Spanish Speakers Research Articles

Latin America and the Caribbean Code Against Cancer 1st edition: Formative research on the comprehension and persuasiveness of the recommendations by the general population

BackgroundCancer prevention is the most efficient and cost-effective strategy in cancer control. One prevention strategy is giving credible, clear, and evidence-based recommendations to the individual; however, it is key that these messages are accepted and understood properly by the public. This study aimed to pilot the draft recommendations developed as part of the Latin America and the Caribbean (LAC) Code Against Cancer 1st edition, in terms of comprehension and persuasion of each message. MethodsA mixed method two-wave study, in which two versions of the messages were presented to the general population in five LAC countries. We used an ad-hoc questionnaire and interviews that followed the cognitive-pretesting methodology. ResultsFindings suggest that the messages were generally well understood, especially in Spanish speaking countries, and that the messages were generally more understandable than persuasive. We adapted and revised the recommendations based on the findings of the first Wave and held a second iteration in the Spanish speaking countries. We observed a better understanding of most messages in Wave 2. ConclusionThe LAC Code Against Cancer is a valuable tool of well understood messages for the public, with concrete actions everyone can take to prevent cancer. Further research should assess particularities of the region for further efficient dissemination of these important health messages, identify key messages for certain population groups and future interventions that strengthen health literacy in rural and less educated populations to increase behavior change.

Unconditional Cash Transfers and Maternal Assessments of Children's Health, Nutrition, and Sleep

Children experiencing poverty are more likely to experience worse health outcomes, including injury, chronic illness, worse nutrition, and poorer sleep. The extent to which poverty reduction improves these outcomes is unknown. To evaluate the effect of a 3-year, monthly unconditional cash transfer on health, nutrition, sleep, and health care utilization among children experiencing poverty who were healthy at birth. This longitudinal randomized clinical trial recruited 1000 mother-infant dyads between May 2018 and June 2019. Dyads were recruited from postpartum wards in 12 hospitals in 4 US cities: New York, New York; Omaha, Nebraska; New Orleans, Louisiana; and Minneapolis/St Paul, Minnesota. Eligibility criteria included an annual income less than the federal poverty line, legal age for consent, English or Spanish speaking, residing in the state of recruitment, and an infant admitted to the well-baby nursery who will be discharged to the mother's custody. Data analysis was conducted from July 2022 to August 2023. Mothers were randomly assigned to receive either a high-cash gift ($333/mo, or $3996/y) or a low-cash gift ($20/mo, or $240/y) for the first several years of their child's life. Primary preregistered outcomes reported here include an index of child health and medical care and child sleep disturbances. Secondary preregistered outcomes reported include children's consumption of healthy and unhealthy foods. A total of 1000 mother-infant dyads were enrolled, with 400 randomized to the high-cash gift group and 600 to the low-cash gift group. Participants were majority Black (42%) and Hispanic (41%); 857 mothers participated in all 3 waves of data collection. We found no statistically detectable differences between the high-cash and low-cash gift groups in maternal assessments of children's health (effect size [ES] range, 0.01-0.08; SE range, 0.02-0.07), sleep (ES range, 0.01-0.10; SE, 0.07), or health care utilization (ES range, 0.01-0.11; SE range, 0.03-0.07). However, mothers in the high-cash gift group reported higher child consumption of fresh produce at child age 2 years, the only time point it was measured (ES, 0.17; SE, 0.07; P = .03). In this study, unconditional cash transfers to mothers experiencing poverty did not improve reports of their child's health, sleep, or health care utilization. However, stable income support of this magnitude improved toddlers' consumption of fresh produce. Healthy newborns tend to grow into healthy toddlers, and the impacts of poverty reduction on children's health and sleep may not be fully borne out until later in life. ClinicalTrials.gov Identifier: NCT03593356.

Assessing Depression and Anxiety Levels in English and Spanish-Speaking Patients throughout a Course of Radiation Therapy

An estimated 32.2% and 41.9% of breast cancer patients experience depression and anxiety, respectively. However, distress experienced by patients with breast cancer receiving radiation therapy may vary at different time points and differ in comparison to other patients with breast cancer, potentially due to differences in the understanding of radiotherapy and variability in the severity of side effects. This study sought to describe the changes in levels of depression and anxiety experienced by English and Spanish-speaking patients throughout a course of radiation therapy for breast cancer, along with the impact of different variables on these levels of distress to better understand and quantify potential gaps. Eligibility criteria included English and Spanish-speaking females, ages 18 or older, undergoing radiation therapy treatment for breast cancer at two institutions, including a safety-net hospital. Pre- and post-treatment surveys were completed before and after delivery of radiation therapy. Sociodemographic characteristics collected included: race, ethnicity, marital status, education level, longest residency location, housing, and food security. The survey ended with the standardized PHQ-4 questionnaire, which uses a maximum total score of 12 to assess anxiety and depression. Results were analyzed using the Analysis of Covariance procedure. A total of 160 participants completed pre- and post-treatment surveys. Half of the participants were non-white (50%), primarily married (42.5%), and had a high school or associate's level education (46.9%). The total baseline distress mean (BDM) was 2.96 (Standard deviation, SD = 3.11), and the final distress mean (FDM) was 2.78 (SD = 3.78). English-speaking patients comprised 82.5% (n = 132) of the sample and had a BDM of 2.91 with an adjusted change mean (ACM) decrease of 0.45. Spanish-speaking patients comprised 17.5% (n = 28) of the sample, with a BDM of 3.21 and an ACM increase of 1.03 (P = 0.002). Housing (P = 0.021) and food insecurity (P = 0.002) also showed increasing distress with increased insecurity at baseline. Our study shows that Spanish-speaking patients present with higher levels of distress than their English-speaking counterparts and their distress increased throughout treatment as opposed to English speakers. Other factors, such as housing and food insecurity, are also significantly associated with increased distress. As the number of Spanish speakers in the US continues to increase, it will be important to continue assessing potential differences in cancer care. In addition, understanding the distress changes throughout radiation treatment could help inform future interventions that address these disparities.

A Preliminary Exploration of Declarative Intonation in the Chilean Diaspora of Sweden

Motivated by a growing body of research on heritage Spanish prosody, the current study uses the Sp_ToBi framework for the transcription of Spanish intonation to report trends in phonological targets of broad focus declaratives produced by heritage speakers of Chilean Spanish living in Stockholm, Sweden. Data were collected via semi-structured interviews from six participants belonging to the same social network including two Spanish-dominant first-generation immigrants and four Swedish-dominant second-generation speakers who were born and raised in Sweden and are heritage speakers of Spanish. The G1 participants are the primary source of Spanish input for the G2 speakers. Data were analyzed by identifying word- and phrase-level phonological targets and associating them with the appropriate pitch accent and boundary tones. Results show that the heritage Spanish declarative intonation patterns of the G2 speakers closely resemble those of the G1 speakers. These patterns are scrutinized in terms of the potential influence of Swedish and/or other varieties of Spanish. This analysis exhibits evidence of the importance of source input variety and cross-generational transmission of phonological targets in a heritage language as well as the potential contributions of multiple intonational systems in forming the phonological inventory of heritage speakers.

Imperatives in Heritage Spanish: Lexical Access and Lexical Frequency Effects

Along with declaratives and interrogatives, imperatives are one of the three major clause types of human language. In Spanish, imperative verb forms present poor morphology, yet complex syntax. The present study examines the acquisition of (morpho)syntactic properties of imperatives in Spanish among English-speaking heritage speakers of Spanish. With the use of production and acceptability judgment tasks, this study investigates the acquisition of verb morphology and clitic placement in canonical and negative imperatives. The results indicate that the acquisition of Spanish imperatives among heritage speakers is shaped by the heritage speakers’ productive vocabulary knowledge, lexical frequency and syntactic complexity. Indeed, most of the variability in their knowledge was found in their production of negative imperatives: heritage speakers show a rather stable receptive grammatical knowledge while their production shows signs of variability modulated by the heritage speakers’ productive vocabulary knowledge and by the lexical frequency of the verb featured in the test items.

Examining cortical tracking of the speech envelope in post-stroke aphasia.

People with aphasia have been shown to benefit from rhythmic elements for language production during aphasia rehabilitation. However, it is unknown whether rhythmic processing is associated with such benefits. Cortical tracking of the speech envelope (CTenv) may provide a measure of encoding of speech rhythmic properties and serve as a predictor of candidacy for rhythm-based aphasia interventions. Electroencephalography was used to capture electrophysiological responses while Spanish speakers with aphasia (n = 9) listened to a continuous speech narrative (audiobook). The Temporal Response Function was used to estimate CTenv in the delta (associated with word- and phrase-level properties), theta (syllable-level properties), and alpha bands (attention-related properties). CTenv estimates were used to predict aphasia severity, performance in rhythmic perception and production tasks, and treatment response in a sentence-level rhythm-based intervention. CTenv in delta and theta, but not alpha, predicted aphasia severity. Neither CTenv in delta, alpha, or theta bands predicted performance in rhythmic perception or production tasks. Some evidence supported that CTenv in theta could predict sentence-level learning in aphasia, but alpha and delta did not. CTenv of the syllable-level properties was relatively preserved in individuals with less language impairment. In contrast, higher encoding of word- and phrase-level properties was relatively impaired and was predictive of more severe language impairments. CTenv and treatment response to sentence-level rhythm-based interventions need to be further investigated.

Infinitive vs. Gerund Use and Interpretation in Heritage Spanish

The present study examines the production and interpretation of infinitives among 26 Spanish heritage speakers born and raised in the US and 25 Spanish-dominant speakers from Mexico and Colombia. We tested participants’ knowledge of infinitives as subjects of the clause and as objects of a preposition via an elicited production task and a contextualized preference task. The results of both tasks showed less infinitive use by the HSs and overextension of the gerund in contexts where it is not required. The results showed that the gerund overextension was modulated by the syntactic context. There was significantly more use of the gerund as the subject of the clause in both production and interpretation and less use as the object of a preposition. Furthermore, the results showed a significant role for proficiency and language experience in the extent of grammatical reconfiguration. The higher the level of Spanish proficiency and the more exposure and use of Spanish, the more likely the participants were to produce and choose infinitives. Results are discussed along the lines of the activation approach.

CONSTRAINTS IN LEARNING SPANISH AS A FOREIGN LANGUAGE: A MIXED-METHOD STUDY

This study aimed to explore the constraints faced by students in learning a foreign language at Camarines Sur Polytechnic Colleges. The researchers formulated two main questions in this study: (1) What are the constraints in learning Spanish as a Foreign language learning in terms of (a) learning differences, (b) learning language material resources, and (c) classroom activities?; (2) What are the factors that affect the constraints in learning Spanish along with (a) learning differences, (b) learning language material resources, and (c) classroom activities? To answer the research questions, the researchers utilized a mixed-method research design. The researchers used a survey questionnaire for the data gathering. The researchers tabulated and calculated the weighted mean of each student‟s perception based on the questionnaire result given to them. Moreover, the researchers interviewed students chosen based on the criterion to triangulate the study results. In addition, thematic analysis was used to analyze the collected data from the transcribed interviews. Research ethics was properly observed during data collection. Furthermore, the findings showed that the constraints faced by the students in Spanish language learning are negative attitude, low motivation, usage of the different learning styles of students, ineffective language material resources, and classroom activities giving less opportunity for students to practice or perform their Spanish speaking skills. The results also revealed the factorsthat cause these constraints.

A Multifaceted Implementation Strategy to Increase Out-of-Office Blood Pressure Monitoring

Few primary care patients complete guideline-recommended out-of-office blood pressure (BP) monitoring prior to having hypertension diagnosed. To evaluate the effectiveness of a behavioral theory-informed, multifaceted implementation strategy on out-of-office BP monitoring (ambulatory BP monitoring [ABPM] or home BP monitoring [HBPM]) among patients with new hypertension. This 2-group, pre-post cluster randomized trial was conducted within a primary care network of 8 practices (4 intervention practices with 99 clinicians; 4 control practices with 55 clinicians) and 1186 patients (857 intervention; 329 control) with at least 1 visit with elevated office BP and no prior hypertension diagnosis between October 2016 and September 2017 (preimplementation period) or between April 2018 and March 2019 (postimplementation period). Data were analyzed from February to July 2023. Usual care (control group) or a multifaceted implementation strategy consisting of an accessible ABPM service; electronic health record (EHR) tools to facilitate test ordering; clinician education, reminders, and feedback relevant to out-of-office BP monitoring; nurse training on HBPM; and patient information handouts. The primary outcome was patient completion of out-of-office BP monitoring within 6 months of an eligible visit. Secondary outcomes included clinician ordering of out-of-office BP monitoring. Blinded assessors extracted outcomes from the EHR. A total of 1186 patients (857 intervention; 329 control) were included, with a mean (SD) age of 54 (16) years; 808 (68%) were female, and 549 (48%) were Spanish speaking; among those with race and ethnicity documented, 123 (10%) were Black or African American, and 368 (31%) were Hispanic. Among intervention practices, the percentage of visits resulting in completed out-of-office BP monitoring increased from 0.6% (0% ABPM; 0.6% HBPM) to 5.7% (3.7% ABPM; 2.0% HBPM) between the preimplementation and postimplementation periods (P = .009). Among control practices, the percentage of visits resulting in completed out-of-office BP monitoring changed from 5.4% (0% ABPM; 5.4% HBPM) to 4.3% (0% ABPM; 4.3% HBPM) during the corresponding period (P = .94). The ratio of relative risks (RRs) of out-of-office BP monitoring in the postimplementation vs preimplementation periods for intervention vs control practices was 10.5 (95% CI, 1.9-58.0; P = .01). The ratio of RRs of out-of-office BP monitoring being ordered was 2.2 (95% CI, 0.8-6.3; P = .12). This study found that a theory-informed implementation strategy that included access to ABPM modestly increased out-of-office BP monitoring among patients with elevated office BP but no hypertension diagnosis. ClinicalTrials.gov Identifier: NCT03480217.

Methodology for Analyzing Qualitative Data in Multiple Languages.

Translation strategies are commonly used for qualitative interview data to bridge language barriers. Inconsistent translation of interviews can lead to conceptual inequivalence, where meanings of participants' experiences are distorted, threatening scientific rigor. Our objective is to describe a systematic method developed to analyze multilingual, qualitative interview data while maintaining the original language of the transcripts. A literature review of translation strategies, cross-language, and multilingual qualitative research was conducted. Combined with criteria for qualitative content analysis and trustworthiness, the methodology was developed and used for a qualitative descriptive study. The study had interview data in both English and Spanish. The research team consisted of both native Spanish and English speakers, who were grouped based on language. Verbatim transcription of data occurred in the original languages. All codes were kept in English, allowing the research team to view the data set as a whole. Two researchers within each group coded each transcript independently before reaching a consensus. The entire research team discussed all transcripts, and finally, major themes were determined. Participants' quotes remained in the original language for publication, with an English translation included when needed. Analyzing transcripts in the original language brought forth cultural themes that otherwise may have been overlooked. This methodology promotes conceptual equivalence and trustworthiness that is paramount in cultural, linguistic, and social determinants of health research to advance health equity.

Association between no-show rates and interpreter use in a pediatric otolaryngology clinic.

To understand how primary language and interpreter use affect no-show rates in pediatric otolaryngology. This is a retrospective cohort study using medical records of new patients in a pediatric otolaryngology clinic from 2014 to 2019. Data was collected on patient demographics including age, primary language, insurance type, maternal education level, maternal primary language, interpreter use at the first visit, total number of appointments scheduled, number of missed appointments, and number of completed appointments. Inferential statistics using parametric (ANOVA) and non-parametric (Mann-Whitney U tests, Kruskal-Wallis tests, and Spearman correlation coefficient) methods were used. Primary language was associated with significant differences in no-show rates (p=0.0474), with Spanish and English speakers having the lowest no-show rate (33%). Overall, interpreter use at the first visit was not significantly associated with subsequent appointment attendance (p=0.3674). Patients with a documented Spanish interpreter at the first visit had the lowest average no-show rate (31%±19%) compared to Haitian Creole (42%±18%) and all other languages (32%±19%) (p=0.0265). Hispanic ethnicity, maternal education level, and maternal primary language were not associated with attendance. Interpreter use at the first visit was not significantly correlated with no-show rates, but among patients that did require an interpreter at the first visit, those receiving services in Spanish had the best clinic attendance.

Static and dynamic analyses of velar palatalization in Chilean Spanish

Abstract Some previous sociolinguistic work in Chilean Spanish has claimed that velar palatalization (i.e., production of a word like gente /xente/ ‘people’ as [çen̪.t̪e] or [xjen̪.t̪e]) is a categorical feature of all speakers of this dialect, while other scholars have argued that palatalization of /x/ is conditioned by sociolinguistic factors. The present study comprises a sociophonetic analysis of the production of /x/ across 61 speakers from Santiago, Chile in an effort to acoustically verify one of these two claims. Via the use of static and dynamic analyses of 2,107 tokens of /x/ in diverse phonological environments, this paper demonstrates that among these data, only linguistic factors condition the place of articulation and degree of constriction of /x/. Overall, /x/ palatalization before /e/ appears to be a gradient strengthening phenomenon generalized among the entire sample of Santiago Spanish speakers. Further, I argue that the dynamic analyses are superior both theoretically and methodologically as they allow for more faithful capturing of the variability inherent in the speech signal.

A usage-based account of paragogic /e/ in 20th century New Mexican Spanish

Abstract This study tests if New Mexican Spanish speakers’ productions of words that variably display paragogic /e/ (rincón ∼ rincon e ‘corner’) are predictable from their lexical frequency, utterance position, and the frequency with which these words occur in an utterance position that conditions paragoge. In the study, the variable that measures the frequency with which words occur in the conditioning context is referred to as the FCC. The analysis of 77 word types and 2,235 tokens produced by 24 speakers demonstrates that the likelihood that a speaker produces paragogic /e/ increases when words are produced at the end of an utterance. The study also finds novel evidence for the mediating effect of lexical frequency on the effect of the FCC variable: the influence of the frequency with which words are produced in utterance-final position on the likelihood of paragogic /e/ is strengthened as lexical frequency decreases. Together with research on reductive phonological processes (e.g., Forrest, John. 2017. The dynamic interaction between lexical and contextual frequency: A case study of (ING). Language Variation and Change 29(2). 129–156), it seems that the effect of the FCC variable is amplified by lexical frequencies that already harbor the phonological process. These novel findings invite scholars to reconsider the assumption that such effects require many exemplars to shape lexical representation and speech production.

The NeuroBel: A Screening Test for Verbal Language Impairment in Spanish-Speaking Elderly People With Cognitive Decline.

The NeuroBel is a short test that can detect cognitive decline using language tasks. This study replicated previous research using larger clinical samples from three Spanish-speaking countries. Eight tasks were used to analyze verbal language functioning using a psycholinguistic approach. A total of 232 elderly, monolingual Spanish speakers from Spain, Cuba, and Colombia participated in this study. Of these, 76 had Alzheimer's disease (AD) in the initial phase, 75 had mild cognitive impairment (MCI), and 81 did not exhibit cognitive impairment (healthy controls). Significant differences were observed among the three clinical groups. The participants with AD and the participants with MCI had significantly lower NeuroBel scores than the control group on most of the tasks. However, repetition (in AD vs. MCI) and auditory lexical decision (in MCI vs. control) tasks were not significant in Tukey's post hoc tests. Discriminant analysis showed that 80.6% of the participants were correctly classified into the original groups and revealed the tasks that were the best and worst for differentiating among groups. The receiver-operating characteristic curves showed high sensitivity for AD and MCI. The area under the curve was .97 in the contrast of AD versus MCI + controls, .96 in the determination of overall cognitive decline (AD + MCI vs. controls), and .93 in the contrast of MCI and control groups. This study confirmed that the NeuroBel is a suitable test for detecting cognitive decline based on language impairment in Spanish-speaking elderly people.

Aspectual se and Telicity in Heritage Spanish Bilinguals: The Effects of Lexical Access, Dominance, Age of Acquisition, and Patterns of Language Use

While differences in the production and acceptability of aspectual inflectional morphology between Spanish–English heritage and monolingually raised speakers of Spanish have been argued to support incomplete acquisition approaches to heritage language acquisition, other approaches have argued that differences in access (e.g., lexical access) to representations for receptive and productive purposes are at the core of some of the unique characteristics of heritage language data. We investigate these issues by focusing on the effects of lexical access, dominance, age of acquisition and patterns of language use in heritage Spanish–English bilinguals. We study aspectual se in Spanish, which yields telic interpretations, in expressions such as María se comió la manzana ‘María ate the apple (completely)’ and Maria ate the apple (where completion may not be reached). Our results indicate that se generates telic interpretations for the heritage and monolingually raised group with no group effect. Heritage speakers showed no English effects in terms of lexical access, age of acquisition, patterns of language use or dominance. This suggests that the heritage group did not differ from their monolingually raised counterparts and showed no evidence of incomplete acquisition of telicity.

Contextual Variables as Predictors of Verb Form: An Analysis of Gender and Stance in Peninsular Spanish Requests

The current experiment employs a variational pragmatics perspective to explore how the contextual variables of power, distance, and imposition jointly affect social groups’ and individuals’ choice of verb forms in requests in Madrid, Spain. Using a mixed-method approach to explore the requests of 111 Spanish speakers from Madrid, quantitative analyses determined the level of significance and hierarchical order of the predictor variables of power, distance, and imposition on verb form and also the distribution of verb forms by gender, with male and female participants exhibiting significant differences. Additionally, certain participants demonstrated decreased sensitivity to contextual factors, adopting more categorically indirect or direct request strategies. The examination of both gendered request patterns and the stances that single participants adopt through their verb-form selections contributes to our understanding of the social moves that are made by all speakers, not just those who fall within the gendered norms. The results highlight the different frames and social meanings attached to these forms at the micro- and macro-social levels, providing new insight into the complex relationship among linguistic variables, contextual factors, and social groups and individuals.

Aggressive Driving, Rule-Breaking, and Driver Stress in Spanish-speaking countries

Driver Aggression is a phenomenon many have studied in all five continents. It has been the focus of curiosity for all sorts of disciplines, and science has been unable to curb it, much less park it. Driver Stress, Road Aggression and Road Rule-Breaking are crucial elements in traffic psychology. Those who do not respect the rules are a major factor in increased risk and the occurrence of major traffic accidents. Little work has been done on how these phenomena behave in Spanish-speaking countries, much less the development of useful instruments to evaluate them. This study aims to generate two unique scales that can be used in Spanish speaking countries regardless of culture or geography, as well as determining the influence Driver Stress has on Driver Aggression and Rule-Breaking. This study comprises a sample of 1827 drivers from Mexico, Guatemala, Costa Rica, and Spain. Through this paper, a small yet significant relationship was found between Driver Stress, Driver Aggression, and Driver Rule-Breaking. This suggests that personality factors are at play in these relationships in Spanish-speaking countries, and that these variables are an important factor on how drivers behave. This study also delivers two useful tools for evaluating Driver Aggression (LatinCAT) and Driver Rule-Breaking (LatinDANT) that have excellent construct validity for further research in Spanish-speaking countries.

Running across the mind or across the park: does speech about physical and metaphorical motion go hand in hand?

Abstract Expression of physical motion (e.g., man runs by) shows systematic variability not only between language types (i.e., inter-typological) but also within a language type (i.e., intra-typological). In this study, we asked whether the patterns of variability extend to metaphorical motion events (e.g., time runs by). Our analysis of randomly selected 450 physical motion (150/language) and 450 metaphorical motion (150/language) event descriptions from written texts originally produced by German, Polish, and Spanish authors showed strong inter-typological differences in the expression of both event types. German and Polish speakers differed from Spanish speakers in how they packaged manner and path components of a motion event; they also differed in how extensively they expressed each component in their lexicalization of motion. The strong inter-typological differences were accompanied by more modest intra-typological variability: Polish and German writers differed in their packaging and lexicalization of manner and path components of metaphorical—but not physical—motion events. Our results provide evidence for robust inter-typological differences evident in the expression of both physical and metaphorical motion, along with less robust intra-typological differences, largely evident in the expression of metaphorical motion. Our study thus highlights event type as an important factor in determining crosslinguistic variation in motion expression.

Speech Discrimination Outcomes in Adult Cochlear Implant Recipients by Primary Language and Bilingual Hispanic Patients.

Compare cochlear implant (CI) outcomes in English speakers, Spanish speakers, and bilingual Hispanics. Retrospective review. Academic tertiary care center. Eighty-five postlingually deafened adults unilaterally implanted between January 2014 and December 2018 were stratified by primary language. Primary outcomes were: (1) English consonant-nucleus-consonant and Spanish bisyllables word tests in quiet, and (2) English AzBio and Latin American Hearing In Noise Test (LA-HINT) sentence tests in quiet and in noise at multiple time-intervals postactivation. In the respective languages, primary Spanish speakers(n = 24), and English speakers (n = 61) experienced the greatest increases in average scores for word and sentence tests in quiet during the first 6 months postactivation, with gradual increases in average scores over time. English speakers performed significantly worse on AzBio tests in noise, compared to quiet, while the addition of noise did not significantly affect average LA-HINT scores in Spanish speakers across multiple time intervals. An early ceiling effect was also demonstrated for LA-HINT. Although not significant, bilingual Hispanics (n = 12) had lower average AzBio in quiet scores than English speakers and higher average LA-HINT in quiet scores than the Spanish speakers across multiple time intervals. English and Spanish CI users experienced the greatest increases in speech understanding in quiet the first few months after implant activation. An early ceiling effect is demonstrated with LA-HINT, indicating LA-HINT is not appropriate for evaluating longitudinal CI outcomes in Spanish speakers. Bilingual Hispanics represent a unique group, and further investigations are necessary to understand speech perception patterns in both languages and develop the best CI test strategies for these individuals.

Patient perceptions of the readability and helpfulness of bilingual clinical forms: a survey study

BackgroundPatients with limited English proficiency (LEP) are rarely provided with translated clinical materials. Typically, healthcare clinics cite high costs of translation and lack of professional translators as barriers to this service. The purpose of the current study was to investigate the perceptions of LEP dental patients regarding the readability, understanding, and helpfulness of translated clinical forms produced by dental student doctor translators.MethodsWe used a survey design and convenience sampling to recruit LEP patients from a dental school clinic. Participants completed a 9-question (8 Likert-type items and 1 open-ended item) paper survey about translated forms. The bilingual survey was a combination of English and 8 other languages (Arabic, Dari, Pashto, Russian, Spanish, Ukrainian, Urdu, or Vietnamese) and assessed the type of form received; self-reported literacy; design, readability, and helpfulness of the form; overall understanding of the form; understanding of medical and dental terms; helpfulness for patient-provider communication; and comfort level with dental care after receiving the form. Demographic characteristics of participants were collected from the clinic’s electronic health record. Survey responses were analyzed descriptively, and Spearman’s correlation was used to examine the relationship between outcomes.ResultsNinety-seven LEP patients (61.9% [60] female, 78.4% [70] Spanish speakers) completed 140 surveys for various translated forms in Dari, Pashto, Spanish, Urdu, or Vietnamese. Participants positively rated translated clinical forms: range, 50.4% (70) for design of the form to 80.0% (112) for comfort level with dental care after receiving the form. For the open-ended item, participants indicated the translations were good, and no improvements were needed. They also thought providing the form was evidence of good customer service. When examining relationships between outcomes, positive correlations were found between self-reported literacy and readability (Spearman r = .57, P < .001), overall understanding and understanding of medical and dental terms (Spearman r = .58, P < .001), and type of form and helpfulness for patient-provider communication (Spearman r = .26, P = .005).ConclusionsStudy results suggested the translated clinical forms were perceived as helpful and beneficial by LEP dental patients. Similar approaches should be considered to reduce language barriers in healthcare.