Language, Literacy, Culture: Communication of Health

许多疾病的关键健康概念的口头交流对于预防、筛查和临床管理至关重要。当语言阻碍时，这种沟通变得更加困难。健康素养受一般识字、语言和文化解释的影响。很少有人知道如何最大限度地跨越这些潜在的障碍，健康概念的口头沟通。由于缺乏知识，需要进行第一阶段的研究，为今后的研究奠定基础。我们提出了一项研究，将开发有效的口头沟通的三个关键健康概念的研究方法：头痛，喘息，抑郁症。1)我们的主要假设是，不同的语言群体和具有不同水平的一般素养的群体将具有不同水平的健康素养，这反过来又会反映在他们对口语关键健康概念的理解上。2)此外，我们假设，我们将能够从焦点小组数据开发一个概念框架，可应用于未来的干预研究，旨在克服口语健康沟通障碍。研究的第一阶段将包括与医学专家进行的主要信息提供者访谈，其中一些专家会讲西班牙语或广东话。在第二阶段，我们会举办12个焦点小组，每组8至10人，分别以英语、西班牙语和广东话进行，每个小组的水平分别为一般识字能力的低和高。我们将使用来自Erlich跨文化咨询公司的高技能焦点小组主持人，他们拥有多年领导每种语言焦点小组的经验。重点小组会议将在一个新的具有广泛技术能力的最先进的重点小组会议设施中举行，其中包括一个观察室，项目领导人将在一名同声传译在场的情况下观察重点小组会议。将对焦点小组进行录像，并对录像进行转录和翻译。我们将使用数据沉浸来分析焦点小组。这将包括系统的内容分析、专题分析和逻辑分析。我们的目标是充分了解不同语言、文化和一般文化水平的人如何理解关键的健康概念，以便开展旨在改善口头健康沟通的干预研究（R01）。

Spoken communication of key health concepts for many diseases is critical to prevention, screening and clinical management. This communication is made more difficult when words get in the way. Health literacy is affected by general literacy, language and cultural interpretation. Very little is known about maximizing spoken communication of health concepts across these potential barriers. Because of the lack of knowledge, there is a need for first stage studies that lay the basis for future research. We propose a study that will develop methodological approaches to the study of effective spoken communication of three key health concepts: headache, wheezing, and depression. 1) Our primary hypothesis is that different language groups and groups with different levels of general literacy will have different levels of health literacy which will, in turn, be reflected in their understanding of spoken key health concepts. 2) Further, we hypothesize that we will be able to develop from focus group data a conceptual framework that can be applied to future intervention studies designed to overcome spoken health communication barriers. The first phase of the study will consist of key informant interviews with medical experts, some of whom are bilingual in Spanish or Cantonese. In the second phase, we will hold 12 focus groups of 8-10 persons in English, Spanish and Cantonese, each at low and high general literacy. We will use highly skilled focus group moderators from Erlich Transcultural Consultants who have many years of experience leading focus groups in each language. The focus groups will be held in a new state-of-the-art focus group facility with extensive technical capability, including an observation room in which the project leaders will observe the focus groups in the presence of a simultaneous translator. Focus groups will be video recorded and the resulting record transcribed and translated. We will use data immersion to analyze the focus groups. This will include a systematic content analysis, a thematic analysis and a logical analysis. Our goal is to develop sufficient understanding of how persons with different language, culture and general literacy understand key health concepts so that an intervention study (R01) aimed at improving spoken health communication can be developed.