Language-Concordant Mobile Health Training and Support for Behavioral Management of Urinary Incontinence for Women with Limited English Proficiency

为英语水平有限的女性提供语言一致的移动健康培训和尿失禁行为管理支持

• 批准号: 10772574
• 负责人: Alison Huang
• 金额: $ 22.56万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-02-15 至 2027-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10772574
• 关键词: Address; Adult; Age; Anti-Cholinergics; Behavioral; Bladder; California; Caring; Cellular Phone; Chinese; Chinese American; Clinical; Communication; Communities; Community Healthcare; Dedications; Education; Electronics; Ethnic Origin; Ethnic Population; Event; Exercise; Face; Feedback; Female; Follow-Up Studies; Funding; Future; Goals; Health; Health Personnel; Healthcare Systems; Improve Access; Incontinence; Language; Latina; Learning; Life Style; Limited English Proficiency; Mainstreaming; Mental Depression; Minority Women; Online Systems; Outcome Measure; Patients; Pelvic Floor Muscle; Pelvic floor structure; Pharmaceutical Preparations; Population; Process Measure; Research; Social isolation; Spanish Americans; System; Techniques; Testing; Training; Training Programs; Training Technics; Translating; Underrepresented Populations; Underserved Population; United States; United States National Institutes of Health; Urinary Incontinence; Woman; Women' s Health; Work; Writing; care systems; community organizations; demographic disparity; design; disparity reduction; ethnic minority; ethnic minority population; experience; follow-up; functional decline; health training; improved; mHealth; marginalization; marginalized population; member; middle age; minority health; older women; physical inactivity; pilot test; programs; prototype; recruit

PROJECT SUMMARY One out of three midlife and older women suffer from urinary incontinence, a condition leading to depression, social isolation, functional decline, and loss of ability to live independently. Although behavioral management strategies such as bladder training and pelvic floor exercises are effective in controlling incontinence, many women with incontinence never receive appropriate training in these first-line behavioral techniques. Furthermore, the usual barriers to engaging in behavioral incontinence management faced by mainstream U.S women are greatly magnified for ethnic minority women with limited English proficiency, who struggle to find healthcare providers who can provide education or support for incontinence in languages other than English. Our research addresses the critical lack of access to training or support for first-line behavioral management of incontinence among ethnic minority women with limited English proficiency. Rather than relying on scarce clinicians who combine clinical expertise in incontinence with fluency in languages other than English, we propose to adapt an interactive, web-based, patient-facing program for behavioral incontinence management (MyHealtheBladder) previously developed by a member of our study team. Designed for smartphones with pictorial, written, and limited audio content, this program offers a potentially accessible, scalable platform for providing language-concordant education and support to diverse women with incontinence in the community. With support from the NIH Office of Research in Women’s Health, we propose to adapt this mobile health program for women from the two largest ethnic minority groups with high rates of limited English proficiency in the United States: Latina women whose preferred language is Spanish, and Chinese American women whose preferred language is Chinese. We will recruit midlife and older women from these backgrounds from the community and obtain their iterative, substantive feedback on the content and format of the mobile health program. Based on pilot-testing of initial language-concordant program versions as well as input from local community organizations focused on Latina and Chinese American health, we will refine program prototypes to pave the way for future follow-up studies that can evaluate feasibility, acceptability, and eventually efficacy of mobile health training in behavioral incontinence management in these populations. If the adapted mobile health program is eventually found to be effective in larger-scale trials, it can be widely disseminated by healthcare systems and community organizations to reduce the burden of incontinence among Spanish- and Chinese-speaking women nationwide, as well as adapted for additional language and ethnic groups in the future. As a result, this research has great potential to decrease disparities in incontinence for demographically important groups who have been marginalized from existing systems of incontinence care.

项目摘要 三分之一的中年和老年妇女患有尿失禁，这是一种导致抑郁的疾病， 社交孤立、功能衰退和丧失独立生活能力。尽管行为管理 诸如膀胱训练和骨盆底锻炼的策略在控制尿失禁方面是有效的， 患有失禁的妇女从未接受过这些第一线行为技术的适当训练。 此外，通常的障碍，从事行为失禁管理所面临的主流美国 对于英语水平有限的少数民族妇女来说，妇女的作用被大大放大了，她们很难找到 可以用英语以外的语言提供失禁教育或支持的医疗保健提供者。 我们的研究解决了严重缺乏获得培训或支持的一线行为管理， 英语能力有限的少数民族妇女大小便失禁。而不是依靠稀缺的 临床医生谁结合联合收割机在失禁的临床专业知识与流利的语言以外的英语，我们 我建议采用一种互动的、基于网络的、面向患者的程序来进行行为失禁管理 （MyHealtheBladder）之前由我们研究团队的一名成员开发。专为智能手机设计， 图片，书面和有限的音频内容，该计划提供了一个潜在的访问，可扩展的平台， 为社区中不同的失禁妇女提供语言一致的教育和支持。 在美国国立卫生研究院妇女健康研究办公室的支持下，我们建议将这种移动的健康 计划的妇女从两个最大的少数民族群体与有限的英语熟练程度高的比例， 美国：拉丁裔妇女，其首选语言是西班牙语， 首选语言为中文。我们将从这些背景中招募中年和老年妇女， 社区，并获得他们对移动的健康的内容和形式的迭代，实质性的反馈 程序.根据对初始语言一致程序版本的试点测试以及当地 社区组织专注于拉丁裔和华裔美国人的健康，我们将完善计划原型， 为未来的后续研究铺平道路，这些研究可以评估 移动的健康培训在这些人群中的行为失禁管理。 如果经过调整的移动的医疗程序最终在大规模试验中被发现是有效的，它可以被广泛应用。 由卫生保健系统和社区组织传播，以减轻失禁的负担 在全国讲西班牙语和汉语的妇女中， 未来的民族。因此，这项研究有很大的潜力，以减少差距，在失禁 针对在人口统计学上重要的群体，这些群体被现有的失禁护理系统边缘化。