English-speaking Participants Research Articles

Low literacy skills in adults can be largely explained by basic linguistic and domain-general predictors.

Despite having sufficient formal education, a large group of people cannot complete everyday tasks like reading, writing, or making basic calculations. Regarding reading, millions of people are not able to understand more complex texts despite the ability to read simple words or sentences; they have low literacy skills. Even though this problem has been known for decades, the causes and predictors of their poor reading comprehension skills are not fully explored. Socioeconomic, sociodemographic, and reading-related (i.e., linguistic) factors, especially of English-speaking participants and thus users of an opaque orthography, were often assessed. The goal of this study was to examine which linguistic, domain-general, or numerical factors predict substandard complex text reading as the core symptom of low literacy skills in adulthood. To this end, we assessed a group of German-speaking participants-users of a transparent orthography-who are at risk for complex text reading deficits. The results indicated that linguistic variables (reduced word/pseudoword reading, weaker oral semantic and grammatical comprehension), working memory, and age predicted lower performance in text comprehension. This model explained 73% of the total variance, indicating that most of the deficits in complex text reading can be explained by a group of basic underlying linguistic and domain-general factors. We conclude that interventions for adults with low literacy skills and others at risk for complex text reading deficits should address word/pseudoword reading and focus on both written and oral comprehension.

A rank ordering and analysis of four cognitive-behavioral stress-management competencies suggests that proactive stress management is especially valuable

The main objective of this study was to determine the relative value of four cognitive-behavioral competencies that have been shown in empirical studies to be associated with effective stress management. Based on a review of relevant psychological literature, we named the competencies as follows: Manages or Reduces Sources of Stress, Manages Thoughts, Plans and Prevents, and Practices Relaxation Techniques. We measured their relative value by examining data obtained from a diverse convenience sample of 18,895 English-speaking participants in 125 countries (65.0% from the U.S. and Canada) who completed a new inventory of stress-management competencies. We assessed their relative value by employing a concurrent study design, which also allowed us to assess the validity of the new instrument. Regression analyses were used to rank order the four competencies according to how well they predicted desirable outcomes. Both regression and factor analyses pointed to the importance of proactive stress-management practices over reactive methods, but we note that the correlational design of our study has no implications for the possible causal effects of these methods. Questionnaire scores were strongly associated with self-reported happiness and also significantly associated with personal success, professional success, and general level of stress. Data were collected between 2007 and 2022, but we found no effect for time. The study supports the value of stress-management training, and it also suggests that moderate levels of stress may not be as beneficial as previously thought.

Patient, Parental, and Health Professional Perspectives on Growth in Children With CKD

Growth failure is a common problem among children with chronic kidney disease (CKD). Reduced height is associated with psychosocial burden, social stigma, and impaired quality of life. This study aimed to describe the aspects of growth impairment that are most impactful from the perspectives of children with CKD, their parents, and health professionals. Qualitative study. 120 children with CKD (aged 8-21 years), 250 parents, and 445 health professionals from 53 countries participated in 16 focus groups, two consensus workshops, and a Delphi survey. A thematic analysis of all qualitative data concerning growth from the Standardized Outcomes in Nephrology - Children and Adolescents (SONG-Kids) initiative. We identified five themes: diminishing psychological wellbeing (compared to and judged by peers, tired of explaining to others, damaging self-esteem), constrained life participation and enjoyment (deprived of normal school experiences, excluded from sports or competing at a disadvantage, impaired quality of life in adulthood); grappling with impacts of symptoms and treatment (difficulty understanding short stature and accessing help, lack of appetite, uncertainty regarding bone pains, medication side effects, burden of growth hormone treatment); facilitating timely interventions and optimizing outcomes (early indicator of disease, assessing management, maximizing transplant outcomes, minimizing morbidity); and keeping growth and health priorities in perspective (quality of life and survival of utmost priority, achieved adequate height). Only English-speaking participants were included. Impaired growth may diminish psychological wellbeing, self-esteem, and participation in daily activities for children with CKD. Balancing different treatments that can affect growth complicates decision-making. These findings may inform the psychosocial support needed by children with CKD and their caregivers to address concerns about growth.

The role of Anupreksha meditation in alleviating negative thinking among adults: a cross-sectional study

Background: Anupreksha-based meditations (AM) involve focusing on objects including images, colors, sounds, and the nature of the body and soul. Similar to Preksha meditation, which has shown positive effects on mental and physical well-being, AM is proposed to have potential benefits. However, the impact of AM on negative thinking, a key factor in various psycho-physiological ailments, has not been thoroughly examined. This study aimed to explore the effectiveness of AM in reducing negative thoughts and improving mental-health and well-being. It hypothesized that practicing AM can positively alter thought patterns and enhance overall well-being. Methods: A total of 462 English-speaking participants aged 19 to 60 years. Among them, 233 were regular AM practitioners with at least 12 months of experience, and 229 were non-meditators. Self-reported scales were used to measure perseverative thinking, mindfulness, self-compassion, and spiritual well-being. Results: Data were checked for normality and the Mann-Whitney U-test was performed. The AM group showed significant lower perseverative thinking scores (p<0.001) and higher mindfulness, self-compassion, and spiritual well-being scores (p<0.001). The scores of perseverative thinking negatively correlated with mindfulness (rho -0.53; p<0.001), self-compassion (rho -0.43; p<0.001), and spiritual well-being (rho -0.22; p<0.001) in meditators. Additionally, mindfulness positively correlated with self-compassion (rho 0.42; p<0.001) and spiritual well-being (rho 0.36; p<0.001). Conclusions: Shreds of evidence indicated that the practice of Anupreksha-based meditations alleviates negative thoughts by promoting mindfulness, self-compassion, and spiritual well-being. Therefore, the AM can be suggested to improve the positive state of mind and also can be practiced to mitigate psychological-related issues.

Comparing Patients’ Perceptions of Dry Eye Disease Between Spanish- and English-Speaking Patients in the United States

Purpose It is well-known that patients’ perceptions of their disease can impact management strategies and disease outcomes. Limited knowledge exists on such perceptions in dry eye disease (DED) and the role of language in these perceptions. Herein, we compared the perceptions about DED between Spanish- and English-speaking patients. Methods This cross-sectional study included 146 patients with DED who underwent ophthalmic evaluation and completed questionnaires assessing their perceptions of DED on a 10-point scale during their routine appointments. Perceptions included opinions on the level of satisfaction with understanding of DED, ease of following doctor’s advice, effectiveness of treatment, satisfaction with DED care, and outlook on DED. Perceptions were categorized as low (scores 0–2), moderate (scores 3–7), and high (scores 8–10). The percentage of patients with high perception scores were then compared between Spanish- and English-speaking patients. Results There were 48 Spanish speakers and 98 English speakers. Overall, high scores of DED perceptions were identified in 47.9% for satisfaction with the level of understanding of DED, 72.6% for ease of following doctor’s advice, 52.1% for helpfulness of DED treatment, 64.4% for satisfaction with DED care, and 52.1% for optimistic outlook on DED. High scores for satisfaction with the level of understanding of DED were significantly lower in Spanish speakers (27.1%) than English speakers (58.2%, p < .001). No significant differences were observed in other perceptions between Spanish- and English-speaking participants. Conclusions Spanish-speaking subjects reported lower satisfaction with their understanding of DED than English speakers. Clinicians should provide health services and educational materials in the patient’s preferred language to minimize barriers to understanding their disease.

Metaphor and gender: are words associated with source domains perceived in a gendered way?

Abstract Conceptual metaphors are one of many linguistic devices that can potentially encode and reinforce gender stereotypes. However, little is known about how metaphors encode gender stereotypes, and in previous literature the concept of “gendered metaphor” has been mostly assumed rather than attested. We take the first step to tackle this issue by examining the gender typicality of specific metaphorical source domains. In the present paper, we conducted three rating experiments (N total = 1,060 English-speaking participants) to determine the genderedness of 50 keywords associated with five frequently used source domains (building, competition, journey, plant, and war). We found that keywords associated with three source domains (building, competition, and war) were viewed as more masculine, while keywords associated with the source domains of journey and plant were viewed as more feminine. These data offer empirical verification for gendered perceptions of keywords associated with some frequently used source domains. The result also provides the first evidence that metaphors could encode gender stereotypes by selection of source domains.

Association of Racial Status and Training Language with Baseline Performance and Training Gains During Computerized Training of Technology-related Everyday Functional Skills In Older Adults

ObjectivesResearch consistently finds that lower baseline performance predicts greater gains with computerized training. Lower baseline performance can originate from many factors, including educational and environmental disadvantages, leading to reduced exposure to functional tasks. Across six computerized technology-related functional skills, baseline performance and training gains were compared across race and training language. DesignRandomized clinical trial. SettingAbout 14 community centers in New York City and Miami. ParticipantsParticipants aged 60–90 with diverse ethnic (52% Latinx) and racial (27% Black) status, trained in in English (60%) or Spanish (40%). InterventionRemotely delivered computerized cognitive and skills training (FUNSATTM) for an hour twice a week for up to 12 weeks. MeasurementsCompletion time across all 6 tests pre and post training. ResultsThe total sample included 42 Black English Speakers, 52 White English speakers, and 61 Spanish speakers. Spanish speakers had the poorest baseline performance on all tasks, underperforming English-speaking Latinx participants. However, Spanish speaking participants had the largest training gains. Lower MOCA scores predicted lower baseline performance and greater training gains across samples. Educational attainment predicted training gains only in the Spanish speakers. Despite education effects in this group, all improvements were statistically significant with large effect sizes. ImplicationsLower baseline performance of functional skills was a positive predictor of training gains and was efficiently reversed through training. Even participants who initially appeared more impaired achieved substantial gains, congruent with the results reported in psychiatric populations. Critically, low baseline competence should not be interpreted as reflecting negatively on potential training gains.

Characterizing the Communication Networks of Spanish- and English-Speaking Latinx Sexual Minority Men and Their Roles in Pre-Exposure Prophylaxis Uptake

While pre-exposure prophylaxis (PrEP) has demonstrated efficacy in preventing HIV transmission, disparities in access persist in the United States, especially among Hispanic/Latinx sexual minority men (SMM). Language barriers and differences in how Latinx SMM obtain information may impact access to PrEP and HIV prevention. This study used data from the 2021 American Men’s Internet Survey (AMIS) to examine differences in communication networks and PrEP use among Latinx SMM by primary language (Spanish vs. English). We examined the associations between Latinx SMM’s individual- and meso-level communication networks and PrEP-related outcomes using modified Poisson regression with robust variances. Spanish-speaking Latinx SMM in the study were less likely to test for HIV, be aware of PrEP, and use daily PrEP, compared to English-speaking participants. Sexuality disclosure to a healthcare provider was positively associated with PrEP uptake among all participants and predicted STI testing over the past 12 months among English-speaking Latinx SMM. Findings highlight disparities in PrEP awareness and uptake among Latinx SMM, especially among those whose primary language is Spanish. Addressing these disparities through targeted interventions, including improved communication with healthcare providers, may help facilitate PrEP access and use in this population.

Echoes of Culture: Relationships of Implicit and Explicit Attitudes With Contemporary English, Historical English, and 53 Non-English Languages

Attitudes are intertwined with culture and language. But to what extent? Emerging perspectives in attitude research suggest that cultural representations in language are more related to implicitly measured (vs. explicitly measured) attitudes, and that such relationships persist across history and diverse languages. We offer a comprehensive test of these ideas by correlating (a) attitudes toward 55 topics (e.g., Rich/Poor, Dogs/Cats, Love/Money) from ~100,000 U.S. English-speaking participants with (b) representations of those same topics in word embeddings from contemporary English text, 200 years of English books, and 53 non-English languages. Strong and robust relationships emerged between representations in contemporary English and implicitly but not explicitly measured attitudes. Moreover, strong correlations with implicitly measured attitudes persisted across 200 years of books, and most non-English languages. Results provide new insights into the nature of implicitly measured attitudes and how they are intertwined with cultural representations that are relatively hidden in patterns of language across time and place.

Developing a multimedia patient-reported outcomes measure for low literacy patients with a human-centered design approach.

Almost all patient-reported outcomes measures (PROMs) are text-based, which impedes accurate completion by low and limited literacy patients. Few PROMs are designed or validated to be self-administered, either in clinical or research settings, by patients of all literacy levels. We aimed to adapt the Patient Reported Outcomes Measurement Information System Upper Extremity Short Form (PROMIS-UE) to a multimedia version (mPROMIS-UE) that can be self-administered by hand and upper extremity patients of all literacy levels. Our study in which we applied the Multimedia Adaptation Protocol included seven phases completed in a serial, iterative fashion: planning with our community advisory board; direct observation; discovery interviews with patients, caregivers, and clinic staff; ideation; prototyping; member-checking interviews; and feedback. Direct observations were documented in memos that underwent rapid thematic analysis. Interviews were audio-recorded and documented using analytic memos; a rapid, framework-guided thematic analysis with both inductive and deductive themes was performed. Themes were distilled into design challenges to guide ideation and prototyping that involved our multidisciplinary research team. To assess completeness, credibility, and acceptability we completed additional interviews with member-checking of initial findings and consulted our community advisory board. We conducted 12 hours of observations. We interviewed 17 adult English-speaking participants (12 patients, 3 caregivers, 2 staff) of mixed literacy. Our interviews revealed two distinct user personas and three distinct literacy personas; we developed the mPROMIS-UE with these personas in mind. Themes from interviews were distilled into four broad design challenges surrounding literacy, customizability, convenience, and shame. We identified features (audio, animations, icons, avatars, progress indicator, illustrated response scale) that addressed the design challenges. The last 6 interviews included member-checking; participants felt that the themes, design challenges, and corresponding features resonated with them. These features were synthesized into an mPROMIS-UE prototype that underwent rounds of iterative refinement, the last of which was guided by recommendations from our community advisory board. We successfully adapted the PROMIS-UE to an mPROMIS-UE that addresses the challenges identified by a mixed literacy hand and upper extremity patient cohort. This demonstrates the feasibility of adapting PROMs to multimedia versions. Future research will include back adaptation, usability testing via qualitative evaluation, and psychometric validation of the mPROMIS-UE. A validated mPROMIS-UE will expand clinicians' and investigators' ability to capture patient-reported outcomes in mixed literacy populations.

A comparison of different connected-speech tasks for detecting mild cognitive impairment using multivariate pattern analysis

ABSTRACT Background It is common for the elderly population to have age-associated cognitive decline and/or develop neurodegenerative diseases such as dementia. Several studies have suggested that classification algorithms based on linguistic features may be useful for the early detection of mild cognitive impairment (MCI). Aims The current study aimed to examine connected-speech performance in people with MCI and cognitively healthy controls (HC). It tests whether patterns of lexical-semantic features extracted from these tasks could distinguish participants with MCI from HC, using univariate and multivariate analyses. Methods & procedure We selected 16 English-speaking participants with MCI and 16 matched HC from the Delaware corpus. Four connected-speech tasks (a picture description, a story narrative, a story recall, and a procedural narrative). Eight lexical-semantic features were selected for analyses. Outcomes & results Univariate analyses showed inter-group differences in revision ratio, core lexicon, or open/closed class words ratio, depending on the task. Multivariate pattern analysis (MVPA) results demonstrated that the story recall task is the only task that can discriminate the two groups above chance. Conclusion To conclude, results showed that connected-speech tasks have the potential to detect subtle language changes in people with MCI. In particular, the story recall task had the potential to predict the group of a participant (MCI or HC).

Effects of fundamental frequency changes on spoken sound loudness.

This study aimed to investigate the perception of loudness in response to changes in fundamental frequency (F0) in spoken sounds, as well as the influence of linguistic background on this perceptual process. The results revealed that participants perceived changes in F0 to have accompanying changes in loudness, with a trend of lower F0 sounds being perceived as louder than higher F0 sounds. This finding contrasts with previous studies on pure tones, where increases in frequency typically led to increases in loudness. Furthermore, the study examined differences between two distinct groups of participants: Chinese-speaking and English-speaking individuals. It was observed that English-speaking participants exhibited a greater sensitivity to minor intensity changes compared to Chinese-speaking participants. This discrepancy in sensitivity suggests that linguistic background may play a significant role in shaping the perception of loudness in spoken sound. The study's findings contribute to our understanding of how F0 variations are perceived in terms of loudness, and highlight the potential impact of language experience on this perceptual process.

Psychosocial Experiences of Spanish-Speaking Parents of Children With Craniofacial Microsomia.

Craniofacial microsomia (CFM) and microtia psychosocial research in the US is primarily with English-speaking participants. Given that 19% of the US is Latino, and there is a higher prevalence of CFM in Latino populations, this study aims to describe psychosocial experiences related to CFM among Spanish-speaking Latino caregivers to better inform health care. Narrative interviews (mean 73±17min) were completed in Spanish with parents of children with CFM aged 3 to 17 (mean age 10.8±4.8years). Transcripts were analyzed using quantitative linguistic analyses and reflexive thematic analysis. Participants (N=12) were mostly mothers (83%) who had immigrated to the US and had low socioeconomic status. Based upon analysis of grouped word counts, participants spent approximately half of their narratives discussing the first two years of their child's life. Themes selected based on US Latino sociodemographics and cultural values included the Impact of Language, Healthcare Challenges, Supportive Healthcare Experiences, Caregiver Coping with CFM, Family Roles, and Addressing Social Implications of CFM. Results highlighted that the first years of care are of critical importance to parents and suggest this is an optimal time to focus on education and support services for families. Additional treatment suggestions include providing interpretation and informational materials in Spanish, addressing care barriers, supporting familial and child coping, accounting for the role of extended family, and helping address social concerns. Ongoing research with Latino families can further assist in guiding culturally sensitive CFM health care.

Validation of Patient-Reported Outcomes in Patients With Nonmetastatic Breast Cancer Receiving Comprehensive Nodal Irradiation in the RadComp Trial

Our purpose was to evaluate the measurement properties of patient-reported outcome (PRO) measures used in the ongoing RadComp pragmatic randomized clinical trial (PRCT). The deidentified and blinded data set included 774 English-speaking female participants who completed their 6-month posttreatment assessment. Eleven PRO measures were evaluated, including the Trial Outcome Index from the Functional Assessment of Cancer Therapy-Breast (FACT-B), Satisfaction with Breast Cosmetic Outcomes, the BREAST-Q, and selected Patient-Reported Outcomes Measurement Information System (PROMIS) measures. PROs were measured at 3 timepoints: baseline, completion of radiation therapy (RT), and 6 months post-RT. Ten variables were used as validity anchors. Pearson or Spearman correlations were calculated between PROs and convergent validity indicators. Mean PRO differences between clinically distinct categories were compared with analysis of variance methods (known-groups validity). PRO change scores were mapped to change in other variables (sensitivity to change). Most correlations between PROs and validity indicators were large (≥0.5). Mean score for Satisfaction with Breast Cosmetic Outcomes was higher (better) for those with a lumpectomy compared with those with a mastectomy (P < .001). Mean scores for the FACT-B Trial Outcome Index and for PROMIS Fatigue and Ability to Participate in Social Roles and Activities were better for those with good baseline performance status compared with those with poorer baseline performance status (P < .05). At completion of RT and post-RT, mean scores for Satisfaction with Breast Cosmetic Outcomes and BREAST-Q Radiation were significantly different (P < .001) across categories for all Functional Assessment of Chronic Illness Therapy -Treatment Satisfaction - General items. There were medium-sized correlations between change scores for FACT-B Trial Outcome Index, Fatigue, Anxiety, and Ability to Participate in Social Roles and change scores in the Visual Analog Scale. For patients with nonmetastatic breast cancer receiving radiation in the RadComp PRCT, our findings demonstrate high reliability and validity for important PRO measures, supporting their psychometric strength and usefulness to reflect the effect of RT on health-related quality of life.

Navigating the climate change minefield: the influence of metaphor on climate doomism

Climate doomism is an increasing concern for climate change communication. In the United States, this opinion regarding anthropogenic climate change is now more prevalent than climate skepticism, and is the primary reason cited for opposition to climate action. Doomism is the belief that catastrophic warming of the planet is now inevitable, and that effective mitigation is impossible. The behaviors resulting from this view are comparable to the result of climate skepticism: doomism produces paralyzing eco-anxiety and subsequently inaction. Prior work has hypothesized that the rise in climate doomism and eco-anxiety is linked to climate change risk communication. This study investigates the possibility that the metaphoric language used to communicate the severity and urgency of climate change could inadvertently promote doomism. We employ a survey model to test the influence of metaphoric language on perception of urgency, feasibility, and individual agency in relation to the climate crisis. American English-speaking participants (N = 1,542) read a paragraph describing climate change either as a “cliff edge” or “minefield,” with human agency manipulated to be present or absent. Responses were considered to be doomist if they reported a high sense of urgency, paired with a low sense of feasibility and/or agency; this indicates they have a high awareness of the risks associated with the climate crisis, but a low belief that it will be addressed, and/or that their actions can produce meaningful change. Use of either metaphor improved perceived feasibility without a reduction in urgency, indicating that metaphor is an effective climate communication strategy for conveying risk without promoting doomism. However, metaphoric presentation is only effective when paired with human agency, suggesting that agency is a necessary component for successful metaphoric climate communication strategies.

Abstract PS18-08: Bridging Disparities in Survivorship Care: Leveraging Telehealth for Diverse Patients in Safety Net Hospital

Abstract Background There are 3.8 million breast cancer survivors (BCS) in the United States and 67-88% of them report unmet needs in survivorship care. With advancements in breast cancer treatment and improved survival rates, there is a growing need to expand survivorship care to address the long-term physical, psychosocial, and medical needs of cancer survivors. There is a significant disparity in access to high-quality survivorship care, particularly for diverse patient populations in safety net hospitals. BCS in marginalized communities experience worse health-related quality of life (HRQOL) outcomes following cancer treatment in the management of symptoms, complications of treatment, and overall health-related distress. Thus, new models that leverage complex care management principles and novel care delivery systems, such as telehealth, are needed to provide multidisciplinary care and support for self-management. Methods We conducted a single-arm, pilot intervention trial of telehealth group medical visits (tGMV) in a safety net hospital serving low-income and racially and ethnically diverse BCS. The study team included physicians, advanced practitioners, PCPs, clinical psychologists, nurses, dieticians, exercise instructors, Traditional Chinese Medicine practitioners, sexual health counselors, research coordinators, and patient navigators. We enrolled a total of 6 cohorts of 7-10 BCS for the tGMV intervention (2 cohorts each in English, Spanish, and Cantonese). Each cohort had four weekly sessions on the following topics: 1) Reclaiming your health after cancer, 2) Managing emotional health, 3) Sexual health and relationship, and 4) Food is medicine. All participants were trained on the telehealth video conference platform. The curriculum was culturally adapted in the Spanish and Cantonese cohorts. Study staff followed up with participants by phone after each session. We evaluated feasibility and acceptability as primary outcomes with prespecified thresholds for &amp;gt;90 % completion of planned sessions and &amp;gt;70% attendance. Participants’ evaluation of the intervention and self-efficacy were secondary outcomes, which are not reported in this abstract. Results Fifty-three women with stage I-III breast cancer were enrolled in the study. The age was 37 to 75 (median: 58). There were 14 (26%) English-speaking participants, 19 (36%) Spanish-speaking participants, and 20 (38%) Cantonese-speaking participants. Eight (15%) participants identified as White, three (5.7%) Black A/A, 23 (43%) Asians, and 19 (36%) Hispanic; 43 (81%) participants were foreign-born. Twenty-seven (51%) participants reported food insecurity on the screening survey. The overall attendance rate was 98% (English: 97%, Spanish: 97%, and Cantonese: 100%). Of the 53 participants, 41 (77%) found the telehealth format acceptable, 47 (88%) agreed/strongly agreed that it was easy to log in and stay connected, 53 (100%) agreed/strongly agreed that tGMV were a good use of their time, 52 (98%) understood the purpose of the telehealth format, and 50 (94%) felt the information was easy to understand. Conclusions Telehealth-delivered group medical visits are feasible and acceptable in a safety net setting and are a promising intervention that may help in addressing the unmet needs of cancer survivors. We also found that despite the reported low uptake of telehealth in safety net settings, emphasis on training and technical support during sessions can increase the utilization of telehealth. Citation Format: Ivan Leung, Evelin Trejo, Ana Velázquez Mañana, Elizabeth Castillo, Barbara Cicerelli, Robin McBride, Piera Wong, Huiyu Xie, Lily Zhang, Nancy Burke, Niharika Dixit. Bridging Disparities in Survivorship Care: Leveraging Telehealth for Diverse Patients in Safety Net Hospital [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PS18-08.

Disparities in Postpartum Pain Management After Cesarean Delivery [ID 2683520

INTRODUCTION: We evaluated whether postpartum pain management differs by practice setting, ethnicity, insurance, and preferred language in women with cesarean deliveries (CDs). METHODS: This is a retrospective cohort study. Participants who underwent CD at term between 2021 and 2022 were included. Participants with history of opioid use, allergies to NSAIDS, general anesthesia, and postpartum stay greater than 5 days were excluded. The outcomes measures include number of oral “as needed” opioids received measured in morphine milligram equivalents, frequency of pain scores done on the postpartum unit, initial pain scores, pain scores at discharge, and the type and amount of opioids prescribed at discharge. The association of these outcomes based on practice setting (federally funded health center [FFHC] versus private practice [PP]), public versus private insurance, preferred language (English versus non-English), and Hispanic versus Non-Hispanic ethnicity were evaluated. Institutional review board approval was obtained. RESULTS: Four hundred seventy-nine participants were included. FFHCs received less “as-needed” opioids than patients of PP (P=.03). Publicly insured received less opioids than privately insured at discharge (P=.03). English-speaking participants were asked about their pain more frequently (P=.05) and received more inpatient opioids than non-English-speaking participants (P=.00). Non-Hispanic participants were asked about their pain more frequently (P=.042) and were more likely to be discharged with opioid-only medications (P=.04) than Hispanic patients who were discharged with combined medications (P=.03). CONCLUSION: Women attending FFHC, non-English-speaking, with public insurance, and of Hispanic ethnicity experience disparities in postpartum pain management. Targeted protocols should be developed to eliminate the disparities that exist in postpartum pain management.

Assessing the Effectiveness of a Unique Visual Aid in Improving Women's Knowledge of the Hysterectomy Procedure [ID 2683416

INTRODUCTION: This study aims to determine the efficacy of a visual aid in improving women's knowledge of the hysterectomy procedure. Currently, there is a lack of literature that examines evidence-based hysterectomy patient education, and a recent literature review stated that there is a deficit in education surrounding the different hysterectomy treatment options. METHODS: This is IRB study #Pro2021000882. Patients were recruited from the Department of Obstetrics, Gynecology &amp; Reproductive Health at the Ambulatory Care Center at University Hospital in Newark, New Jersey. Participants consented and patient information was de-identified. Participants completed a 28-question pre-test, watched the visual aid in either English or Spanish, and then completed the same 28-question post-test. For both English- and Spanish-speaking participants, the percentage of participants who answered each pre- and post-test question correctly was calculated. Finally, average pre-test scores were compared to average post-test scores for each language. RESULTS: After watching the video, average test scores of English-speaking (N=30) participants increased by 19.76 (95% CI: 10.9, 28.6) percentage points, whereas Spanish-speaking (N=20) participants increased by 28.93 (95% CI: 19.7, 38.1) percentage points. From the 28-question knowledge test, there were 15 questions in the English version and 23 questions in the Spanish version where the percent of respondents who answered that question correctly after watching the video improved by 20 percentage points or greater compared to before watching the video. CONCLUSION: Our preliminary data provide evidence that the hysterectomy visual aid/video we created significantly improves knowledge of the hysterectomy procedure as measured by a validated hysterectomy knowledge quiz.

Prenatal Decision-Making in Patients with Limited English Proficiency: What Factors are Involved?

A comprehensive definition of culture encompasses shared norms, beliefs, expectations, language, and customs, all of which are crucial considerations when working with patients with limited English proficiency (LEP). In this study, the authors examined how language, external influences, and patient-provider relational factors associated with decisional conflict in prenatal care patients. The authors conducted a cross-sectional study to assess decisional conflict related to postpartum contraception, elective induction, and newborn feeding methods. The survey included questions about demographics, communication methods, external influences, and provider trust, and was distributed to prenatal care patients who spoke either English or Spanish. Data analysis involved using descriptive statistics and chi-square analyses. Out of the 23 respondents, 12 were Spanish-speaking and 11 were English-speaking. Spanish-speaking participants were less likely to have health insurance compared to English-speaking participants (χ2(1, N = 23) = 3.67, p = 0.016). There was no statistically significant difference in decisional conflict between English- and Spanish-speaking participants. Religion affected 11 of 23 participants' decisions, while partner expectations influenced 10 of 23 participants. Working with an interpreter and the quality of interpretation were crucial for Spanish-speaking individuals. Most participants (59%) felt that the provider's understanding of the patient's cultural background was important for decision-making. While there was no association between language discordance and decisional conflict, several factors influencing prenatal decision-making were identified. The use and quality of interpretation significantly affected decision-making and should be prioritized for patients with LEP. Religion and partner expectations were found to be highly influential in decision-making. Respondents also emphasized the importance of the provider's understanding of the patient's cultural background.

Ways to Improve Uptake of Tier 2 Weight Management Programmes in BAME Communities in Medway

Overweight and obesity is usually determined by Body Mass Index (BMI). Twelve BAME adults participated in the interviews: six were female, ten were first-generation migrants, three were retirees, none lived with a disability, and all were concerned about their excess weight. There were four themes from the data and eight subthemes obtained. To improve the uptake of the weight management service provided in Medway, the participants recommended the use of strategies such as indigenous food labelling, BAME-led clinics, the use of translated leaflets, the recruitment of local weight management champions, better coordination of services, appropriate communication strategies, and further research. This study investigated a small sample of English-speaking participants, which may not represent all people from BAME backgrounds in Medway and across the United Kingdom (UK). This study investigated the perspectives of residents who are overweight or obese, as well as weight management concerns among ethnically diverse adults. It also investigated how to increase the use of weight management services in Medway, England. In Medway, 69.2% of adults are living with overweight or obesity, which is considerably higher than the national average of 62%. Indigenous food labelling, BAME-led clinics, the use of translated leaflets, the recruitment of local weight management champions, better coordination of services, appropriate communication strategies, and further research are essential ingredients that can be used to improve access to and uptake of weight management programmes in BAME communities.