Bilingual Health Professionals Research Articles

Translation, Cross-Cultural Adaptation and Psychometric Validation of the Arabic Version of the Cardiac Rehabilitation Barriers Scale (CRBS-A) with Strategies to Mitigate Barriers.

Cardiac rehabilitation (CR) utilization is low, particularly in Arabic-speaking countries. This study aimed to translate and psychometrically validate the CR Barriers Scale in Arabic (CRBS-A), as well as strategies to mitigate them. The CRBS was translated by two bilingual health professionals independently, followed by back-translation. Next, 19 healthcare providers, followed by 19 patients rated the face and content validity (CV) of the pre-final versions, providing input to improve cross-cultural applicability. Then, 207 patients from Saudi Arabia and Jordan completed the CRBS-A, and factor structure, internal consistency, construct, and criterion validity were assessed. Helpfulness of mitigation strategies was also assessed. For experts, item and scale CV indices were 0.8-1.0 and 0.9, respectively. For patients, item clarity and mitigation helpfulness scores were 4.5 ± 0.1 and 4.3 ± 0.1/5, respectively. Minor edits were made. For the test of structural validity, four factors were extracted: time conflicts/lack of perceived need and excuses; preference to self-manage; logistical problems; and health system issues and comorbidities. Total CRBS-A α was 0.90. Construct validity was supported by a trend for an association of total CRBS with financial insecurity regarding healthcare. Total CRBS-A scores were significantly lower in patients who were referred to CR (2.8 ± 0.6) vs. those who were not (3.6 ± 0.8), confirming criterion validity (p = 0.04). Mitigation strategies were considered very helpful (mean = 4.2 ± 0.8/5). The CRBS-A is reliable and valid. It can support identification of top barriers to CR participation at multiple levels, and then strategies for mitigating them can be implemented.

Translation, Cross-Cultural Adaptation, and Psychometric Validation of the Russian Coronary Artery Disease Education Questionnaire II (CADE-Q II) in chronic coronary syndrome patients

Aim. This study sought to translate, cross-culturally adapt, and psychometrically validate the Coronary Artery Disease Education Questionnaire II (CADE-Q II) in Russian.Material and methods. Independent translations and back-translations of the CADE-Q II were conducted by bilingual health professionals and certified translators, respectively. Experts met to consider cultural relevance of the items to Russian patients. The finalized version was then pilot tested in a group of patients to assess understanding and time to complete the tool. Following these steps, 303 patients with a diagnosis of stable coronary artery disease treated in the Outpatient Cardiology Department between April and November 2021 completed the CADE-Q II. The following psychometric properties were evaluated: confirmatory factor analysis, internal consistency (assessed by Cronbach's alpha), test-retest reliability (ICC), and criterion validity (assessed through the association with CADE-Q II and The Self Care of Coronary Heart Disease Inventory and SF-36 scores, among other characteristics from the participants including educational level).Results. After items were translated, revised, culturally adapted and finalized, 30 patients took 30 minutes to complete the CADE-Q II during pilot test and questionnaire was considered understandable by all. Factor analysis (Kaiser-Meyer-Olkin =0.692 and Bartlett's criterion of Sphericity <0.05) revealed four factors, all internally consistent and aligned with the original version of the questionnaire. Cronbach's alpha of subscales ranged from 0.61 to 0.88 and ICC was 0.81. Criterion validity was confirmed by significant differences in total CADE-Q II scores by participants' educational level and correlations between CADE-Q II and The Self Care of Coronary Heart Disease Inventory scores (r=0.251, p<0.05).Conclusion. The Russian CADE-Q II presented sufficient validity and reliability for use to assess disease-related knowledge of chronic coronary syndrome patients in Russia.

Collaborating with Culturally Competent Prenatal Education among Hispanic Communities.

IntroductionHispanics represent the largest minority group in the United States. In Kansas, the population of Hispanics has been increasing; unfortunately, their infant mortality rate has increased as well. Baby Talk is a prenatal education program promoting maternal and infant health through risk-reduction strategies and healthy decision-making. The aim of this pilot project was to develop and evaluate a Spanish curriculum for Baby Talk.MethodsA collaborative partnership between bilingual community members and health professionals from different origins, nationalities, and Spanish dialects was formed to create a culturally and linguistically appropriate Spanish Baby Talk curriculum. This interventional pilot mixed methods research study employed quantitative and qualitative methods to evaluate participant knowledge, intentions, satisfaction, and perceptions of the new curriculum.ResultsFifteen pregnant women participated in Spanish Baby Talk. Of those, 12 participated in either phone interviews (n = 6) or a focus group (n = 6). All respondents described their experience with the Spanish Baby Talk program as “excellent”. Significant increases in knowledge were seen related to topics such as benefits of full-term pregnancy and benefits of breastfeeding. Four themes were identified from the focus group and interviews: 1) lack of accessible community resources; 2) sense of community; 3) Spanish Baby Talk strengths; and 4) areas for improvements.ConclusionsFindings suggested that the Spanish Baby Talk curriculum was linguistically appropriate and resulted in increases in knowledge and intentions related to health and safety behaviors. Areas for improvement were related to marketing the program and referring to resources that provide material supports (i.e., diapers) to continue the move towards a culturally competent program.

Translation, Cross-Cultural Adaptation, and Psychometric Validation of the Chinese/Mandarin Cardiac Rehabilitation Barriers Scale (CRBS-C/M).

Objective Cardiovascular diseases are among the leading causes of morbidity in China and around the world. Cardiac rehabilitation (CR) effectively mitigates this burden; however, utilization is low. CR barriers in China have not been well characterized; this study sought to translate, cross-culturally adapt, and psychometrically validate the CR Barriers Scale in Chinese/Mandarin (CRBS-C/M). Methods Independent translations of the 21-item CRBS were conducted by two bilingual health professionals, followed by back-translation. A Delphi process was undertaken with five experts to consider the semantics and cross-cultural relevance of the items. Following finalization, 380 cardiac patients from 11 hospitals in Shanghai were administered a validation survey including the translated CRBS. Following exploratory and confirmatory factor analysis, internal consistency was assessed. Validity was tested through assessing the association of the CRBS-C/M with the CR Information Awareness Questionnaire. Results Items were refined and finalized. Factor analysis of CRBS-C/M (Kaiser Meyer Olkin = 0.867, Bartlett's test p < 0.001) revealed five factors: perceived CR need, external logistical factors, time conflicts, program and health system-level factors, and comorbidities/lack of vitality; Cronbach's alpha (α) of the subscales ranged from 0.67 to 0.82. The mean total CRBS score was significantly lower in patients who participated in CR compared with those who did not, demonstrating criterion validity (2.35 ± 0.71 vs. 3.08 ± 0.55; p < 0.001). Construct validity was supported by the significant associations between total CRBS scores and CR awareness, sex, living situation, city size, income, diagnosis/procedure, disease severity, and several risk factors (all p < 0.05). Conclusions CRBS-C/M is reliable and valid, so barriers can be identified and mitigated in Mandarin-speaking patients.

Report finds Utah needs more early‐childhood MH services

While Utah has increasingly focused its attention on the teen mental health crisis, younger children also face a shortage of resources that could prevent long‐term emotional and physical health problems, according to a new study, the Deseret News reported Oct. 5. National estimates show between 10% and 20% of Utah children through age 8 could experience mental, emotional, developmental or behavioral challenges, Samantha Ball, senior research associate with the Kem C. Gardner Policy Institute, said as she presented key findings from the institute's soon‐to‐be‐released study during the inaugural Summit on Children's Mental Health. “Utah also has among the highest prevalence of youth mental health disorders and those who are not receiving care in the nation,” she noted. There's also limited access to mental health providers, who are “unevenly distributed” in Utah, Ball noted. Other barriers are cost, transportation, waiting lists and a limited number of bilingual and multicultural mental health professionals. Some therapists also don't feel comfortable treating children age 4 and younger. The report calls for collection of data on early‐childhood mental health services, the number of children receiving services and school‐based mental health services.

'I had to stifle my feelings' - Bilingual health professionals translating for family members in a healthcare setting. A qualitative study.

As an alternative to a professional interpreter, children or relatives often act as so-called 'language brokers' in the healthcare sector. Litterature have demonstrated that the cultural context is significant for the potential outcome for child language brokers. For individuals from a collectivistic family pattern, it becomes natural and is often regarded as respectful, to assist older relatives day and night. Very little is known about young people providing informal translation services in a Scandinavian context. We therefore aimed to capture the lived experiences of bilingual health professionals, students and postgraduates who have experienced interpreting for family members in a healthcare setting. By interviewing bilingual health professionals, we aimed to obtain two perspectives, the translators and the professionals, in one interview. Analysing the conditions, meanings and reasoning, it became possible for us to understand the young translators' situations and how their life conditions affected their reasons for action in certain ways and in certain conditions. The analysis revealed four main themes: (i) the importance of social relations and cultural conditions; (ii) the hidden burden of consequences for participants' health conditions due to the focus on health-related consequences and emotionally difficult situations experienced by the participants; (iii) participants experienced limitations in language skills as a challenge; and (iv) being 'in between' in the encounter with the professional system. When family members interpret for the family, the family interpreter is at risk of being excluded by the family or being exposed to and involved in highly sensitive dilemmas that may forever impair normal family relations: health professionals should be aware of this and take professional responsibility.

Cross-Cultural Adaptation And Pilot Testing Of The Cancer Care Coordination Questionnaire For Patients (CCCQ-P) In Chinese And Arabic Languages.

BackgroundThe Cancer Care Coordination Questionnaire for Patients (CCCQ-P) has been designed to measure patients’ experience of this crucial aspect of their cancer care. Migrants are at particular risk of receiving poorly coordinated cancer care due to challenges in communication as well as unfamiliarity with the health system and roles of health professionals. The aim of this study was to cross-culturally adapt and pilot test the CCCQ-P in Chinese and Arabic languages.MethodsThis study followed an established five-stage process for cross-cultural adaptation of self-report measures. The CCCQ-P was forward and back-translated into Arabic, Simplified Chinese, and Traditional Chinese languages by two independent translators. An expert committee review panel appraised the translations, resulting in a pre-final version in the target languages. Face validity, content validity, and consistency of the translated CCCQ-P were then assessed in a sample of bilingual former cancer patients and health professionals. In addition, structured interviews were conducted to explore the meaning of each question and responses to participants.ResultsThirteen health professionals (7 Chinese, 6 Arabic) and 19 former cancer patients (11 Chinese, 8 Arabic) participated in the face validation. Across both language groups, participants agreed that the cross-culturally adapted and translated versions had clear instructions and response options that were appropriate and understandable. All items were considered important and significant to the tool and so no item was removed. Complex medical words caused some differences in preferred terminology in Arabic and Chinese; however, participants agreed that the meaning of the questions and response options was not lost.ConclusionThe Arabic, Simplified Chinese, and Traditional Chinese cross-culturally adapted and piloted versions of the CCCQ-P are useful tools to measure patients’ experience of cancer care coordination. Further validation and psychometric testing of the instrument are warranted.

Standardization of an Arabic-Language Neuropsychological Battery for Epilepsy Surgical Evaluations.

This study provides a standardized Arabic language neuropsychological test battery and tests its ability to distinguish patients with left and right hemisphere epileptic foci who are candidates for surgical resection. An Arabic language battery of 15 tests was developed based on the neuropsychological test battery used at the Johns Hopkins Hospital for surgical evaluation of patients undergoing temporal lobe resection. With modifications where culturally required, 11 tests were translated to Arabic by the principal investigator and back-translated by two bilingual health professionals; four tests were available in Arabic and added to the battery. The battery was administered to 21 Arabic-speaking patients with left temporal epileptic foci, 21 with right temporal epileptic foci, and 46 neurologically and psychiatrically healthy adults. Nearly all the Arabic test versions were capable of differentiating healthy controls and the temporal lobe epilepsy (TLE) groups. Tests known to distinguish left and right temporal lobectomy candidates, such as wordlist memory and prose recall, were able to do so as accurately as the English versions. Also, a roughly "culturally free" task (the Baltimore Board) and a newly developed version of the Boston Naming Test demonstrated some sensitivity to left temporal lobe involvement. Arabic-language neuropsychological tests for epilepsy surgical evaluations are made available, demonstrate cultural sensitivity and clinical validity, and require further psychometric property and normative research. (JINS, 2019, 25, 761-771).

A narrative review of the evidence regarding the use of telemedicine to deliver video-interpreting during dementia assessments for older people.

As Australia's aging population increases and diversifies, there will be a growing need to address the burden of dementia among culturally and linguistically diverse (CALD) communities. Due to a lack of CALD-appropriate services and bilingual health professionals, older people from CALD backgrounds often receive a delayed diagnosis of dementia. The use of telemedicine (TM) to deliver video-interpreting services may overcome the barriers of interpreter availability when diagnosing and assessing dementia in older people from CALD backgrounds. This paper aims to present a review of the literature on the use of TM to deliver video-interpreting during dementia assessments. Factors affecting the reliability and agreement, feasibility, and satisfaction and acceptability when using TM or video-interpreting have been described. The review found evidence that dementia assessments conducted via TM are as reliable as face-to-face (FTF) assessments and that participants are satisfied and find TM acceptable. There was less evidence about the feasibility of TM from the health care perspective, particularly regarding the acceptability and potential financial cost-savings. Only five studies investigated the use of video-interpreting during clinical assessments with CALD patients. Although video-interpreting was found to be satisfactory among CALD patients and clinicians, a common finding was the preference for FTF interpreting. More research is needed to examine the financial feasibility and the health care perspective on the implementation and adoption of TM for dementia assessments. The use of TM to deliver video-interpreting for dementia assessments has never been investigated and represents a significant gap in the literature.

Tradução e adaptação do Check List RE-AIM para a realidade Brasileira

&#x0D; &#x0D; &#x0D; O objetivo foi traduzir e adaptar os itens de codificação relacionados às dimensões do modelo RE-AIM para auxiliar no planejamento e avaliação de programas de promoção da atividade física e saúde, bem como na análise da qualidade do relato em estudos de revisão sistemática. Foram realizadas equivalência conceitual, de itens e semântica por profissionais de saúde mono e bilíngues. Na análise conceitual e de itens foi realizada discussão entre especialistas e na semântica, tradução inversa (inglês para português) e reversa (português para inglês) dos itens. Posteriormente, foi avaliada a equivalência entre as retraduções e o conteúdo original. Dessa forma, foi apresentada a tradução e adaptação dos 54 itens que permite o planejamento e avaliação de programas e dos 21 itens para análise da qualidade das informações relatadas em evidências científicas. Espera-se contribuir para o planejamento e avaliação de programas ou revisões sistemáticas para promoção da atividade física e saúde.&#x0D; &#x0D; &#x0D;

Context of Breastfeeding among Latina Mothers using a Social-ecological Approach: An Exploratory Study

Emerging research has begun to examine the breastfeeding experiences among racial/ethnic minority women. However, limited research to date has explored the potential factors that impact Latina mothers' breastfeeding through a multi-level lens. We examined the context of breastfeeding among Latina mothers in an exploratory study. We conducted semi-structured interviews with a convenience sample of 9 Latina mothers. Guided by the social-ecological model, thematic content analysis was used. Latina mothers described individual- (e.g., knowledge of breastfeeding), interpersonal- (e.g., social support and norms), institutional- (e.g., healthcare system), and community-level (e.g., cultural norms) influences on their breastfeeding. Mothers recommended provision of bilingual and bicultural health professionals, information on US breastfeeding norms, and Latino-friendly informational materials in other languages. Considering the multi-level factors that shape Latina mothers' breastfeeding is essential to develop and implement culturally tailored initiatives and facilitate access to breastfeeding support to improve maternal and infant health.

Abstract A30: The role of community health workers in disseminating colorectal cancer guidelines in Asian Americans

Abstract Background Community health workers (CHWs) are lay people from within the communities where they work, who share common characteristics with their members, such as ethnicity, culture, and language. They are frontline health workers who often serve socially and linguistically isolated populations. As trusted members of their communities, they provide critical links between community and systems of care. CHWs can empower community members with enhanced health knowledge, help navigating health systems, and access to care. This study examined the central role of CHWs in disseminating colorectal cancer screening guidelines in seven Asian immigrant communities (Cambodian, Chinese, Filipino, Korean, Lao, South Asian, and Vietnamese) in Chicago. Method The parent project was designed to use a community-centered dissemination model to promote the adoption of colorectal cancer (CRC) screening guidelines in seven Asian communities. In this study, we used social marketing campaign and CHWs as part of the intervention to disseminate CRC screening guidelines. Although social marketing campaigns can create public awareness, they rarely shape attitudes and bring behavior change. To take community members from awareness to commitment and then action, we used CHWs as influencers. All ten CHWs recruited in this study were bicultural and bilingual health professionals. In addition, all CHWs had at least a bachelor's degree, had worked in the community for more than a year and well understood the social norms of the community. All CHWs were required to attend a 6-hour training course on CRC screening, motivational interviewing techniques, and the application of Stage of Change Theory. A CHW guidebook, which listed rationales and components of the intervention, was given to the CHWs. The roles and responsibilities of the CHW (outreaching, educating, navigating and collecting data) were also clearly stated in the guidebook. All CHEs were committed 20 hours/week for the project during the 12-week intervention period. Both quantitative and qualitative data were collected during and after the CHW intervention through weekly activity logs, site visits notes, and focus groups with implementation CHWs at the end of the project. Results Our ten CHWs placed 320 posters (in English or native language) to promote CRC screening in different venues, such as restaurants, churches, temples, and grocery stores, that were frequented by local community members. They also sent out 4,665 CRC postcards to clients on their mail lists. Besides one-on-one counselling session, CHW also conducted 32 CRC information sessions (&amp;gt; 5 people). Across the seven communities, over 2,400 community residents were reached through one-on-one education or small group information sessions over the 12-week intervention period. Most of the CHWs used familiar places to do their outreach, such as in-house programs (e.g. senior services or immigrant programs) or other places that they have implemented programs before. They also used other opportunities, such when they were shopping at the community store or in a bible study, as well as family and friend gatherings, to disseminate CRC screening guidelines. Although not all people they encountered wanted to be screened, they felt that they at least got them thinking about CRC and had impact on them. For personal experience, most CHWs stated that the project increased their knowledge of CRC and they also felt valued. Discussion Participation of CHWs in this demonstration project was invaluable. Each CHW brought critical knowledge of their community, its language, values, norms, and health beliefs. CHWs are uniquely positioned to deliver culturally ad linguistically tailored intervention and can serve as a source of peer support and social influence. Citation Format: Karen Kim, Michael Quinn, Edwin Chandrasekar, Helen Lam. The role of community health workers in disseminating colorectal cancer guidelines in Asian Americans. [abstract]. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2016 Sep 25-28; Fort Lauderdale, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(2 Suppl):Abstract nr A30.

Improving management of type 2 diabetes in South Asian patients: a systematic review of intervention studies

ObjectivesOptimal control of type 2 diabetes is challenging in many patient populations including in South Asian patients. We systematically reviewed studies on the effect of diabetes management interventions targeted at...

Bridging barriers to health promotion: a feasibility pilot study of the 'Promoting Aging Migrants' Capabilities study'.

Improving the possibilities for ageing persons to take control over their health is an increasingly important public health issue. Health promotion has previously been visualized to succeed with this goal, but research has primarily focused on ageing persons who are native-born, leaving the generalizability to persons who are foreign-born unexplored. Therefore, as part of the development of a larger health promotion initiative for ageing persons who have experienced migration, this study aimed to assess the feasibility of an adapted protocol. The specific feasibility objectives were to assess recruitment procedure, retention rates, study questionnaire administration and variability of collected data. Forty persons who were ≥70 years, and who had migrated from Finland, Bosnia and Herzegovina, Croatia, Montenegro or Serbia to Sweden were randomly allocated to a health promotion programme or a control group. The programme was linguistically adapted with regard to translated information material, bilingual health professionals and evaluators, and a person-centred approach was applied to both programme development and provision. The data analysis was explorative and descriptive. The results visualized structural and linguistic barriers to recruitment and study questionnaire administration, and describe strategies for how to bridge them. Retention rates and data variability were satisfying. Calling for iterative and pragmatic programme design, the findings describe how to move towards a more inclusive health care environment. Person-centred and bilingual approaches with attention to the possibilities for building authentic relationships between participants and providers are emphasized, and a structured methodology for developing study questionnaires is suggested.

Trauma and Second Language Learning among Laotian Refugees

Unprecedented numbers of adult refugee learners are entering ESL classes, many of whom escaped war-torn countries and endured long stays in refugee camps. Research in public health and psychology has documented high levels of depression, anxiety, and posttraumatic stress disorder in refugee populations. Drawing on ethnographic research with Laotian refugee women who experienced pre-settlement trauma during the Vietnam War and interviews with bilingual mental health professionals, this article examines current second language acquisition theories to consider how they elucidate the effect of trauma on second language learning. The article offers cross-cultural perspectives about the impact of trauma on learning and recommendations for working with adult refugee learners who have experienced trauma. Findings have implications for ESL instructors and second language researchers concerned with the impact of presettlement experiences on second language acquisition and implications for classroom instruction.

Chronic disease management in developed and developing countries: a cardiovascular case study

CALD Australians are over-represented in the figures of consumers experiencing difficulties managing their medicines. To address this inequality, NPS MedicineWise developed an in-language educational program on the quality use of medicines (QUM) for CALD consumers from ten language groups. As a novel approach, it is delivered by bilingual pharmacists in their native tongue. It aimed to: Improve awareness and knowledge of quality use of medicines among CALD seniors; Influence their behaviour in a manner that supports QUM; and create and strengthen partnerships with ethnospecific organisations and bilingual health professionals. Methods: Education seminars were developed for 2 topis, Safe and wise use of medicines and Managing pain. Education seminars were run nationally over 12 months in ten different languages. Telephone surveys were conducted in-language with 50 Korean, 50 Macedonian and 50 Spanish consumers attending a seminar on Safe and Wise Use of Medicines. A retrospective pre-test design was used to assess any changes in knowledge and behaviour as a result of attending the seminars. Results: There was a significant increase in the number of CALD consumers using their medicines correctly. The seminars prompted improvements in recognition of the risks of using medicines, including, allergic reactions (+11.3%, p1⁄40.015); side effects (+10%, p1⁄40.017); combining different types of medicines (+9.3, p1⁄40.046). The seminars also successfully prompted respondents to use a medicines list. The top three likes of participants were: It provided helpful information (92.7%, n1⁄4139); it was conducted in the participants’ own language (48%, n1⁄472); and it was presented by a health professional (40%, n1⁄460). Conclusions: Empowering the consumer to take control of their medicines management is an important step to improving health outcomes. The seminars helped participants make informed choices about their medicines in partnership with their health professional, by encouraging them to ask the right questions and increase their own knowledge.

A Comparison of Human and Machine Translation of Health Promotion Materials for Public Health Practice

Most local public health departments serve limited English proficiency groups but lack sufficient resources to translate the health promotion materials that they produce into different languages. Machine translation (MT) with human postediting could fill this gap and work toward decreasing health disparities among non-English speakers. (1) To identify the time and costs associated with human translation (HT) of public health documents, (2) determine the time necessary for human postediting of MT, and (3) compare the quality of postedited MT and HT. A quality comparison of 25 MT and HT documents was performed with public health translators. The public health professionals involved were queried about the workflow, costs, and time for HT of 11 English public health documents over a 20-month period. Three recently translated documents of similar size and topic were then machine translated, the time for human postediting was recorded, and a blind quality analysis was performed. Seattle/King County, Washington. Public health professionals. (1) Estimated times for various HT tasks; (2) observed postediting times for MT documents; (3) actual costs for HT; and (4) comparison of quality ratings for HT and MT. Human translation via local health department methods took 17 hours to 6 days. While HT postediting words per minute ranged from 1.58 to 5.88, MT plus human postediting words per minute ranged from 10 to 30. The cost of HT ranged from $130 to $1220; MT required no additional costs. A quality comparison by bilingual public health professionals showed that MT and HT were equivalently preferred. MT with human postediting can reduce the time and costs of translating public health materials while maintaining quality similar to HT. In conjunction with postediting, MT could greatly improve the availability of multilingual public health materials.

Health Services for Linguistic Minorities in a Bilingual Setting

We explore in this qualitative research the challenges faced by bilingual health and social services professionals in a Canadian bilingual setting, as well as the strategies used to overcome them. Eight focus groups were conducted with a total of 43 bilingual Francophone professionals who offered services in French in 21 health and social service organizations in eastern Ontario, Canada. We highlight linguistic issues affecting a minority Francophone clientele, the shortage of services in French, and organizational issues within these agencies. The solutions that the professionals adopt for better serving the clients and overcoming these challenges focus on adapting services from linguistic angles. In the long term, such an enhanced approach can affect staff well-being. Ensuring access to services for linguistic minority populations and the active offer of same should not rest solely on the shoulders of such professionals, but rather on organizational strategies.

A pilot of an intervention delivered to Chinese- and Spanish-speaking carers of people with dementia in Australia.

There are limited language- and culture-specific support programs for carers of people with dementia living in Australia. A group intervention for use with Chinese and Spanish speakers in the United States was adapted to the Australian context, and a pilot study was undertaken with these 2 communities. The intervention is based on a cognitive behavioral therapy approach and was delivered by bilingual health professionals. The adapted material comprised 7 sessions, spanning 2 hours in duration. All 22 participants completed the Depression Anxiety and Stress Scale-Short form (DASS-21) pre- and postintervention. A significant decrease in depression, anxiety, and stress was observed among Spanish speakers; a significant decrease in depression and anxiety was present among the Chinese speakers. The implications are considered in the context of Australia's changing aged care service system.

Building Capacity to Improve Latino Health in Rural North Carolina: A Case Study in Community-University Engagement

In North Carolina, health disparities for the emergent Latino population are well documented. Between 2005 and 2009, a community-university engagement model with Latino leaders and university faculty and students in rural eastern North Carolina worked to address solutions to health disparities among Latinos. Based on principles of community-based participatory research, this model focused on partnership formation and capacity building. Community partners acquired leadership and research skills. University partners gained a local understanding of Latino health through collaborative community and systems-level initiatives. Mutual benefits were achieved in partnerships established, resources leveraged, and community members reached. These strategies can be replicated in other communities that have an immigrant Latino population, community-oriented, bilingual health professionals, and a university committed to engagement.