Preferred Language Research Articles

Clinical genetic counselors' use of people- and identity-first language in regard to patients' identification with disability.

The language surrounding disabilities has evolved from derogatory terms to the adoption of people-first language. However, identity-first language is being advocated for by some within the disability community. Using the preferred terminology is crucial to demonstrate respect and prevent stigmatization, especially in healthcare settings like genetic counseling, where language can impact relationships with the community. However, the specific language practices of genetic counselors and their underlying reasons are unclear. This qualitative study explored the language practices employed by genetic counselors when interacting with individuals with disabilities. Fifteen interviews were conducted with genetic counselors who had clinical experience. Reflexive thematic analysis revealed that the perceptions and practices about language used with patients and disability communities overall varied, with overarching themes of people-first language is the preferred and default language, counselors mirror patient language with some exceptions, acknowledging the evolving nature of language, recognizing differences in language preferences, and reacting to outdated terminology. These findings show the importance of continuing education to stay abreast of preferred verbiage within communities and individual patients.

Primary Human Papillomavirus Screening: Women's Perceptions of New Cervical Cancer Screening Recommendations.

Background: Current clinical guidelines recommended primary human papillomavirus (HPV) screening for cervical cancer testing. Previous studies reported patient-level barriers (e.g., limited knowledge and attachment to Pap test) that may hinder wide adoption of primary HPV screening. We assessed these women-level factors following the implementation of primary HPV screening (July 2020) at Kaiser Permanente Southern California (KPSC). Methods: We administered a patient survey (mail and on-line) to female KPSC members aged 30-65 years who received primary HPV screening between October and December 2020. Those who preferred English vs. Spanish language were sampled separately. The survey included domains on knowledge about HPV and HPV screening, awareness of screening guidelines, and attitudes about HPV testing. Demographic data were collected using electronic health records. We used weighted multivariable logistic and modified Poisson regressions for associations between language preference and survey responses. Results: In total, 3,009 surveys were returned (38.0% response rate). Few women (7.0%) found HPV testing as an acceptable screening method. The majority of women (92.2%) remained unaware that HPV testing can replace Pap test for screening. The Pap test was the most preferred screening approach for 33.2% Spanish-speaking women vs. 19.9% English-speaking women. Only 20.6% knew that women aged 30-65 years can be screened every 5 years with cotest or primary HPV screening. Most women (96.4%) did not perceive stigma about taking the HPV test. Conclusion: Proactive patient education will help improve women's knowledge about primary HPV screening, which may facilitate its implementation in additional health care settings.

Antenatal depression and drug use among deaf and hard-of-hearing birthing parents: results from a U.S. National Survey.

This study aimed to investigate antenatal depression and drug use among deaf and hard-of-hearing (DHH) birthing parents who use American Sign Language (ASL), spoken English, or bilingually both ASL and English. DHH participants in the United States responded to the Survey on Pregnancy Experiences of Deaf and Hard-of-Hearing Women. Respondents self-reported their antenatal depression diagnoses and drug use (i.e., pain relievers, cannabis, or illicit drugs) during their last pregnancy. Poisson regression models were used to estimate prevalence ratios, adjusting for age, race/ethnicity, education, marital status, and parity. The average age of respondents (n = 587) was 35 years. Respondents were predominantly non-Hispanic white (80%), college educated (60%), and married (74%). Relative to DHH English-speakers, DHH ASL-users had lower prevalence of reporting antenatal depression diagnosis (aPR = 0.40, 95% CI: 0.23 to 0.72). DHH people who reported antenatal depression diagnosis had higher prevalence of reporting antenatal drug use (PR = 2.34, 95% CI: 1.65 to 3.33). There were no significant associations between preferred language and antenatal drug use. DHH ASL-users are less likely to report receiving an antenatal depression diagnosis compared to DHH English-speakers. Given well-documented patient-provider communication barriers among DHH ASL-users, it is unclear if the lower prevalence observed in this study is the result of inadequate or inaccessible screening during pregnancy. Future work should consider universal use of linguistically appropriate screening tools for DHH birthing parents in both clinical and research settings.

Does Changes in the Muscles Beneath the Submucosal Tissues Necessitate a Novel Strategy in the Medical Management of OSMF: A Systematic Review.

This study is envisioned to assess the structural changes the muscles undergo beneath the submucosal tissues and whether these changes necessitate a novel strategy from the existing conventional modality in the treatment of oral submucous fibrosis (OSMF) medically through a systematic literature survey. Literature search was performed electronically using Medline, EMBASE and CENTRAL databases to identify published literature until the end of April 2024 in dental, oral and maxillofacial surgery, plastic surgery and otolaryngology journals containing the terms "oral submucous fibrosis", "muscles of mastication", "muscles of facial expression", "histopathologic study", "ultrasonographic study", "CT", "MRI" in either their titles, abstracts, and keywords with only English being the preferred language. The data was extracted from the selected articles and prudently studied to gather and compile the data. Descriptive data from all the carefully chosen articles were selected and analysed. Seven studies met the inclusion criteria. It was observed that the masseter muscle was the first to be involved in the disease process of OSMF among the muscles of mastication and facial expression. It was observed that the anterior temporalis and orbicularis oris muscles remained unaffected. However, the buccinator muscle which lies in utmost vicinity is not evaluated in the included studies. The degree of muscle degeneration and the degree of disease progression were directly related to the duration of the habit. The restricted mouth opening noticed in OSMF is not only governed by the subepithelial fibrosis but also on the extent of muscle degeneration. The changes the surrounding muscles undergo could be a manifestation of the disease, atrophy as a sequalae to the limited functional activity of the muscles which is brought about by fibrosis or it could be an essential part of the disease itself.

Cultural Adaptation of Skills Training in Affective and Interpersonal Regulation Therapy for Spanish-speaking Caribbean Veterans at the VA Caribbean Healthcare System: A preliminary study of feasibility and acceptability in a Primary Care setting

The U.S. Department of Veterans Affairs has endorsed the Skills Training in Affective and Interpersonal Regulation (STAIR) therapy as an effective intervention for reducing PTSD symptoms, enhancing self-regulation, and improving interpersonal efficacy. However, Spanish-speaking veterans at the VA Caribbean Healthcare System lacked access to STAIR manuals in their preferred language. This study addressed this gap by translating and culturally adapting the STAIR therapy participant manual using the Ecological Validity Model (EVM). The materials were then tested in a randomized intervention with six Caribbean Spanish-speaking male veterans, aged 23-62, diagnosed with PTSD who received mental health services at the Primary Care Mental Health Integration (PC-MHI) level of care. Nonparametric tests were used to evaluate symptom progression, and content analysis was conducted on semi-structured interviews. There were no statistically significant changes in PTSD, emotion regulation, or interpersonal problems within the groups. However, participants in the intervention group reported clinically significant changes regarding PTSD symptoms. Interviews with therapists and STAIR participants highlighted improvements in social engagement and interpersonal boundaries. The intervention was found to be feasible and acceptable at PC-MHI. The culturally adapted Spanish version of the STAIR manual proved to be effective, suggesting that STAIR may be a viable approach for reducing PTSD symptoms and improving interpersonal and self-regulation strategies among Spanish-speaking veterans in primary care settings. A randomized control trial is recommended to further explore its efficacy.

Bridging Language Barriers in COVID-19 Research: Descriptive Study of AccesoCovid.com's Reach and User Engagement.

The COVID-19 pandemic underscored the challenge of swiftly disseminating research findings to a global audience. Language barriers further exacerbated disparities in access to timely scientific information, particularly for non-English speaking communities. The majority of COVID-19 research was published in English, limiting accessibility for Spanish-speaking populations. This paper aims to assess the reach and effectiveness of AccesoCovid.com, a platform designed to disseminate up-to-date COVID-19 research in both English and Spanish, addressing the language gap in scientific communication. AccesoCovid.com was developed through a partnership between the University of California, San Francisco (UCSF) and Universidad Nacional Autónoma de México (UNAM). The website's performance and user engagement were evaluated using Google Analytics over a span of 2 years. Key metrics included user language preference, geographical distribution, and site traffic. The website summarized and translated 1032 articles on various COVID-19 topics, such as "Pharmaceutical Interventions and Vaccines." From February 2021 to February 2023, the platform attracted 57,000 users. Of the 43,000 unique new visitors, 84.2% (n=36,219) hailed from Spanish-speaking regions. The majority accessed the site organically through search engines, with 88.4% (n=38,000) of users arriving this way, while 5000 (11.6%) users accessed the site directly. Most users (n=30,894, 72.1%) preferred the Spanish version of the site. The website's most accessed category was "Pharmaceutical Interventions and Vaccines," followed by "Clinical Presentation and Management" and "Mental Health." Regarding language distribution, 72.1% (n=30,894) of users primarily used Spanish; 21.4% (n=9215) used English; and 6.7% (n=2891) spoke other languages, including Portuguese, Chinese, and German. Geographically, the website attracted visitors from 179 countries, with the highest visitor counts from Mexico (n=12,342, 28.7%), Spain (n=6405, 14.9%), the United States (n=4416, 10.3%), and Peru (n=3821, 8.9%). AccesoCovid.com successfully bridged a critical language gap in the dissemination of COVID-19 research. Its success underscores the pressing need for multilingual scientific resources. The platform demonstrated significant user engagement and reach, particularly in Spanish-speaking countries. This highlights the potential for similar platforms to ensure equitable access to scientific knowledge across diverse linguistic communities. Future efforts should focus on expanding to other languages and conducting formal evaluations to enhance user satisfaction and impact.

Characterizing Spanish-speaking patients' patient-centered care experiences in the emergency department.

Patient-centered care (PCC) is an essential component of high-quality health, yet patients with non-English language preferences (NELP) experience worse PCC outcomes. Additionally, there are likely unique aspects to PCC for patients with NELP in the emergency department (ED). To inform the development of strategies to improve PCC for NELP in the ED, we sought to understand how Spanish-speaking ED patients experience care and the factors that influenced their perceptions of the patient-centeredness of that care. We conducted a single-center qualitative study using semistructured interviews with adult, Spanish-speaking patients who had been discharged home from the ED. Interviews were conducted using an interview guide, recorded, transcribed, and analyzed iteratively in Spanish using inductive and deductive thematic analysis. We conducted 19 interviews with participants from 24 to 72 years old. Participants were born in seven different Spanish-speaking countries. Participants identified three domains of PCC: patient, medical team's skills, and system. Several of the identified themes such as shared decision making, open communication, compassionate care, and coordination of follow-up care are often incorporated into PCC definitions. However, other themes, including uncertainty leading to fear, use of professional interpreters to promote understanding, receiving equitable care, technical proficiency, and efficiency of care expand upon existing domains in PCC definitions. We now have a more nuanced understanding of how Spanish-speaking patients with NELP experience PCC in the ED and what matters to them. Several of the themes identified in this analysis add details about what matters to patients within the domains of previous PCC definitions. This suggests that the conceptualization of PCC may vary based on the setting where care is provided and the population who is receiving this care. Future work should consider patient population and setting when conceptualizing PCC.

Fl-IRT-ing with Psychometrics to Improve NLP Bias Measurement

To prevent ordinary people from being harmed by natural language processing (NLP) technology, finding ways to measure the extent to which a language model is biased (e.g., regarding gender) has become an active area of research. One popular class of NLP bias measures are bias benchmark datasets—collections of test items that are meant to assess a language model’s preference for stereotypical versus non-stereotypical language. In this paper, we argue that such bias benchmarks should be assessed with models from the psychometric framework of item response theory (IRT). Specifically, we tie an introduction to basic IRT concepts and models with a discussion of how they could be relevant to the evaluation, interpretation and improvement of bias benchmark datasets. Regarding evaluation, IRT provides us with methodological tools for assessing the quality of both individual test items (e.g., the extent to which an item can differentiate highly biased from less biased language models) as well as benchmarks as a whole (e.g., the extent to which the benchmark allows us to assess not only severe but also subtle levels of model bias). Through such diagnostic tools, the quality of benchmark datasets could be improved, for example by deleting or reworking poorly performing items. Finally, in regards to interpretation, we argue that IRT models’ estimates for language model bias are conceptually superior to traditional accuracy-based evaluation metrics, as the former take into account more information than just whether or not a language model provided a biased response.

Exploring Women's Health and Medical Treatment in Renaissance Italy Through Giovanni Marinello's Treatise

This article looks at a 16th-century medical book called Le medicine partenenti alle infermità delle donne by Giovanni Marinello (Venice, 1574), who wrote it intending to assist midwives and other delivery attendants in improving their professional practices. It is a very successful text that serves as an illustration of the rich body of treatises on women's diseases that were published in Europe in the sixteenth century and up until the first half of the seventeenth and which, despite disagreements and controversies, reflect a rekindled and passionate interest in medicine for the uniqueness of the female body that is beginning to diverge from the scholastic view of woman as an imperfect male. In addition, Marinello's work depicts the nature of contemporary daily life. It provides in great detail natural cures for sterility issues and all conditions related to pregnancy, childbirth, and postpartum, always within the bounds of what is reasonable for a period defined by the ideas of the Council of Trent. The writings of Giovanni Marinello on women's diseases and cosmetics have two main advantages: first, they present traditional medical notions about female physiology and pathology in a way that is understandable through the use of colloquial language and an unpretentious style; second, they provide invaluable information on aspects of daily life. A significant portion of this practical book, which contains both prescribing and discursive material, is devoted to issues related to health and disease, the look of the body in life, pain, and methods to address these issues. Discussions include the human obligation to compete with natural rules, reflections on aesthetic canons and goals, and the interaction between nature and art or technology. The analysis of Marinello's texts focuses on both the form and the substance to make them accessible to a primarily female readership. The purpose of Marinello's three books, organized in a chronological order that starts with marriage and ends with childbirth, is to inform women of all the methods for maintaining their bodies and posses-sions. In the first book, we discuss eliminating all the annoying obstacles like urinary incontinence or lousy breath while discussing various sterility therapies in the seco- nd and pregnancy and childbirth in the third one. Despite the abundance of graphic and comprehensive erotic counsel, Marinello always sees it as an essential medical treatise while guaranteeing procreation. Mari- nello consequently highlights women's health through reproduction to safeguard the marriage and family unit. In addition to viewing health as the outcome of humoral balance, me- dieval medicine, based on the Hippocratic idea of humor, also consi- dered that physicians were responsible for aiding in the redemption of the soul alongside preachers (Jacquart & Thomasset, 1989; Lan, 1970). Especially when we consider that medical texts were written in Latin, a preferred language for disseminating science, until well into the seven- teenth and even the eighteenth century, the healing of diseases was associated with an unquestionable hermeticism, only accessible to spe- cialists, never to patients' objectives. As a counterpart to the idea of a Latin language associated with science, this study aims to present a guided reading of a work written in Italian, Le medicine partenenti alle enfermità delle donne, by Giovanni Marinello, the first to use his lan- guage instead of scientific Latin.

Abstract P318: English and Spanish-Speaking Patient Preferences on Home Blood Pressure Monitors: A Qualitative Study in an Urban Safety Net Setting

Background: Self-measured blood pressure (SMBP) monitoring improves hypertension (HTN) control. Adoption of SMBP monitoring is lower among low-income or minoritized patients, who have higher rates of uncontrolled HTN. Little is known about these patients’ preferences for or challenges with SMBP monitoring. Objective: We explored patient perspectives on SMBP monitoring among patients receiving care at an urban safety-net system. Methods: We interviewed English and Spanish-speaking patients with HTN about preferences for different BP monitoring devices and their accompanying mobile apps, past experiences sharing BP data with their clinical care team, and knowledge about home BP monitoring. Interviews were conducted in the participants’ preferred language. We also asked participants to demonstrate a home BP measurement to evaluate their measurement technique. We presented two BP monitoring devices: a Bluetooth-enabled device and a cellular-enabled device. Rapid qualitative data analysis was used to analyze data. Results: Of the 15 participants (8 English-speaking; 7 Spanish-speaking), eight identified as Latine, four as Black or African American, one as American Indian/Native American, one as Asian/Pacific Islander, and one as multi-ethnic. Highest educational attainment varied: five less than high school, five high school/GED, and five college. Most required assistance with Bluetooth pairing to share data and navigating app features. All participants valued tracking their BP and were motivated to engage in SMBP monitoring but desired more training. Nearly all participants demonstrated inadequate BP knowledge and incorrect BP measurement techniques based on AHA/AMA recommendations. Few reported receiving training on SMBP monitoring techniques. Spanish speakers reported that using apps was challenging due to language discordance and wanted translated apps and resources. Costs related to device features were a key factor in preferences. Conclusions: Patient-reported barriers to SMBP adoption include cost, insufficient training, digital exclusion, and language discordance. Addressing these challenges may increase adoption of SMBP monitoring in safety-net populations. Clinicians should consider patients’ preferences when recommending SMBP monitoring. Cellular SMBP devices that automatically transmit BP readings may mitigate challenges with digital literacy and promote data sharing with clinical care teams, though future studies are needed to evaluate usability.

Early use of professional interpreters improves trauma outcomes: Results of a single-center retrospective study

Patients with limited English proficiency (LEP) experience reduced pain assessment and treatment, less comprehensive physical exams, and fewer explanations of the next steps in care. These disparities persist in hospitals with staffed professional interpreters, raising questions about interpreter access and the impact on outcomes. A retrospective review of 1133 trauma activations at a single center Level 1 Trauma Center in 2021–2022 was conducted. Demographic, injury, and outcome data were drawn from the institutional trauma registry, and patient-preferred language was pulled from EMR data. Early interpreter use was defined as documentation of professional interpreter use within 24 h of arrival. LOS and ICU LOS were compared between language groups using Cox regression, and mortality was compared using Fischer's exact test. 1114 patients had data available on initial injury severity and preferred language. Of the 70 LEP patients, 62 (88.6 %) required an interpreter, and 41 of those (66.1 %) had evidence of professional interpreter use within 24 h of arrival. LEP patients who lacked early interpreter use had longer hospital stays than both English proficient (EP) patients (HR 0.59, p < 0.05) and LEP patients with early interpreter use (HR 0.51, p < 0.05) when stratified by ISS and controlling for GCS and patient age. There is no difference in LOS between LEP trauma patients who used an interpreter and EP patients, suggesting that early use of an interpreter may improve the length of stay in LEP trauma patients.

Modalités préférées des femmes à la Réunion pour le dépistage du cancer du col de l’utérus par prélèvement vaginal

BackgroundSince the introduction of HPV testing as a first-line screening method for women aged 30 and over, vaginal sampling (VS) by a healthcare professional or self-sampling (SS) is now possible for women who have not responded to the organized screening program using cervical uterine sampling. The aim of this study was to understand the choices made by a sample of women from La Reunion would like to perform their VS, and the content of the instructions they would like to receive. MethodsWe conducted a cross-sectional descriptive study using a single-answer questionnaire. Patients were either interviewed in doctors’ office or offered the possibility to answer an online questionnaire. We included women aged 30 to 65 in La Reunion who were concerned by CC screening. We compared the answers of women who were up to date with their screening with those of women who were not. ResultsWe included 202 women. The study showed that 64.9% of patients wished to collect the VS kit from a healthcare professional, 80.8% wished to perform SS and 52.5% wished to return it to the laboratory. The preferred language of the instruction was French, with pictures and drawings for 48.5% of patients. There was no significant difference between the answers of women who were up to date with their screening and those who were not. ConclusionIn a sample of women eligible for CC screening in La Reunion, the preferred methods for CC screening were to collect the PV kit from a healthcare professional, perform the SS at home and then return it to the laboratory. These responses differed from other studies. A feasibility study on a part of La Reunion's eligible population for CC screening would enable us to assess the feasibility and generalizability of a screening modality based on SS.

A critical view: Examining disparities regarding timely cholecystectomy

BackgroundImplicit bias may prevent patients with abdominal pain from receiving optimal workup and treatment. We hypothesized that patients from socially disadvantaged backgrounds would be more likely to experience delays in receiving operative treatment for cholecystitis. To study this question, we examined factors related to having a prior emergency department presentation for abdominal pain (prior emergency department visit) within 3 months of urgent cholecystectomy. MethodsWe performed a retrospective analysis of consecutive patients who received an urgent cholecystectomy at an urban safety net public hospital between July 2019 and December 2022. The main outcome of interest was prior emergency department visit within 3 months of index cholecystectomy. We examined patient age, sex, race, ethnicity, preferred language, insurance, and employment status. Bivariate comparisons and logistic regression were used to determine the relationship between patient factors and prior emergency department visit. ResultsOf 508 cholecystectomy patients, 138 (27.2%) had a prior emergency department visit in the 3 months preceding their surgery. In bivariate analysis, younger age, Black race, Hispanic ethnicity, non-English preferred language, and type of insurance (P < .05) were associated with prior emergency department visit. In regression, younger age, Black race, Hispanic ethnicity, and having Medicare or being uninsured were associated with higher odds of having a prior emergency department visit. ConclusionMore than 1 in 4 patients had an evaluation for abdominal pain within 3 months of having an urgent cholecystectomy, and these patients were more likely to be from socially disadvantaged backgrounds. Standardized evaluation pathways for abdominal pain are needed to reduce disparities from institutional or implicit bias.

Reexamining the Relationship Between Communication and Language Through Discourse Analysis: A Case Study Using Movie Material*

The purpose of this paper is to examine the nature of communication and the function of language through discourse analysis using movie material. To achieve this, six English-major undergraduates were selected as subjects. The movie used for this study was &lt;i&gt;Mrs. Harris Goes to Paris&lt;/i&gt; (Fabian, 2022). Over a three-month period, the subjects participated and were administered six tests, along with one report. Two tests focused on content relevant to the case study (the second and sixth tests), while three tests focused on form (the first, third, and fourth tests). The fifth test combined content and form. The results indicated that subjects B, C, and D preferred content-based instruction (emphasizing the nature of communication, stories, culture, etc.), despite subject D not achieving a high test score. Subject A was ambivalent, noting that while content-based instruction was beneficial, language learning was also necessary. Subjects E and F preferred English language learning. In their reports commenting on the method, subjects B, C, and D were positive, subject A had mixed feelings, and subjects E and F were indifferent. Considering that three out of six subjects responded positively, we believe that using discourse analysis can be effective in helping students understand the nature of communication.

Author language and communication preferences, and familiarity with global publication guidelines, for English-language industry-sponsored publications in Asia-Pacific: insights from a cross-sectional survey

Objective To understand current practices and challenges for collecting author feedback for English-language, industry-sponsored publications in Asia-Pacific (APAC), and the implications for adherence to international publication guidelines. Methods A cross-sectional, internet-based survey of industry (‘internal’) authors (17 questions) and publication professionals (18 questions) supporting publications in APAC, conducted between November 18 and December 4, 2022. Results Overall, 142 survey responses were received, of which 94 (66%) were complete and included in the analysis (33 internal authors, 61 publication professionals). Almost half (45%) of internal authors preferred a non-English language for providing feedback on publications, and most (70%) would use this language whenever possible. Internal authors favored written (91%) versus spoken (73%) English, and email was the preferred mode of communication. Publication professionals said they have observed qualitative differences when authors provide feedback in a preferred non-English language versus English. Many agreed that authors tend to provide more substantive or critical feedback when they can respond in their preferred non-English language. Internal authors had low self-assessed familiarity with key publication guidelines, while most publication professionals had a moderate or high self-assessed familiarity. The main barriers to application of publication guidelines, as rated by publication professionals, were that external authors in APAC are not familiar with global publication guidelines and do not always provide feedback/responses in writing. Conclusion It is important to consider the diverse language, cultural, and communication preferences of individuals involved in English-language publication development in APAC, and to ensure that authors are aware of current publication guidelines and best practices.

Use of Cognitive Interviews in the Development of a Survey Assessing American Indian and Alaska Native Adult Perspectives on Genetics and Biological Specimens.

The cognitive interview process is a method to validate a survey instrument's face validity and enhance confidence in item interpretation, as well as a method to engage communities in the research process. Trained American Indian and Alaska Native (AIAN) interviewers conducted retrospective cognitive interviews at three AIAN communities to assess the item quality of a 131-item survey item that measures AIAN knowledge and attitudes on genetics and biological specimens. A cognitive interview process was used to assess cultural consonance, thought processes used when considering survey instructions, items and responses, and language preference of survey items in the development of a survey to assess public knowledge and attitudes on genetics. Content analysis was used to analyze interview data. Survey instructions, items and scales generated no cognitive difficulties. The participants noted being unfamiliar with terminology used to describe genetic and biological specimens. In several cases, the participants' written response in the survey and verbal response in the interview did not align. A resultant 52-item survey for use in AIAN communities was finalized. Cognitive interviewing is resource-intensive; however, ignoring community engagement during survey development results in inappropriate interpretations about culturally diverse populations such as AIAN peoples.

Reporting Primary Language in Cardiology Clinical Trials

This Viewpoint highlights the limited representation of patients with non-English language preference (NELP) in cardiology clinical trials and registries and recommends several methods to better include patients with NELP.

Through the eyes of Spanish-speaking patients, caregivers, and community leaders: a qualitative study on the in-patient hospital experience

BackgroundSpanish-speakers with non-English language preference and complex medical needs suffer disparities in quality of care, safety, and health outcomes. Communication challenges during prolonged hospitalizations for complex illnesses negatively influence how this group engages in their care and decision-making while hospitalized. Limited literature capturing the perspectives of Spanish-speaking patients in this context exists. Given the impact of language barriers on care and medical decision-making, this study documents the experiences of Spanish-speaking patients with NELP and hospitalized with complex care needs as well as caregivers and community leaders.MethodsUsing community-engaged recruitment strategies and semi-structured interviews and a focus group, we gathered insights from Spanish-speaking patients hospitalized for prolonged periods, caregivers, and community leaders from three geographic regions. Data were deidentified, transcribed, translated, coded in duplicate, and analyzed guided by grounded theory using NVivo.ResultsWe interviewed 40 participants: 27 patients, 10 caregivers and 3 community leaders. We identified four major themes: (1) Disconnected experiences impeding interactions, communication, and decision-making (2) Inadequate interpreter services (3) Benefits and consequences of family at the bedside (4) Community -informed recommendations.ConclusionThe study showed that in-person interpreters were preferred to virtual interpreters; yet interpreter access was suboptimal. This resulted in ad hoc family interpretation. Participants noted language negatively impacted patient’s hospital experience, including decreasing confidence in medical decision-making. Recommendations from patients, caregivers, and community leaders included expanding interpreter access, bolstering interpreter quality and accuracy, and increasing resources for patient education.

Factors of Language Dominance Chosen by Young Self-Learning Bilinguals on X Platform

This study aims to explore the patterns of English language dominance among young self-learning bilinguals on platform X, while also uncovering the factors that affect their ability to communicate with others in English. Additionally, it examines how the use of English as the dominant language impacts these young bilingual learners. The research employs a qualitative approach, gathering data through in-depth interviews with participants and focusing on the social media accounts of bilingual youth engaged in independent learning on platform X. The collected data is analyzed through a data condensation process leading to conclusions. The findings indicate that specific languages play a significant role in fostering emotional connections and enhancing language proficiency, which in turn influences the dominant language usage among young self-learning bilinguals on X by creating meaningful connections through language. Furthermore, the study discusses how a language can develop linguistic skills through patterns of communicative interaction, which can affect each individual's language preferences and proficiencies. It highlights the positive correlation between proficiency in one language and proficiency in another, emphasizing the various interaction dynamics among factors such as language skills, personal backgrounds, language delivery, and the ability to interpret and understand communication outcomes.

Enhancing Access Through Language-Tailored Approach in Telehealth and Veterans Video Connect: Traumatic Brain Injury (TBI) Veterans Satisfaction Assessment.

Traumatic brain injury (TBI) can impact language processing, necessitating language-tailored approaches. Telehealth may expand rural Veterans' access but has unknown feasibility for language preferences. This study explored telehealth/Veterans Video Connect satisfaction for Spanish/English TBI screening. The study was approved by the VA Caribbean Healthcare System Institutional Review Board and the Research and Development Committee. Mixed methods evaluated telehealth satisfaction in Veterans receiving TBI assessments from October 2021 to October 2023. Surveys included the 16-item Clinical Video Telehealth (CVT) questionnaire on communication, technical factors, coordination, and overall satisfaction, and the 21-item Telemedicine Satisfaction and Usefulness Questionnaire (TSUQ) examining usefulness, ease of use, manners, quality, and satisfaction. Mean domain/item scores were calculated among 57 Veterans, 12 English, and 45 Spanish-speaking. Semi-structured interviews also elicited user experiences from 4 providers and 5 Veterans. Transcripts underwent qualitative coding for themes using Atlas.ti.8. On CVT (0-5 scale), overall satisfaction averaged 4.50 (English) and 4.69 (Spanish). Lowest scoring item for English users was easy video connection (4.25), while unclear expectations had the lowest Spanish score (3.60). For TSUQ, overall mean scores were 4.50 (English) and 4.67 (Spanish), with improved health post-telehealth having the lowest average (English 3.33, Spanish 3.67). Qualitatively, Veterans and providers noted strengths like access and communication but weaknesses around connectivity, care delays, and privacy. Differences emerged regarding convenience (Veterans) versus operational barriers (providers). There was a strong positive correlation for Spanish surveys and a moderate correlation for English surveys (r = 0.71 Spanish surveys, r = 0.69 English surveys) between TSUQ and CVT for individual respondents. Patients conveyed positive experiences, but qualitative data revealed actionable targets for optimization like infrastructure and coordination improvements. Key limitations include small samples and lack of comparison to in-person care. Still, high satisfaction coupled with specific user feedback highlights telehealth's potential while directing enhancements. The results found high Veteran satisfaction with Spanish/English TBI telehealth, but mixed methods illuminated salient domains for better accommodating user needs, particularly regarding logistics and technology. Rigorously integrating experiences with metrics over expanded diverse samples and modalities can further guide refinements to enhance telehealth with a language-tailored approach.