English-speaking Population Research Articles

Centering Health Equity Within COVID-19 Contact Tracing: Connecticut's Community Outreach Specialist Program.

Context:The COVID-19 pandemic has disproportionately impacted vulnerable populations, including those who are non–English-speaking and those with lower socioeconomic status; yet, participation of these groups in contact tracing was initially low. Distrust of government agencies, anticipated COVID-19–related stigma, and language and cultural barriers between contact tracers and communities are common challenges.Program:The Community Outreach Specialist (COS) program was established within the Connecticut Department of Public Health (DPH) COVID-19 contact tracing program to encourage participation in contact tracing and address a need for culturally competent care and social and material support among socially vulnerable and non–English-speaking populations in 11 high-burden jurisdictions in Connecticut.Implementation:In partnership with state and local health departments, we recruited 25 COS workers with relevant language skills from target communities and trained them to deliver contact tracing services to vulnerable and non–English speaking populations.Evaluation:We conducted a cross-sectional analysis using data from ContaCT, DPH's enterprise contact tracing system. Overall, the COS program enrolled 1938 cases and 492 contacts. The proportion of residents reached (ie, called and interviewed) in the COS program was higher than that in the regular contact tracing program for both cases (70% vs 57%, P < .001) and contacts (84% vs 64%, P < .001). After adjusting for client age, sex, race and ethnicity, language, and jurisdiction, we found that the COS program was associated with increased reach for contacts (odds ratio [OR] = 1.52; 95% confidence interval [95% CI], 1.17-1.99) but not for cases (OR = 0.78; 95% CI, 0.70-0.88). Rapid qualitative analysis of programmatic field notes and meeting reports provided evidence that the COS program was feasible and acceptable to clients and contributed to COVID-19 education and communication efforts.Conclusion:A COS program employing a client-centered, community-engaged strategy for reaching vulnerable and non–English-speaking populations was feasible and more effective at reaching contacts than standard COVID-19 contact tracing.

Arabic identity in English foreign language classroom conversation: Language selection, patterns, and functions

Conversation analysis is one of the practical strategies for discourse analysis in speaking that may be used to teach oral English in an English foreign language classroom. Through conversational analysis, this study intends to examine the theoretical foundations of Arabian social identity and the possibility of using a discourse way of speaking to educate a group of learners. The current study focuses on cultural disparities between Arabic-speaking and English-speaking populations, examining the impact of such cultural barriers on Arab-English foreign language learners' communication. A case study of English foreign language students from the International Arab Egyptian School (IAES) was conducted to achieve this purpose. Using contrastive rhetoric, several challenges in students' English speaking were explained. Qualitative data analysis of culturally bound distinctions in numerous linguistic features such as letters, vowels, writing style, word use, and syntax, as well as some rhetoric and structural styles such as coordinating, subordinating, and metaphoric styles, revealed the high potential for errors and issues faced by Egyptian EFL students when developing spoken English. Data was collected by recording some sessions and extracting some language from both teachers and students by analyzing the language used inside the classroom. The most significant finding of this research is the organizing training to differentiate the interaction medium in the language classroom. In other words, teachers should use an "interactive decision-making" method in which they must make rapid decisions on which media to use to meet emerging issues such as subject matter comprehension, classroom management, or building a good rapport in the classroom.

Prevelar Vowel Raising and Merger in Manitoba English.

This study examines production of the vowels /æ/, /ɛ/, and /e/ among three different English-speaking ethnic populations in Manitoba, Canada, focusing on patterns of raising and vowel overlap in prevelar contexts. Although raising of /æ/ before /ɡ/ has been documented for the Prairies region of Canada generally, its specific occurrence in Manitoba as well as the occurrence of vowel merger(s) there has not previously been examined in detail. This study finds that pre-velar patterns are distinguished by coda voicing, with voiceless /k/ producing lowering and some retraction while voiced /ɡ/ and /ŋ/ produce similar raising and especially fronting patterns in preceding /æ/ and /ɛ/. Statistical analysis of spatial and temporal qualities shows that, while complete merger is not observed between any of the three vowels, there is much more substantial overlap in their productions before the voiced velars than in other contexts; in contrast, the voiceless velar /k/ is associated with productions which often substantially diverge from these. The results suggest that Manitoba speakers’ productions of these vowels share some features of other dialects with velar-affected productions, but the arrangement of these features in Manitoba may represent a unique configuration having a potential, incipient, or early-stage prevelar merger of /æ/ and /ɛ/, mainly without the participation of /e/. Social factors such as conservatism and extra-local affiliation are also found to play a role in production.

Cross-Cultural Adaptation and Validation of the Dagbani Readiness for Hospital Discharge Scale–New Mother

The Readiness for Hospital Discharge Scale–New Mother (RHDS-NM), originally developed for use in English-speaking populations, is an instrument designed to measure women’s perceptions of readiness for hospital discharge after birth. We translated and cross-culturally adapted the RHDS-NM into Dagbani and conducted reliability and validity assessments of the new Dagbani RHDS-NM in the Tamale Metropolitan Area, Ghana. The average scale-level content validity index was excellent at 1.00. The Dagbani RHDS-NM had a Cronbach’s α reliability coefficient of .94. Exploratory factor analysis indicated four factors with Cronbach’s α reliability coefficients of .958, .915, .899, and .667 that represented the Personal Status, Knowledge, Expected Support, and Coping Ability subscales, respectively. Our findings provide initial evidence to support the reliability and validity of the Dagbani RHDS-NM.

An investigation of the cutoff point of the English version of speech handicap index in the American total laryngectomees

Objectives The present article aims to identify the optimal cutoff score and the diagnostic accuracy for the English version of Speech Handicap Index (SHI) to screen out individuals with and without speech disorders in daily life. Materials and methods In this cross-sectional cohort study, a volunteer sample of 104 adult patients after total laryngectomy and 99 healthy controls in the United States completed the English version of SHI online questionnaire. Sensitivity and specificity were computed for a range of cut-off values using the Receiving Operating Characteristics (ROC) analysis to establish an optimal cutoff point for the SHI. Other measures of diagnostic accuracy, such as likelihood ratios (LR), positive predictive values (PPV), and negative predictive values (NPV) were also computed. Results Patients after total laryngectomy obtained a higher score than the healthy controls on the mean scores of SHI. According to the ROC analysis, an optimal cutoff score of 17 points determined by Youden index was identified on the head and neck cancer population with a sensitivity of 92.31%, specificity of 92.31%, PPV of 90.60%, NPV of 91.75%, LR + of 9.14, and LR- of 0.09. Conclusions The cutoff score of the English version of SHI applied on the English-speaking population in the United States demonstrated promising diagnostic accuracy.

Advancing the assessment of mindful eating: Exploring the psychometric properties and validating the mindful eating behaviour scale in English.

Background: Mindful eating has been described as significant in motivating research and clinical outcomes in weight regulation and healthy eating. The use of psychometric tools to measure mindful eating is problematic, with results often leading to interpretations that are not reflective of mindful eating theory and fundamentals of mindfulness. Aim: In this research, we explored the Mindful Eating Behaviour Scale (MEBS) within a British sample to validate the factorial structure, and widen the use of a scale that appears appropriate for measuring mindful eating. Methods: A community sample (n = 742) was recruited via social media, and the findings supported the factorial structure proposed through the original Dutch sample. Predictive validity was also assessed, with the scale and subscales predicting fat and sugar consumption. Results: Cronbach's α values were acceptable and similar to the original findings, also supporting the internal consistency of the scale. Conclusion: While factorial structure, predictive validity and internal consistency propose a scale that can be adopted with English speaking populations, we propose the potential of furthering scientific inquiry on mindful eating research by highlighting the behavioural aspects of the scale.

Assessing clinical utility of machine learning and artificial intelligence approaches to analyze speech recordings in multiple sclerosis: A pilot study

BackgroundAn early diagnosis together with an accurate disease progression monitoring of multiple sclerosis is an important component of successful disease management. Prior studies have established that multiple sclerosis is correlated with speech discrepancies. Early research using objective acoustic measurements has discovered measurable dysarthria. MethodThe objective was to determine the potential clinical utility of machine learning and deep learning/AI approaches for the aiding of diagnosis, biomarker extraction and progression monitoring of multiple sclerosis using speech recordings. A corpus of 65 MS-positive and 66 healthy individuals reading the same text aloud was used for targeted acoustic feature extraction utilizing automatic phoneme segmentation. A series of binary classification models was trained, tuned, and evaluated regarding their Accuracy and area-under-the-curve. ResultsThe Random Forest model performed best, achieving an Accuracy of 0.82 on the validation dataset and an area-under-the-curve of 0.76 across 5 k-fold cycles on the training dataset. 5 out of 7 acoustic features were statistically significant. ConclusionMachine learning and artificial intelligence in automatic analyses of voice recordings for aiding multiple sclerosis diagnosis and progression tracking seems promising. Further clinical validation of these methods and their mapping onto multiple sclerosis progression is needed, as well as a validating utility for English-speaking populations.

Diversity in bilingual child language acquisition research: A commentary on.

Kidd and Garcia (2022) report that language acquisition studies are skewed towards monolingual and English-speaking populations. This commentary considers Kidd and Garcia's arguments in light of our research on mother-preschooler discourse and non-verbal communication in Thai monolingual and Thai-English bilingual children. We discuss lessons learned from testing linguistically diverse children and underscore the importance of research on non-WEIRD populations. We advocate for the inclusion of children who speak understudied languages and those who speak multiple languages in developmental science.

Post-Pandemic Telehealth Policy for Primary Care: An Equity Perspective.

National telehealth policy thus far has focused on broadening access to service, specialties, and originating sites. Yet telehealth policy can further equity by providing system-level change needed to reduce structural determinants that hamper telehealth access in historically marginalized, low income, and limited English-speaking populations. The authors propose policy solutions for states and CMS to help address these structural determinants of telehealth care. A telehealth "ecosystem" grounded in the following core components would ensure equitable access to care: use of technology inclusive of economically marginalized patients, access to the technology and broadband for completing virtual visits, and concrete support for patients as they develop their digital and telehealth skills.

Predicting subjective well-being in a high-risk sample of Russian mental health app users

Despite recent achievements in predicting personality traits and some other human psychological features with digital traces, prediction of subjective well-being (SWB) appears to be a relatively new task with few solutions. COVID-19 pandemic has added both a stronger need for rapid SWB screening and new opportunities for it, with online mental health applications gaining popularity and accumulating large and diverse user data. Nevertheless, the few existing works so far have aimed at predicting SWB, and have done so only in terms of Diener’s Satisfaction with Life Scale. None of them analyzes the scale developed by the World Health Organization, known as WHO-5 – a widely accepted tool for screening mental well-being and, specifically, for depression risk detection. Moreover, existing research is limited to English-speaking populations, and tend to use text, network and app usage types of data separately. In the current work, we cover these gaps by predicting both mentioned SWB scales on a sample of Russian mental health app users who represent a population with high risk of mental health problems. In doing so, we employ a unique combination of phone application usage data with private messaging and networking digital traces from VKontakte, the most popular social media platform in Russia. As a result, we predict Diener’s SWB scale with the state-of-the-art quality, introduce the first predictive models for WHO-5, with similar quality, and reach high accuracy in the prediction of clinically meaningful classes of the latter scale. Moreover, our feature analysis sheds light on the interrelated nature of the two studied scales: they are both characterized by negative sentiment expressed in text messages and by phone application usage in the morning hours, confirming some previous findings on subjective well-being manifestations. At the same time, SWB measured by Diener’s scale is reflected mostly in lexical features referring to social and affective interactions, while mental well-being is characterized by objective features that reflect physiological functioning, circadian rhythms and somatic conditions, thus saliently demonstrating the underlying theoretical differences between the two scales.

Portable automated rapid testing in Spanish: Validation and norms of central hearing processes on a Mexican population

Portable automated rapid testing of central auditory processing measures implemented in the app PART (https://braingamecenter.ucr.edu/games/p-a-r-t/) were adapted for Spanish-speaking populations. This adaptation included the generation of a corpus equivalent to the CRM to test a speech-on-speech masking task, in addition to frequency modulation tasks, temporal gap, temporal, spectral and spectro-temporal modulations, and pure tone detection in noise. This battery of tests was selected for its potential clinical utility and its previous validation across several settings including remote testing with participant-owned headphones, tablets or smartphones. Here, we tested 96 young adults in Mexico City (ages 18–45) with normal hearing. As expected, distributions of scores were similar to previously reported norms for the English-language version of the battery in English-speaking populations. Scores for the newly developed Spanish-language speech-on-speech masking tests were also similar to data previously reported in English-speaking populations. Furthermore, there was no significant effects of age or subjective hearing handicap (HHIA) in any of the tests. This study can be now used as a normative dataset, and the adapted battery can be used as an accsessible tool (available freely online) for valid and reliable testing of central auditory processing measures in Spanish-language populations.

Examining the relationship between oral language skills and executive functions: Evidence from Greek-speaking 4–5-year-old children with and without Developmental Language Disorder

BackgroundChildren with Developmental Language Disorder (DLD) have been found to demonstrate low performance in Executive Functions (EFs). However, the evidence-based data is so far scarce, especially for 4–5-year-old children. Most of the existing research involves English-speaking populations, while very few studies have been carried out with non-English-speaking populations. Nevertheless, it is documented that possible differences in the language-cognition relations may exist due to the specific characteristics of each language, and studies across different languages could contribute to the above. AimsThe present study aimed to systematically investigate the profile of oral language and EF skills (verbal and nonverbal) and the way these skills are related with each other in 4–5-year-old Greek-speaking children with and without DLD. Methods and proceduresFifty-three 4–5-year-old children (age range: 51– 57 months) with DLD, and 62 Typically Developing (TD) peers (age range: 51– 57 months) were assessed on a standardized psychometric battery for oral language skills (phonological and morphological awareness, oral language comprehension, vocabulary knowledge, narrative speech and pragmatics) and on a series of verbal (v) and nonverbal (nv) tasks tapping EFs skills (updating-accuracy, inhibition –accuracy and reaction time-, and cognitive flexibility). Outcomes and resultsChildren with DLD demonstrated statistically significant lower performance across all oral language measures in comparison to their TD peers. Additionally, they performed significantly lower in the updating (nv) task, as well as in cognitive flexibility (v & nv) in comparison to the TD group. Further regression analyses demonstrated that updating (nv), inhibition (nv) and cognitive flexibility (v) predicted oral language comprehension in children with DLD while updating (v & nv), inhibition-reaction time (nv) and cognitive flexibility (v & nv) predicted phonological and morphological awareness, oral language comprehension, narrative speech as well as total language score in TD children. Conclusions and implicationsThese results provide important information about the profile of oral language and EF skills in children with DLD compared to their TD peers as well as on the relationship of these skills in both groups. The findings also suggest that improving EFs skills may be a possible way for improving oral language skills in young children with DLD. Our findings are discussed in terms of their theoretical as well as practical implications regarding the diagnostic and intervention procedures for children with DLD.

French-Canadian Translation and Cultural Adaptation of the Clinical Opiate Withdrawal Scale: The COWS-FC.

The assessment of opioid withdrawal symptoms is common in both clinical and research settings. The Clinical Opiate Withdrawal Scale (COWS) is among the most frequently used instruments for the assessment of signs and symptoms associated with opioid withdrawal. The COWS is a validated, clinician-administered instrument initially developed and validated for English-speaking populations. To date, however, the COWS has yet to be linguistically and culturally adapted for French-Canadian populations.ObjectiveThe main objective of the present study was to develop a French-Canadian translation and adaptation of the COWS (i.e., the COWS-FC) for the assessment of opioid withdrawal symptoms in clinical and research settings.MethodsThe French-Canadian translation and cultural adaptation of the COWS was performed following guidelines for the translation and cross-cultural adaptation of self-report measures. The steps consisted of (1) initial translation from English to French, (2) synthesis of the translation, (3) back-translation from French to English, (4) expert committee meeting, (5) test of the prefinal version among healthcare professionals and (6) review of final version by the expert committee. The expert committee considered four major areas where the French-Canadian version should achieve equivalence with the original English-version of the COWS. These areas were (1) semantic equivalence; (2) idiomatic equivalence; (3) experiential equivalence and (4) conceptual equivalence.ResultsRigorous steps based on the guidelines for the translation and cultural adaptation of assessment tools were followed, which led to a semantically equivalent version of the COWS. After a pretest among healthcare professionals, members from the expert committee agreed upon slight modifications to the French-Canadian version of the COWS to yield a final COWS-FC version.ConclusionsA French-Canadian translation and adaptation of the COWS (i.e., the COWS-FC) was developed. The COWS-FC could be used for the assessment of opioid withdrawal symptoms in clinical and research settings.

Telehealth diabetes services for non-English speaking patients

BackgroundSeveral studies have shown the use of telehealth in diabetes management to be as efficacious as traditional clinic visits; however, these studies focused on English-speaking populations. ObjectivesThe primary objective of this study was to evaluate whether telehealth is an effective approach for participation in pharmacist collaborative diabetes management services among non-English–speaking or limited English proficiency (LEP) patients at a federally qualified health center (FQHC). The secondary objective was to evaluate glycated hemoglobin (A1c) as a clinical outcome in patients participating in telehealth versus in-person visits. MethodsThis study was a retrospective chart review. Patients were non-English–speaking or LEP adults (≥ 18 years of age) with a diagnosis of type-2 diabetes (T2D) referred for pharmacist collaborative diabetes management services by a medical provider. This study reviewed patient participation and A1c values over 6 months (May to October) of 2 consecutive years (2019 and 2020). ResultsIn this study, 40 patients in 2019 and 50 patients in 2020 met the inclusion criteria. In 2019, the primary visit model was in-person and 123 total visits were scheduled with a pharmacist. In 2020, the primary visit model was telehealth and 143 total visits were scheduled. In 2019, there were 28 no-show visits, which accounted for 22.8% of total visits. In 2020, there were 27 no-show visits, which accounted for 18.9% of total visits. The mean change in A1c from baseline to follow-up was found to decrease by 1.0% in 2019 and 0.95% in 2020. ConclusionsWe concluded that telehealth participation in pharmacist-provided collaborative T2D services and decrease in A1c were similar during telehealth compared with in-person visits among non-English–speaking and LEP patients at a FQHC. However, further studies with larger sample sizes are necessary to determine the overall impact of telehealth in non-English–speaking or LEP patients.

Validation of the English Version of the General Dietary Behavior Inventory (GDBI-E).

In medical science and practice, dietary behavior is mostly assessed by item-extensive questionnaires (e.g., food-frequency-questionnaires) or by questionnaires focusing on psychological aspects of dietary behavior neglecting dietary quality or quantity. In consequence, these questionnaires do not capture the full bandwidth of dietary behavior or are less effective in the assessment of dietary behavior because of the large item pools. Therefore, the aim of this validation study was to translate the existing General Dietary Behavior Inventory (GDBI), which was constructed as a behavior-related, as well as effective, instrument, and verifying its construct and criterion validity. This inventory is based on the general nutrition recommendations of the World Health Organization (WHO). Our English-speaking convenience sample consisted of 263 participants. The study results confirmed convergent, as well as criterion validity of the English version of the GDBI (GDBI-E). Discriminant validity of the GDBI-E could mainly be verified. Different dietary behavior clusters were identified in a cluster analysis. The found clusters represented a rather healthy and a rather unhealthy dietary behavior in the sample according to the recommendations of the WHO. The results underpinned the validity of the GDBI-E. The GDBI-E is applicable in research and clinical practice to assess dietary behavior in the English-speaking population.

Translation of the quality of life questionnaire for primary ciliary dyskinesia (QOL‐PCD) into Hebrew: The Israeli experience

BackgroundPatients with primary ciliary dyskinesia (PCD) have chronic morbidities affecting their quality of life (QOL). Health‐related QOL (HRQOL) has been recognized as an important tool for assessing the burden of PCD on patients and their families. A PCD‐specific HRQOL questionnaire (QOL‐PCD) was developed and validated for the English‐speaking populations. Still, it has not yet been translated into Hebrew or adapted for Israeli PCD patients.MethodsThis describes our translation of the original English version of QOL‐PCD into a Hebrew version. The process involved forward translation by independent translators, construction of a consensus version, back‐translation into the original English version, analysis by the expert committee, and a pretest. The pretest was administered to 20 participants with PCD (the patients and the parents of minor patients) to assess the feasibility and practicality of the tool. Scale and item indices (scale‐level content validity index [S‐CVI] and item‐level content validity index [I‐CVI]) were calculated for content validity.ResultsAll study participants understood the final Hebrew version that the expert committee had approved with no difficulty. The instrument had satisfactory (>0.80) content validity, with S‐CVI indexes of 0.99 for the adult version, 0.86 for the parental version, 0.95 for the adolescent version, and 1.00 for the child version.ConclusionThe English version of a QOL‐PCD was translated into Hebrew and adapted in Israel. This translation is a valid instrument to assess HRQOL in Hebrew‐speaking patients with PCD and their family members. It may be helpful for PCD patient management and research in Israel.

Measurement of Pain and Related Symptoms in Irritable Bowel Syndrome: The Use of Validated Pain Measurement Tools

This paper reviews the tools available to assess outcomes of treatment in irritable bowel syndrome, especially the effect on abdominal pain. Tools were identified through a wide-ranging scrutiny of PubMed and Google Scholar, together with a review of further references quoted in those publications. It critically considers their development, relevance and reliability. The Irritable Bowel Severity Scoring System (IBS-SSS) was the first simple method of monitoring the progress of the disease and its treatment. It led on to other instruments, such as The Irritable Bowel Syndrome Quality of Life (IBS-QOL). It is easier to read and faster to complete than the IBS-SSS., However, these and other tools were developed for English speaking populations. This review considers the impact of ethnicity and gender, together with the lack of information on the effect of age on the potential validity of these tools in other populations. Issues with the adequacy and appropriateness of translations of such tools are discussed. The overall conclusion is that there are few tools which meet the criteria necessary to place confidence in their validity as appropriate measures of patient outcomes.

Different Language Modalities Yet Similar Cognitive Processes in Arithmetic Fact Retrieval.

Does experience with signed language impact the neurocognitive processes recruited by adults solving arithmetic problems? We used event-related potentials (ERPs) to identify the components that are modulated by operation type and problem size in Deaf American Sign Language (ASL) native signers and in hearing English-speaking participants. Participants were presented with single-digit subtraction and multiplication problems in a delayed verification task. Problem size was manipulated in small and large problems with an additional extra-large subtraction condition to equate the overall magnitude of large multiplication problems. Results show comparable behavioral results and similar ERP dissociations across groups. First, an early operation type effect is observed around 200 ms post-problem onset, suggesting that both groups have a similar attentional differentiation for processing subtraction and multiplication problems. Second, for the posterior-occipital component between 240 ms and 300 ms, subtraction problems show a similar modulation with problem size in both groups, suggesting that only subtraction problems recruit quantity-related processes. Control analyses exclude possible perceptual and cross-operation magnitude-related effects. These results are the first evidence that the two operation types rely on distinct cognitive processes within the ASL native signing population and that they are equivalent to those observed in the English-speaking population.

Construct Validity of the Pictogram Test for Diagnosis of Schizophrenia.

Objectives: To examine construct validity of the Pictogram Test (PT) which assesses disturbances in thinking in individuals with schizophrenia. The PT was developed in Russia; it was found to be applicable for the English-speaking population of the USA. The variables of the PT were correlated with Minnesota Multiphasic Personality Inventory (MMPI-2).Method: Russian-and English-speaking participants completed the PT and MMPI-2 in their native languages.Results: The PT variables that reflected attribute selection choice of intermediate concepts for memorization and the variables that were geometrical shapes had significant correlations with MMPI-2 scales linked to schizophrenia. This represents evidence of convergent validity. The same PT indices did not significantly correlate with most of the MMPI-2 scales that are not elevated in schizophrenia, representing some discriminant validity of the PT.Conclusions: The less often the participants were able to connect target words with economical intermediate concepts, the higher were the elevations of schizophrenia-related scales. Also, the more abstract and remote their intermediate concepts, the less often they recalled targets. These findings give evidence of the validity of the PT in assessing the thinking of individuals with schizophrenia and related conditions.

The Future of Virtual Care for Older Ethnic Adults Beyond the COVID-19 Pandemic.

The COVID-19 pandemic has fundamentally changed how Canadians access health care. Although it is undeniable that the rapid adoption of virtual care has played a critical role in reducing viral transmission, the gap in equitable access to virtual care remains pervasive for Canada’s aging and ethnocultural minority communities. Existing virtual care solutions are designed for the English-speaking, health-literate, and tech-savvy patient population, excluding older ethnic adults who often do not see themselves reflected in these identities. In acknowledging the permanency of virtual care brought on by the pandemic, we have a collective responsibility to co-design new models that serve our older ethnic patients who have been historically marginalized by the status quo. Building on existing foundations of caregiving within ethnocultural minority communities, one viable strategy to realize culturally equitable virtual care may be to engage the highly motivated and skilled family caregivers of older ethnic adults as partners in the technology-mediated management of their chronic disease. The time is now to build a model of shared virtual care that embraces Canada’s diverse cultures, while also providing its older ethnic adults with access to health innovations in partnership with equally invested family caregivers who have their health at heart.