Language, Literacy, Culture: Communication of Health Concepts

许多疾病的关键健康概念的口头交流对预防、筛查和临床管理至关重要。当言语成为障碍时，这种交流就变得更加困难。健康素养受一般识字、语言和文化解读的影响。关于跨越这些潜在障碍最大限度地进行健康概念的口头交流，人们知之甚少。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，将开发研究三个关键健康概念：头痛、喘息和抑郁的有效口语交流的方法学方法。1)我们的基本假设是，不同的语言群体和具有不同一般识字水平的群体将具有不同的健康素养水平，这反过来将反映在他们对所说的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中开发出一个概念性框架，该框架可以应用于未来旨在克服口语健康沟通障碍的干预研究。研究的第一阶段将包括主要线人与医学专家的访谈，其中一些专家会说西班牙语或广东话的双语。在第二阶段，我们将以英语、西班牙语和广东话举办12个专题小组，每组8至10人，每个小组的一般文化程度分为低读写和高读写。我们将使用埃利希跨文化咨询公司的高技能焦点小组主持人，他们拥有在每种语言方面领导焦点小组的多年经验。焦点小组将在一个新的最先进的焦点小组设施中举行，该设施具有广泛的技术能力，包括一个观察室，项目领导人将在观察室内观察焦点小组，并有一名同声传译在场。焦点小组将被录像，由此产生的记录将被转录和翻译。我们将使用数据沉浸式来分析焦点小组。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具有不同语言、文化和一般识字率的人如何理解关键的健康概念，以便开发旨在改善口语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.