavio E, Cappetta K, Wolf Craig KS. Deaf ACCESS: Adapting Consent Through Community Engagement and State-of-the-Art Simulation. JOURNAL OF DEAF STUDIES AND DEAF EDUCATION 2020; 25:115-125. [PMID: 31782774 PMCID: PMC6951030 DOI: 10.1093/deafed/enz035] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 07/31/2019] [Accepted: 07/31/2019] [Indexed: 06/10/2023]
Abstract
One of the most understudied health disparity populations in the United States is the Deaf community, a sociolinguistic minority group of more than 500,000 individuals who communicate via American Sign Language. Research on Deaf health disparities is lacking due to inaccessible recruitment, sampling, and data collection procedures, as well as the fundamental disconnect between medical and cultural views of Deaf people. A potential starting place for addressing inaccessible research methods and mistrust of the biomedical research community is the careful reconsideration of the traditional informed consent process, often a Deaf individual's first point of contact with the research world. Yet, most Deaf individuals experience obstacles to engaging in informed consent due to differences in language and development compared to hearing individuals. In response to these issues, our team led a three-phase, formative, community-engaged approach to adapt the informed consent process and train research staff in the updated method so that all required components are properly communicated and understood. The goals of our work were to promote Deaf engagement in research about the Deaf community, increase the number of Deaf individuals who participate in general population biomedical research, and generalize our findings to improve research accessibility for the general population.
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Affiliation(s)
| | | | | | | | - Kurt Gagne
- University of Massachusetts Medical School
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Guptarak M, Conway J, Stone TE, Fongkaew W, Settheekul S, Baxter E. Health Beliefs of Nurses in Northern Thailand: A Q-Methodology Study. J Transcult Nurs 2019; 31:350-359. [PMID: 31382839 DOI: 10.1177/1043659619865589] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Introduction: Northern Thailand has a distinct culture and set of health beliefs. Nurses' beliefs influence approaches to care affecting health care outcomes. This study explored the content, origin, and sociocultural influences on health beliefs of Northern Thai nurses and how they influence clinical practice and education. Method: Q-methodology was used in this study. Data were collected with interviews using Q-cards, Q-sort distribution board, and a semistructured interview guide. Results: Data were collected from 30 clinical nurses and 30 nurses working in academia. Q-factor analysis produced three factors accounting for 48% of variance: personal experience, Thai and Buddhist beliefs, and contemporary beliefs. Discussion: Participants who felt strongly rooted in their culture and beliefs were homogeneous in recognizing the need for evidence-based practice. Nurses aware of the nature and sources of their beliefs and those of patients are well-placed to balance maintenance of cultural traditions with the need to provide evidence-based practice.
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Affiliation(s)
- Marisa Guptarak
- Chiang Mai University Faculty of Nursing, Chiang Mai, Thailand
| | - Jane Conway
- University of New England, Armidale, New South Wales, Australia
| | | | | | | | - Emily Baxter
- University of New England, Armidale, New South Wales, Australia
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Squires A, Sadarangani T, Jones S. Strategies for overcoming language barriers in research. J Adv Nurs 2019; 76:706-714. [PMID: 30950104 DOI: 10.1111/jan.14007] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 12/26/2018] [Accepted: 01/09/2019] [Indexed: 01/26/2023]
Abstract
AIM This paper seeks to describe best practices for conducting cross-language research with individuals who have a language barrier. DESIGN Discussion paper. DATA SOURCES Research methods papers addressing cross-language research issues published between 2000-2017. IMPLICATIONS FOR NURSING Rigorous cross-language research involves the appropriate use of interpreters during the research process, systematic planning for how to address the language barrier between participant and researcher and the use of reliably and validly translated survey instruments (when applicable). Biases rooted in those who enter data into "big data" systems may influence data quality and analytic approaches in large observational studies focused on linking patient language preference to health outcomes. CONCLUSION Cross-language research methods can help ensure that those individuals with language barriers have their voices contributing to the evidence informing healthcare practice and policies that shape health services implementation and financing. Understanding the inherent conscious and unconscious biases of those conducting research with this population and how this may emerge in research studies is also an important part of producing rigorous, reliable, and valid cross-language research. IMPACT This study synthesized methodological recommendations for cross-language research studies with the goal to improve the quality of future research and expand the evidence-base for clinical practice. Clear methodological recommendations were generated that can improve research rigor and quality of cross-language qualitative and quantitative studies. The recommendations generated here have the potential to have an impact on the health and well-being of migrants around the world.
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Affiliation(s)
- Allison Squires
- Rory Meyers College of Nursing, New York University, New York City, New York.,School of Medicine, New York University, New York City, New York
| | - Tina Sadarangani
- Rory Meyers College of Nursing, New York University, New York City, New York
| | - Simon Jones
- Population Health, School of Medicine, New York University, New York City, New York
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Wong G, Koziol-McLain J, Glover M. Working With Asian Language Interpreters in Qualitative Research: A Comparative Study. QUALITATIVE HEALTH RESEARCH 2019; 29:868-875. [PMID: 30501491 DOI: 10.1177/1049732318809352] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Health researchers employ health interpreters for research interviews with linguistically diverse speakers. Few studies compare inconsistencies between different interpretations of the same interview data. We compared interpreted with independently reinterpreted English language transcripts from five in-home family interviews conducted in five different Asian languages. Differences included augmented, summarized, and/or omitted information. Researchers should ensure that they, and their interpreters, follow rigorous processes for credible qualitative data collection, and audit their interpreted data for accuracy. Different interpretations of the same data can be incorporated into analyses.
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Affiliation(s)
- Grace Wong
- 1 Auckland University of Technology, Auckland, New Zealand
| | | | - Marewa Glover
- 2 School of Health Sciences, College of Health, Massey University, Auckland, New Zealand
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Ganek H, Nixon S, Smyth R, Eriks-Brophy A. A Cross-cultural Mixed Methods Investigation of Language Socialization Practices. JOURNAL OF DEAF STUDIES AND DEAF EDUCATION 2019; 24:128-141. [PMID: 30597063 DOI: 10.1093/deafed/eny037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 11/08/2018] [Accepted: 11/15/2018] [Indexed: 06/09/2023]
Abstract
This embedded mixed methods study explores how cultural differences in language socialization practices influence parent-child verbal interactions. The Language ENvironment Analysis (LENA) System audio recorded families of children who are and are not deaf and hard of hearing in Canada and Vietnam. Software automatically calculated an average conversational turn count. Canadian families participated in more turns than Vietnamese families regardless of hearing status. Interviews with the children's caregivers provided context for these results. Within Vietnamese families, the language socialization practice "Intelligence" results in reduced opportunities for turn-taking, while the Canadian focus on creating personal "Identity" encouraged them. "Intelligence" encompasses Vietnamese participants' desire to ensure their children are learning and "Identity" expresses the Canadian participants' appeal to encourage individuality in their children. The findings suggest directions for the adaptation of intervention. It is the first known study to incorporate LENA results into a mixed methods design.
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Keikelame MJ, Swartz L. “I wonder if I did not mess up….”: Shame and resistance among women with epilepsy in Cape Town, South Africa. Seizure 2018; 61:50-56. [DOI: 10.1016/j.seizure.2018.07.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Revised: 07/26/2018] [Accepted: 07/28/2018] [Indexed: 11/30/2022] Open
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Anderson ML, Riker T, Gagne K, Hakulin S, Higgins T, Meehan J, Stout E, Pici-D'Ottavio E, Cappetta K, Wolf Craig KS. Deaf Qualitative Health Research: Leveraging Technology to Conduct Linguistically and Sociopolitically Appropriate Methods of Inquiry. QUALITATIVE HEALTH RESEARCH 2018; 28:1813-1824. [PMID: 29890891 PMCID: PMC6449691 DOI: 10.1177/1049732318779050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
One of the most understudied health disparity populations in the United States is the Deaf community-a sociolinguistic minority group of at least 500,000 individuals who communicate using American Sign Language. Research within this population is lacking, in part, due to researchers' use of methodologies that are inaccessible to Deaf sign language users. Traditional qualitative methods were developed to collect and analyze participants' spoken language. There is, therefore, a paradigm shift that must occur to move from an auditory data schema to one that prioritizes the collection and analysis of visual data. To effectively navigate this shift when working with Deaf sign language users, there are unique linguistic and sociopolitical considerations that should be taken into account. The current article explores these considerations and outlines an emerging method of conducting qualitative analysis that, we argue, has the potential to enhance qualitative researchers' work regardless of the population of focus.
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Affiliation(s)
- Melissa L Anderson
- 1 University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Timothy Riker
- 1 University of Massachusetts Medical School, Worcester, Massachusetts, USA
- 2 Brown University, Providence, Rhode Island, USA
| | - Kurt Gagne
- 1 University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Stephanie Hakulin
- 1 University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Todd Higgins
- 1 University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Jonah Meehan
- 1 University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Elizabeth Stout
- 1 University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | | | - Kelsey Cappetta
- 1 University of Massachusetts Medical School, Worcester, Massachusetts, USA
- 3 Gallaudet University, Washington, District of Columbia, USA
| | - Kelly S Wolf Craig
- 1 University of Massachusetts Medical School, Worcester, Massachusetts, USA
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Im EO, Lee SJ, Hu Y, Cheng CY, Iikura A, Inohara A, Kim S, Hamajima Y, Yeo SA, Chee E, Chee W. The use of multiple languages in a technology-based intervention study: A discussion paper. Appl Nurs Res 2017; 38:147-152. [PMID: 29241508 PMCID: PMC5882236 DOI: 10.1016/j.apnr.2017.10.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Accepted: 10/15/2017] [Indexed: 01/29/2023]
Abstract
BACKGROUND AND OBJECTIVES With an increasing number of racial/ethnic minorities in the U.S., nursing research frequently involves the use of multiple languages, especially to promote the understanding of educational materials related to nursing care. Furthermore, with a recent emphasis on innovation in health-related research, the use of technology is prominent in nursing research. However, practical issues in the use of multiple languages, especially in technology-based intervention studies, have rarely been reported and/or discussed in nursing literature. The purpose of this paper is to identify practical issues in conducting a technology-based intervention study using multiple languages among Asian American breast cancer survivors. METHODS In a large-scale technology-based breast cancer intervention study, research team members wrote memos on issues in translation process and plausible reasons for the issues. Then, the memos and written records were analyzed using a content analysis. By using individual words as the unit of analysis, line-by-line coding was done, and idea categories representing practical issues were extracted from the codes. RESULTS Six themes representing the practical issues were extracted. Issues were found in recruiting and retaining bilingual research team members; maintaining consistency in translation process; keeping cultural and conceptual equivalence; repeating IRB protocol modifications; finding and using existing translated versions; and arranging technological aspects related to electronic multiple-language versions. CONCLUSION The use of multiple languages in a technology-based intervention study is feasible. However, it is necessary to effectively manage unforeseen challenges through various strategies.
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Affiliation(s)
- Eun-Ok Im
- Duke University, School of Nursing, United States.
| | - Soo Jin Lee
- Korea National Open University, School of Nursing, South Korea.
| | - Yun Hu
- Duke University, School of Nursing, United States.
| | | | - Atsumi Iikura
- Korea National Open University, School of Nursing, South Korea
| | | | - Sarah Kim
- Duke University, School of Nursing, United States
| | - Yuko Hamajima
- Duke University, School of Nursing, United States; University of North Carolina, Chapel Hill, United States.
| | | | - Eunice Chee
- Duke University, School of Nursing, United States; University of North Carolina, Chapel Hill, United States
| | - Wonshik Chee
- Duke University, School of Nursing, United States
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Miner S, Liebel DV, Wilde MH, Carroll JK, Omar S. Somali Older Adults' and Their Families' Perceptions of Adult Home Health Services. J Immigr Minor Health 2017; 20:1215-1221. [PMID: 28929315 DOI: 10.1007/s10903-017-0658-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Many studies have identified the vulnerability of ethnic elders, and there is promising evidence indicating home health care (HHC) services can improve the health outcomes of Somali older adults. This study used a community-engaged qualitative descriptive approach with the participation of non-profit organization Refugees Helping Refugees. The purpose of this study was to explore and describe Somali older adults' and their families' perceptions of and experiences with HHC services in order to improve its use and access. Data collection included home visits (n = 15), semi-structured interviews (n = 17) and debriefing sessions (n = 16) with 19 individuals from 14 Somali families. Somali families recognized HHC services were needed and believed having services in the home facilitated learning but HHC agencies should work more with the Somali community. HHC agencies need to work with community organizations to facilitate cultural and health understanding, and better health care for Somali older adults.
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Affiliation(s)
- Sarah Miner
- NYU Rory Meyers College of Nursing, 433 1st Avenue, New York, NY, 10010, USA.
| | - Dianne V Liebel
- University of Rochester School of Nursing, Rochester, NY, USA
| | - Mary H Wilde
- University of Rochester School of Nursing, Rochester, NY, USA
| | - Jennifer K Carroll
- University of Colorado Denver Department of Family Medicine, Aurora, CO, USA
| | - Sadiya Omar
- Refugees Helping Refugees, Rochester, NY, USA
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Oxley J, Günhan E, Kaniamattam M, Damico J. Multilingual issues in qualitative research. CLINICAL LINGUISTICS & PHONETICS 2017; 31:612-630. [PMID: 28665758 DOI: 10.1080/02699206.2017.1302512] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
This study is a reflective account of how problem solving was accomplished during the translation of semi-structured interviews from a source language to a target language. Data are drawn from two qualitative research studies in which Interpretative Phenomenological Analysis was used to obtain insights into the lived experience of parents of children with disabilities in India and Turkey. The authors discuss challenges to interpretation that arise when participants and the main researcher speak the same non-English native language and the results of the study are intended for an English-speaking audience. A common theme in both the Turkish and Indian data relates to parents' understanding of their children's symptomology and the prognosis. Implications include the need for both reflective conversation within the research team to address the translation of problematic utterances, and documentation of the translation process in the presentation of research findings.
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Affiliation(s)
- Judith Oxley
- a Department of Communicative Disorders , University of Louisiana at Lafayette , Lafayette , Louisiana , USA
| | - Evra Günhan
- b Department of Speech and Language Therapy , İstanbul Medipol University , İstanbul , Turkey
| | - Monica Kaniamattam
- a Department of Communicative Disorders , University of Louisiana at Lafayette , Lafayette , Louisiana , USA
| | - Jack Damico
- a Department of Communicative Disorders , University of Louisiana at Lafayette , Lafayette , Louisiana , USA
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Walton AL, LePrevost CE, Linnan L, Sanchez-Birkhead A, Mooney K. Benefits, Facilitators, Barriers, and Strategies to Improve Pesticide Protective Behaviors: Insights from Farmworkers in North Carolina Tobacco Fields. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:E677. [PMID: 28644414 PMCID: PMC5551115 DOI: 10.3390/ijerph14070677] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Revised: 06/12/2017] [Accepted: 06/14/2017] [Indexed: 11/17/2022]
Abstract
Pesticide exposure is associated with deleterious health effects. Prior studies suggest Latino farmworkers perceive little control over their occupational health. Using the Health Belief Model as a theoretical guide, we explored the perceptions of Latino farmworkers working in tobacco in North Carolina (n = 72) about benefits and facilitators of pesticide protective behaviors as well as barriers, and strategies to overcome barriers to their use. Interviews were conducted with participants at farmworker housing during non-work time. Qualitative data were analyzed using ATLAS.ti. Farmworkers recognized pesticide protective behaviors as helping them to not get sick and stay healthy. Farmworkers perceived work experience as facilitating protective behaviors. Wetness in the field was the most commonly cited barrier to protective behavior use. To overcome this barrier, farmworkers suggested use of water-resistant outerwear, as well as packing a change of clothes for mid-day, with space and time to change provided by employers. Examination of the efficacy and feasibility of farmworkers' suggestions for addressing barriers is warranted. Training and behavior modeling by experienced peers may improve behavior adoption and perceived control.
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Affiliation(s)
- AnnMarie Lee Walton
- School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
| | - Catherine E LePrevost
- Department of Applied Ecology, North Carolina State University, Raleigh, NC 27695, USA.
| | - Laura Linnan
- Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
| | | | - Kathi Mooney
- College of Nursing, The University of Utah, Salt Lake City, UT 84112, USA.
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Issues in Developing and Evaluating a Culturally Tailored Internet Cancer Support Group. Comput Inform Nurs 2017; 34:462-469. [PMID: 27379523 DOI: 10.1097/cin.0000000000000261] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The purpose of this article is to explore practical issues in developing and implementing a culturally tailored Internet Cancer Support Group for a group of ethnic minority patients with cancer-Asian Americans. Throughout the research process of the original study testing the Internet cancer support group, the research team made written records of practical issues and plausible rationales for the issues. Weekly group discussion among research team members was conducted, and the discussion records were evaluated and analyzed using a content analysis (with individual words as the unit of analysis). The codes from the analysis process were categorized into idea themes, through which the issues were extracted. The issues included those in (1) difficulties in using multiple languages, (2) collaboration with the information technology department and technical challenges, (3) difficulties in recruitment, (4) difficulties in retention, (5) optimal timing, and (6) characteristics of the users. Based on the findings, we suggest that researchers plan a workable translation process, check technical needs in advance, use multiple strategies to recruit and retain research participants, plan the right time for data collection, and consider characteristics of the users in the study design.
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Helmich E, Cristancho S, Diachun L, Lingard L. 'How would you call this in English?' : Being reflective about translations in international, cross-cultural qualitative research. PERSPECTIVES ON MEDICAL EDUCATION 2017; 6:127-132. [PMID: 28220459 PMCID: PMC5383565 DOI: 10.1007/s40037-017-0329-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
INTRODUCTION Medical education researchers increasingly collaborate in international teams, collecting data in different languages and from different parts of the world, and then disseminating them in English-language journals. Although this requires an ever-present need to translate, it often occurs uncritically. With this paper we aim to enhance researchers' awareness and reflexivity regarding translations in qualitative research. METHODS In an international study, we carried out interviews in both Dutch and English. To enable joint data analysis, we translated Dutch data into English, making choices regarding when and how to translate. In an iterative process, we contextualized our experiences, building on the social sciences and general health literature about cross-language/cross-cultural research. RESULTS We identified three specific translation challenges: attending to grammar or syntax differences, grappling with metaphor, and capturing semantic or sociolinguistic nuances. Literature findings informed our decisions regarding the validity of translations, translating in different stages of the research process, coding in different languages, and providing 'ugly' translations in published research reports. DISCUSSION The lessons learnt were threefold. First, most researchers, including ourselves, do not consciously attend to translations taking place in international qualitative research. Second, translation challenges arise not only from differences in language, but also from cultural or societal differences. Third, by being reflective about translations, we found meaningful differences, even between settings with many cultural and societal similarities. This conscious process of negotiating translations was enriching. We recommend researchers to be more conscious and transparent about their translation strategies, to enhance the trustworthiness and quality of their work.
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Affiliation(s)
- Esther Helmich
- Center for Education Development and Research in Health Professions, University of Groningen, Groningen, The Netherlands.
| | - Sayra Cristancho
- Centre for Education Research & Innovation and Department of Medicine, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
| | - Laura Diachun
- Centre for Education Research & Innovation and Department of Medicine, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
| | - Lorelei Lingard
- Centre for Education Research & Innovation and Department of Medicine, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
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Flax VL, Thakwalakwa C, Ashorn U. Perceptions of Child Body Size and Health Care Seeking for Undernourished Children in Southern Malawi. QUALITATIVE HEALTH RESEARCH 2016; 26:1939-1948. [PMID: 26487759 PMCID: PMC4925312 DOI: 10.1177/1049732315610522] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Child undernutrition affects millions of children globally, but little is known about the ability of adults to detect different types of child undernutrition in low-income countries. We used focused ethnographic methods to understand how Malawian parents and grandparents describe the characteristics they use to identify good and poor child growth, their actual or preferred patterns of health seeking for undernourished children, and the perceived importance of child undernutrition symptoms in relation to other childhood illnesses. Malawians value adiposity rather than stature in assessing child growth. Symptoms of malnutrition, including wasting and edema, were considered the least severe childhood illness symptoms. Parents delayed health care seeking when a child was ill. When they sought care, it was for symptoms such as diarrhea or fever, and they did not recognize malnutrition as the underlying cause. These findings can be used to tailor strategies for preventing and treating growth faltering in Malawian children.
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Affiliation(s)
- Valerie L Flax
- University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Kemp C, Gerth-Guyette E, Dube L, Andrasik M, Rao D. Mixed-Methods Evaluation of a Novel, Structured, Community-Based Support and Education Intervention for Individuals with HIV/AIDS in KwaZulu-Natal, South Africa. AIDS Behav 2016; 20:1937-50. [PMID: 27553008 DOI: 10.1007/s10461-016-1386-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
People living with HIV in Sub-Saharan Africa face significant challenges accessing care. Community-based peer support groups can increase linkage to treatment, though the effectiveness of structured, scalable groups has not been demonstrated. This study aimed to measure the impact of the structured Integrated Access to Care and Treatment intervention on clients' knowledge, attitudes, and practice regarding HIV/AIDS, including their experiences of stigma, in KwaZulu-Natal, South Africa. Data collection involved pre-/post-tests and client interviews. Pre-/post-test data from 66 clients were collected. 17 participants were interviewed. Paired t-tests did not detect significant changes in the main outcomes. Qualitative results suggested a psychosocial benefit as participants connected with their peers, expressed themselves openly, and re-engaged with their communities. Unfortunately, this study did not quantitatively measure psychosocial changes, and the results have limited generalizability to men. I ACT may be an effective complement to clinic-based support services, though further study should quantify the psychosocial benefit.
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Affiliation(s)
- Christopher Kemp
- Department of Global Health, University of Washington, Ninth and Jefferson Building, 13th Floor, 908 Jefferson Street, Box 359932, Seattle, WA, 98104, USA.
| | | | - Lungile Dube
- SaveAct, 123 Jabu Ndlovu St, Pietermaritzburg, 3201, South Africa
| | - Michele Andrasik
- Department of Global Health, University of Washington, Ninth and Jefferson Building, 13th Floor, 908 Jefferson Street, Box 359932, Seattle, WA, 98104, USA
- Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue N, E3-300, Seattle, WA, 98109, USA
| | - Deepa Rao
- Department of Global Health, University of Washington, Ninth and Jefferson Building, 13th Floor, 908 Jefferson Street, Box 359932, Seattle, WA, 98104, USA
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Phillipson L, Larsen-Truong K, Pitts L, Nonu M. Knowledge of, beliefs about, and perceived barriers to organ and tissue donation in Serbian, Macedonian, and Greek Orthodox communities in Australia. Prog Transplant 2015; 25:91-9. [PMID: 25758807 DOI: 10.7182/pit2015550] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONTEXT Despite the lifesaving benefits of organ and tissue donation, a worldwide shortage of suitable and registered donors exists. Although the reasons for this shortage are multifactorial, it has been recognized that distinct barriers to registration, family discussion, and consent that require targeted intervention and action are present among minority cultural, religious, and immigrant communities. OBJECTIVE To explore the knowledge, attitudes, and beliefs of 3 orthodox religious communities in Australia (Macedonian, Greek, and Serbian Orthodox) and determine the implications for engaging with these communities to improve knowledge, attitudes, family discussion, and the ability to make an informed decision about donation. DESIGN Qualitative approach using focus groups moderated by researchers and bicultural health workers with the assistance of accredited interpreters. PARTICIPANTS 98 adult members of the Greek, Macedonian, and Serbian Orthodox communities in the Illawarra region of New South Wales, Australia. RESULTS Clear barriers to discussing and making an informed decision about organ and tissue donation were identified. Knowledge of processes and procedures was low and discussion about death (and organ and tissue donation) with family members and loved ones was considered taboo. Despite these barriers, all 3 communities expressed a desire for more information and engagement. Of particular interest were the perspectives of 3 types of "experts": medical, religious, and other community members (who had experience with the organ and tissue donation system). Future programs designed for orthodox religious communities should consider the need for active strategies that facilitate information sharing and engagement between community members and these 3 types of experts.
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Affiliation(s)
| | | | - Leissa Pitts
- Illawarra Shoalhaven Local Health District, Australia
| | - Miriam Nonu
- Illawarra Shoalhaven Local Health District, Australia
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Al-Amer R, Ramjan L, Glew P, Darwish M, Salamonson Y. Language translation challenges with Arabic speakers participating in qualitative research studies. Int J Nurs Stud 2015; 54:150-7. [PMID: 25936733 DOI: 10.1016/j.ijnurstu.2015.04.010] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2014] [Revised: 04/08/2015] [Accepted: 04/13/2015] [Indexed: 01/01/2023]
Abstract
This paper discusses how a research team negotiated the challenges of language differences in a qualitative study that involved two languages. The lead researcher shared the participants' language and culture, and the interviews were conducted using the Arabic language as a source language, which was then translated and disseminated in the English language (target language). The challenges in relation to translation in cross-cultural research were highlighted from a perspective of establishing meaning as a vital issue in qualitative research. The paper draws on insights gained from a study undertaken among Arabic-speaking participants involving the use of in-depth semi-structured interviews. The study was undertaken using a purposive sample of 15 participants with Type 2 Diabetes Mellitus and co-existing depression and explored their perception of self-care management behaviours. Data analysis was performed in two phases. The first phase entailed translation and transcription of the data, and the second phase entailed thematic analysis of the data to develop categories and themes. In this paper there is discussion on the translation process and its inherent challenges. As translation is an interpretive process and not merely a direct message transfer from a source language to a target language, translators need to systematically and accurately capture the full meaning of the spoken language. This discussion paper highlights difficulties in the translation process, specifically in managing data in relation to metaphors, medical terminology and connotation of the text, and importantly, preserving the meaning between the original and translated data. Recommendations for future qualitative studies involving interviews with non-English speaking participants are outlined, which may assist researchers maintain the integrity of the data throughout the translation process.
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Affiliation(s)
- Rasmieh Al-Amer
- School of Nursing and Midwifery, University of Western Sydney, Locked Bag 1797, Penrith, NSW 2751, Australia.
| | - Lucie Ramjan
- School of Nursing and Midwifery, University of Western Sydney, Locked Bag 1797, Penrith, NSW 2751, Australia.
| | - Paul Glew
- School of Nursing and Midwifery, University of Western Sydney, Locked Bag 1797, Penrith, NSW 2751, Australia.
| | - Maram Darwish
- School of Medicine, Hashemite University, Zarqa, Jordan; Department of General Surgery, Jordanian Royal Medical Services, Amman, Jordan.
| | - Yenna Salamonson
- School of Nursing and Midwifery, University of Western Sydney, Locked Bag 1797, Penrith, NSW 2751, Australia.
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Im EO, Kim S, Tsai HM, Nishigaki M, Yeo SA, Chee W, Chee E, Mao JJ. Practical issues in multi-lingual research. Int J Nurs Stud 2015; 54:141-9. [PMID: 25739658 DOI: 10.1016/j.ijnurstu.2015.02.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2014] [Revised: 02/07/2015] [Accepted: 02/09/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND With an increasing number of ethnic minority populations, the use of multiple languages in one research study has increased in recent years. The use of multiple languages helps increase comprehensiveness of educational materials and/or survey questionnaires, and promote ethnic minorities' participation in research. However, little has been clearly known about practical issues in using multiple languages in one research study. OBJECTIVES The purpose of this paper is to explore practical issues in using multiple languages in a study among diverse sub-ethnic groups of Asian American breast cancer survivors in order to propose future directions for the use of multiple languages in research projects. METHODS Throughout the research process, research team made written records of practical issues and possible reasons for the issues as they arose. Weekly group discussions among research team members were administered, and the written records of these discussions were reviewed and analyzed using the content analysis. The unit of analysis was individual words. The words in the data (memos and written records) were classified into idea categories that emerged from the coding process. RESULTS The idea categories included issues in: (a) collaborators from various sub-ethnic groups; (b) IRB protocol submissions; (c) consistencies in translation process, (d) conceptual equivalence; (e) cultural differences; (f) existing translated versions; and (g) authorship issues. Based on the issues, we made the following suggestions for multi-lingual research: (a) networking and setting multiple communication channels with potential collaborators; (b) checking the institution's IRB policies related to the use of multiple languages; (c) setting the rules and procedures for translation process; (d) checking existing different language versions of instruments; and (e) setting the rules for authorship in advance. CONCLUSIONS The suggestions made in this study would help the researchers be prepared in advance to deal with the challenges.
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Affiliation(s)
- Eun-Ok Im
- School of Nursing, University of Pennsylvania, 418 Curi Blvd., Philadelphia, PA 19104, United States.
| | - Sangmi Kim
- School of Nursing, University of Pennsylvania, 418 Curi Blvd., Philadelphia, PA 19104, United States.
| | - Hsiu-Min Tsai
- Chang Gung University of Science and Technology, 261 We-hua 1st Road, Kwei-shan, Tao-yuan, Taiwan.
| | - Masakazu Nishigaki
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Yoshida-Konoe-cho, Sakyo-ku, Kyoto 606-8501, Japan.
| | - Seon Ae Yeo
- University of North Caronia, Carrington Hall, CB No. 7460, Chapel Hill, NC 27599, United States.
| | - Wonshik Chee
- School of Nursing, University of Pennsylvania, 418 Curi Blvd., Philadelphia, PA 19104, United States.
| | - Eunice Chee
- School of Engineering and Applied Science, University of Pennsylvania, 220 S 33rd St, Philadelphia, PA 19104, United States.
| | - Jun James Mao
- School of Medicine, University of Pennsylvania, 415 Curie Blvd, Philadelphia, PA 19104, United States.
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Santos HPO, Black AM, Sandelowski M. Timing of translation in cross-language qualitative research. QUALITATIVE HEALTH RESEARCH 2015; 25:134-44. [PMID: 25189538 DOI: 10.1177/1049732314549603] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Although there is increased understanding of language barriers in cross-language studies, the point at which language transformation processes are applied in research is inconsistently reported, or treated as a minor issue. Differences in translation timeframes raise methodological issues related to the material to be translated, as well as for the process of data analysis and interpretation. In this article we address methodological issues related to the timing of translation from Portuguese to English in two international cross-language collaborative research studies involving researchers from Brazil, Canada, and the United States. One study entailed late-phase translation of a research report, whereas the other study involved early phase translation of interview data. The timing of translation in interaction with the object of translation should be considered, in addition to the language, cultural, subject matter, and methodological competencies of research team members.
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Affiliation(s)
| | - Amanda M Black
- University of North Carolina, Chapel Hill, North Carolina, USA
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Ciuk S, James P. Interlingual translation and the transfer of value-infused practices: An in-depth qualitative exploration. MANAGEMENT LEARNING 2014. [DOI: 10.1177/1350507614560304] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Against the background of a marked lack of studies exploring the role of language and more particularly interlingual translation in the travel of ideas and practices across organisational contexts, this article provides an analysis of an attempt by a group of managers to translate a set of corporate values into Polish from English. The findings reported serve to demonstrate the relevance of such translation processes to the transfer of knowledge and practices within multinationals. By prompting sensemaking around a value-laden text, the studied translation exercise is shown to have encouraged discussions around understandings of local needs and preferred meanings which served to trigger debates and reflections around local identity and affinities with the parent company. In doing so, it provided a ‘situated platform’ through which participants exercised a collective agency aimed at establishing what were perceived to constitute appropriate and productive accommodations between local and extra-local pressures. At the same time, the translation is shown to have been very much shaped by material interests and priorities, notably the performance expectations embedded in the subsidiary’s relationship with its parent. As a result, care needs to be taken not to overstate the role of such translations in facilitating locally driven cultural adaptations.
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Sousa CA, Kemp S, El-Zuhairi M. Dwelling within political violence: Palestinian women's narratives of home, mental health, and resilience. Health Place 2014; 30:205-14. [PMID: 25306419 DOI: 10.1016/j.healthplace.2014.09.005] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Revised: 08/16/2014] [Accepted: 09/05/2014] [Indexed: 11/27/2022]
Abstract
Political violence is increasingly played out within everyday civilian environments, particularly family homes. Yet, within the literature on political violence and mental health, the role of threats to home remains under-explored. Using focus group data from 32 Palestinian women, this paper explores the implications of violations to the home within political violence. Threats to the privacy, control, and constancy of the family home - key dimensions of ontological security (Giddens, 1990) emerged as central themes in women's narratives. Surveillance, home invasions, and actual or threatened destruction of women's home environments provoked fear, anxiety, grief, humiliation, and helplessness, particularly as women struggled to protect their children. Women also described how they mobilized the home for economic, familial and cultural survival. Study findings illuminate the impact of threats to intimate environments on the well-being of women and their families living with chronic political violence, and underscore the importance of attention to violations of place and home in research on civilian experiences of and responses to political violence.
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Affiliation(s)
- Cindy A Sousa
- Bryn Mawr College, Graduate School of Social Work and Social Research, 300 Airdale Road, Bryn Mawr, PA 19010-1697, United States.
| | - Susan Kemp
- University of Washington School of Social Work, Seattle, WA, United States
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Al-Amer R, Ramjan L, Glew P, Darwish M, Salamonson Y. Translation of interviews from a source language to a target language: examining issues in cross-cultural health care research. J Clin Nurs 2014; 24:1151-62. [PMID: 25181257 DOI: 10.1111/jocn.12681] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2014] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES To illuminate translation practice in cross-language interview in health care research and its impact on the construction of the data. BACKGROUND Globalisation and changing patterns of migration have created changes to the world's demography; this has presented challenges for overarching social domains, specifically, in the health sector. Providing ethno-cultural health services is a timely and central facet in an ever-increasingly diverse world. Nursing and other health sectors employ cross-language research to provide knowledge and understanding of the needs of minority groups, which underpins cultural-sensitive care services. However, when cultural and linguistic differences exist, they pose unique complexities for cross-cultural health care research; particularly in qualitative research where narrative data are central for communication as most participants prefer to tell their story in their native language. Consequently, translation is often unavoidable in order to make a respondent's narrative vivid and comprehensible, yet, there is no consensus about how researchers should address this vital issue. DESIGN An integrative literature review. METHODS PubMed and CINAHL databases were searched for relevant studies published before January 2014, and hand searched reference lists of studies were selected. RESULTS This review of cross-language health care studies highlighted three major themes, which identify factors often reported to affect the translation and production of data in cross-language research: (1) translation style; (2) translators; and (3) trustworthiness of the data. CONCLUSION A plan detailing the translation process and analysis of health care data must be determined from the study outset to ensure credibility is maintained. A transparent and systematic approach in reporting the translation process not only enhances the integrity of the findings but also provides overall rigour and auditability. RELEVANCE TO CLINICAL PRACTICE It is important that minority groups have a voice in health care research which, if accurately translated, will enable nurses to improve culturally relevant care.
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Affiliation(s)
- Rasmieh Al-Amer
- School of Nursing and Midwifery, University of Western Sydney, Penrith, NSW, Australia
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Parsons JA, Baker NA, Smith-Gorvie T, Hudak PL. To 'Get by' or 'get help'? A qualitative study of physicians' challenges and dilemmas when patients have limited English proficiency. BMJ Open 2014; 4:e004613. [PMID: 24902724 PMCID: PMC4054645 DOI: 10.1136/bmjopen-2013-004613] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE Encounters between patients and physicians who do not speak the same language are relatively common in Canada, particularly in urban settings; this trend is increasing worldwide. Language discordance has important effects on health outcomes, including mortality. This study sought to explore physicians' experiences of care provision in situations of language discordance in depth. DESIGN Qualitative study based on individual interviews. Interview guides elicited physicians' perspectives on how they determined whether communication could proceed unaided. A descriptive qualitative approach was adopted, entailing inductive thematic analysis. PARTICIPANTS 22 physicians experienced in treating patients in situations of language discordance were recruited from the emergency and internal medicine departments of an urban tertiary-care hospital. SETTING Large, inner-city teaching hospital in Toronto, Canada, one of the most linguistically diverse cities internationally. RESULTS Determining when to 'get by' or 'get help' in order to facilitate communication was described as a fluid and variable process. Deciding which strategy to use depended on three inter-related factors: time/time constraints, acuity of situation and ease of use/availability of translation aids. Participants reported at times feeling conflicted about their decisions, portraying some of these clinical encounters as a 'troubling space' in which they experienced one or more dilemmas related to real versus ideal practice, responsibility and informed consent. CONCLUSIONS In situations of language discordance, a physician's decision to 'get by' (vs 'get help') rests on a judgement of whether communication can be considered 'good enough' to proceed and depends on the circumstances of the specific encounter. The tension set up between what is 'ideal' and what is practically possible can be experienced as a dilemma by physicians. The study's findings have implications for practice and policy not only in Canada but in other multilingual settings, and indicate that physicians require greater support.
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Affiliation(s)
- Janet A Parsons
- Applied Health Research Centre, Li Ka Shing Knowledge Institute, St Michael's Hospital,Toronto, Ontario, Canada
- Department of Physical Therapy and Graduate Department of Rehabilitation Science, University of Toronto,Toronto, Ontario, Canada
| | - Natalie A Baker
- Applied Health Research Centre, Li Ka Shing Knowledge Institute, St Michael's Hospital,Toronto, Ontario, Canada
| | - Telisha Smith-Gorvie
- Division of Emergency Medicine, Department of Medicine, University Health Network (Toronto General Hospital),Toronto, Ontario, Canada
- Department of Medicine, University of Toronto,Toronto, Ontario, Canada
| | - Pamela L Hudak
- The Alternative Dispute Resolution Practice, Toronto, Ontario, Canada
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Yilmaz M, Sayin YY. Turkish translation and adaptation of Champion's Health Belief Model Scales for breast cancer mammography screening. J Clin Nurs 2013; 23:1978-89. [PMID: 24028176 DOI: 10.1111/jocn.12370] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2013] [Indexed: 11/27/2022]
Abstract
AIMS AND OBJECTIVES To examine the translation and adaptation process from English to Turkish and the validity and reliability of the Champion's Health Belief Model Scales for Mammography Screening. Its aim (1) is to provide data about and (2) to assess Turkish women's attitudes and behaviours towards mammography. BACKGROUND The proportion of women who have mammography is lower in Turkey. The Champion's Health Belief Model Scales for Mammography Screening-Turkish version can be helpful to determine Turkish women's health beliefs, particularly about mammography. DESIGN Cross-sectional design was used to collect survey data from Turkish women: classical measurement method. METHODS The Champion's Health Belief Model Scales for Mammography Screening was translated from English to Turkish. Again, it was back translated into English. Later, the meaning and clarity of the scale items were evaluated by a bilingual group representing the culture of the target population. Finally, the tool was evaluated by two bilingual professional researchers in terms of content validity, translation validity and psychometric estimates of the validity and reliability. The analysis included a total of 209 Turkish women. The validity of the scale was confirmed by confirmatory factor analysis and criterion-related validity testing. RESULTS The Champion's Health Belief Model Scales for Mammography Screening aligned to four factors that were coherent and relatively independent of each other. There was a statistically significant relationship among all of the subscale items: the positive and high correlation of the total item test score and high Cronbach's α. The scale has a strong stability over time: the Champion's Health Belief Model Scales for Mammography Screening demonstrated acceptable preliminary values of reliability and validity. CONCLUSION The Champion's Health Belief Model Scales for Mammography Screening is both a reliable and valid instrument that can be useful in measuring the health beliefs of Turkish women. RELEVANCE TO CLINICAL PRACTICE It can be used to provide data about healthcare practices required for mammography screening and breast cancer prevention. This scale will show nurses that nursing intervention planning is essential for increasing Turkish women's participation in mammography screening.
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Affiliation(s)
- Meryem Yilmaz
- Surgical Nursing Division, Department of Nursing, Faculty of Health Sciences, Cumhuriyet University, Sivas, Turkey
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Narushima M, Wong JPH, Li A, Sutdhibhasilp N. Sustainable capacity building among immigrant communities: the raising sexually healthy children program in Canada. Health Promot Int 2013; 29:26-37. [PMID: 23740257 DOI: 10.1093/heapro/dat035] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The Raising Sexually Healthy Children (RSHC) program is a peer-to-peer leadership training program for immigrant parents in Toronto, Canada. It was established in 1998 with the goal of promoting family sex education and parent-child communication. This evaluative study examined the developmental processes and outcomes of the RSHC program to identify the strengths, challenges and insights that can be used to improve the program. It employed a multi-case study approach to compare the RSHC programs delivered in the Chinese, Portuguese and Tamil communities. Data collection methods included focus groups, individual interviews and document analysis. The cross-case analysis identified both common and unique capacity building processes and outcomes in the three communities. In this paper, we report factors that have enhanced and hindered sustainable capacity building at the individual, group/organizational and community levels, and the strategies used by these communities to address challenges common to immigrant families. We will discuss the ecological and synergetic, but time-consuming processes of capacity building, which contributed to the sustainability of RSHC as an empowering health promotion program for immigrant communities. We conclude the paper by noting the implications of using a capacity building approach to promote family health in ethno-racial-linguistic minority communities.
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Garrett JJ, Barrington C. 'We do the impossible': women overcoming barriers to cervical cancer screening in rural Honduras--a positive deviance analysis. CULTURE, HEALTH & SEXUALITY 2013; 15:637-651. [PMID: 23406345 DOI: 10.1080/13691058.2012.760206] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Cervical cancer is the leading cause of cancer death for women in Honduras, and sexual behaviour and low screening uptake are two major factors contributing to high rates of morbidity and mortality. A qualitative study was conducted to investigate barriers that prevent rural Honduran women from engaging in screening and ways that women overcome those barriers. This study examined examples of positive deviance, or individuals engaging in the uncommon but beneficial practise of screening. Amor por sí misma (self-love), and social support were identified as two constructs women employed to overcome barriers to screening. Participants defined self-love as the act of displaying care and concern for oneself and one's health and suggested that it compels women to participate in screening. Social support was defined as receiving tangible aid and advice from others that facilitated women's screening participation. Findings suggest that the concept of self-love could be used in future screening promotion efforts and that integrating social support would also be beneficial. Engaging men in sexual and reproductive health programming is suggested in order to ensure male partners offer social support for screening and to challenge the cultural, gender and sexual norms that place women at higher risk for cervical cancer.
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Affiliation(s)
- Jenna J Garrett
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, NC, USA.
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Harding A, Harper B, Stone D, O'Neill C, Berger P, Harris S, Donatuto J. Conducting research with tribal communities: sovereignty, ethics, and data-sharing issues. ENVIRONMENTAL HEALTH PERSPECTIVES 2012; 120:6-10. [PMID: 21890450 PMCID: PMC3261947 DOI: 10.1289/ehp.1103904] [Citation(s) in RCA: 91] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2011] [Accepted: 09/02/2011] [Indexed: 05/20/2023]
Abstract
BACKGROUND When conducting research with American Indian tribes, informed consent beyond conventional institutional review board (IRB) review is needed because of the potential for adverse consequences at a community or governmental level that are unrecognized by academic researchers. OBJECTIVES In this article, we review sovereignty, research ethics, and data-sharing considerations when doing community-based participatory health-related or natural-resource-related research with American Indian nations and present a model material and data-sharing agreement that meets tribal and university requirements. DISCUSSION Only tribal nations themselves can identify potential adverse outcomes, and they can do this only if they understand the assumptions and methods of the proposed research. Tribes must be truly equal partners in study design, data collection, interpretation, and publication. Advances in protection of intellectual property rights (IPR) are also applicable to IRB reviews, as are principles of sovereignty and indigenous rights, all of which affect data ownership and control. CONCLUSIONS Academic researchers engaged in tribal projects should become familiar with all three areas: sovereignty, ethics and informed consent, and IPR. We recommend developing an agreement with tribal partners that reflects both health-related IRB and natural-resource-related IPR considerations.
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Affiliation(s)
- Anna Harding
- School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR 97331, USA.
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Learning lessons from a traditional midwifery workforce in Western Kenya. Midwifery 2011; 27:324-30. [DOI: 10.1016/j.midw.2011.01.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2010] [Revised: 11/04/2010] [Accepted: 01/26/2011] [Indexed: 11/22/2022]
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Croot EJ, Lees J, Grant G. Evaluating standards in cross-language research: a critique of Squires' criteria. Int J Nurs Stud 2011; 48:1002-11. [PMID: 21571272 DOI: 10.1016/j.ijnurstu.2011.04.007] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2010] [Revised: 04/13/2011] [Accepted: 04/17/2011] [Indexed: 10/18/2022]
Abstract
Innovative methods to conduct cross-language research continue to evolve. There is a need to evaluate the processes involved in cross-language research to assess the extent to which they are fit for purpose from an epistemological point of view, and the subsequent impact on quality of resultant findings. Debate continues about the application of evaluative criteria to qualitative research, not least because of the multiplicity of worldviews and perspectives associated with different qualitative research paradigms. In this article we use two of the authors' studies to discuss how we assess whether methodologies underpinning cross-language research and the choice of methods used are 'fit for purpose'. We use Squires' (2009) 14 criteria to evaluate cross-language nursing and health sciences research based around conceptual equivalence, translator credentials, translator role/competence and study methods, and consider their value as an heuristic or a guide to encourage reflexivity and fuller accounting of the justifications for the approaches taken.
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Affiliation(s)
- Elizabeth J Croot
- University of Sheffield, School of Health and Related Research, 219 Portabello, Sheffield, S1 4DA, United Kingdom.
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Dietsch E, Mulimbalimba-Masururu L. The experience of being a traditional midwife: living and working in relationship with women. J Midwifery Womens Health 2011; 56:161-6. [PMID: 21429082 DOI: 10.1111/j.1542-2011.2011.00025.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The purpose of this project was to learn from traditional midwives about their experience of practicing in an area of rural Kenya. METHODS This qualitative, service-based research project used a simple exploratory and descriptive design. Data were collected through in-depth interviews and fieldwork notes taken during and immediately after the interviews with 84 traditional midwives. Data were thematically analyzed and themes identified through paired-author consensus. Exemplars using the participants' translated words were used for analysis and presentation purposes. RESULTS In being humble, patient, and kind, the traditional midwives used their relationships with women to create an enabling, calm, and physiologically sound intrapartum environment. DISCUSSION Traditional midwives provide a valuable service to women in this area of Kenya at a time when their role is being increasingly devalued by global health agencies. We recommend a redirection of global policy from one that esteems only professional caregivers to one that recognizes the potential value of traditional midwives and supports them through sustainable, evidence-based education and resourcing.
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Affiliation(s)
- Elaine Dietsch
- School of Nursing, and a Midwifery and Indigenous Health , Centre for Inland Health at Charles Sturt University, Australia.
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