Cultural and translation challenges in assessing health literacy among immigrants from the former Soviet Union.
Cultural and translation challenges in assessing health literacy among immigrants from the former Soviet Union.
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评估前苏联移民健康素养的文化和翻译挑战。
DOI：
10.1093/heapro/daad103
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发表时间：
2023
影响因子：
2.7
通讯作者：
Korchmaros,JosephineD
中科院分区：
文献类型：
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作者：
Shaw,SusanJ;HuebnerTorres,Cristina;Lee,JeannieK;Gavrilyuk,Dina;Korchmaros,JosephineD
健康素养是促进健康的重要基础，也是移民和难民群体未得到充分认识的风险因素。然而，衡量不同种族和语言人口的健康素养面临着复杂的挑战。我们描述了在衡量美国讲俄语的移民的健康素养时遇到的文化和翻译挑战，并提供了一种混合方法来理解这些挑战。处方健康素养(RxHL)研究使用横断面定量和定性数据，调查了五个文化群体和四个语言群体(拉丁裔、越南语、非裔美国人、讲俄语的移民和美国白人)的健康素养和服药依从性，这些人是马萨诸塞州斯普林菲尔德的关爱健康中心的患者，该中心是一家获得联邦资格的健康中心。我们将现有的健康素养量表翻译成俄语和越南语，并检查了不同文化群体的项目难度。我们进行了定性的认知访谈，以了解俄语使用者对量表的理解。不同文化群体的健康素养得分不同，说俄语的人正确回答的范围比其他群体大得多。说俄语的人的正确率变化了69.7%，而其他组的正确率为25.0-44.0%。这些发现表明，与其他群体相比，这一群体的健康素养水平存在更大的差异。对讲俄语的参与者进行的认知访谈揭示了对几个项目的多种解释，这表明，英文版的量表包含了与美国医疗保健背景相关的隐含含义，而翻译后的工具并未包含这些含义。结合定性和定量的研究方法，可以更好地洞察语境和翻译因素，这些因素可能会以意想不到的方式影响翻译工具的结果。
Health literacy is an important foundation for health promotion and an under-recognized risk factor for immigrant and refugee groups. Yet measuring health literacy among diverse ethnic and linguistic populations presents complex challenges. We describe cultural and translation challenges encountered in measuring health literacy among Russian-speaking immigrants to the USA and offer a mixed-methods approach to understanding them. The Rx-Health Literacy (RxHL) study used cross-sectional quantitative and qualitative data to examine health literacy and medication adherence among five cultural and four language groups (Latinx, Vietnamese, African-American, Russian-speaking immigrant and White American) who are patients at Caring Health Center, a federally qualified health center in Springfield, MA. We translated an existing health literacy scale into Russian and Vietnamese and examined item difficulty across cultural groups. We conducted qualitative cognitive interviews to learn more about Russian speakers’ understandings of the scale. Health literacy scores varied by cultural group, and the range of correct responses was much greater among Russian speakers than in other groups. Percentage correct varied by 69.7% for Russian speakers, compared with 25.0–44.0% for other groups. These findings indicate greater variability in health literacy levels among this group compared with others. Cognitive interviews with Russian-speaking participants revealed multiple interpretations of several items, suggesting that the English version of the scale contained embedded meanings associated with an American health care context that were not captured in the translated instrument. Combining qualitative and quantitative research methods allows for greater insight into contextual and translation factors that may shape the results of translated instruments in unanticipated ways.