Integrated Second Language Learning for Chronic Care: A model to improve primary care for Hispanics with diabetes

描述（由申请人提供）：慢性病护理的综合第二语言学习：改善西班牙裔糖尿病患者护理的干预措施摘要医疗保健中的语言障碍被认为是美国西班牙裔人健康差异的主要决定因素。1有限的英语水平（LEP）也与西班牙裔人糖尿病流行病飙升有关。对于西班牙裔来说，2型糖尿病（DM 2）的患病率是非西班牙裔白人的1.5倍。3在家不讲英语的西班牙裔患者接受糖尿病护理的风险更大，而且他们采取特殊饮食控制糖尿病、定期锻炼、 最近的研究表明，患者和初级保健提供者之间的语言一致性（LC）是改善LEP糖尿病患者治疗结果的有效先决条件。增加LC护士执业人数的干预措施包括为医疗保健专业人员开发第二语言（L2）能力的教育计划。第二语言训练的现存文献综述 对卫生专业人员的调查显示，绝大多数方案和材料都是针对基本水平的熟练程度，并限于有限类型的临床互动。目前的研究团队认为，这些计划和材料基本上是面向急性护理的，反映了患有慢性疾病的LEP患者人群与接受过L2急性护理功能培训的卫生专业人员之间的不匹配。这种不匹配，我们争辩说，加剧了LEP患者所面临的困难，糖尿病患者在实现成功的自我管理和身体和情绪的健康，随之而来的沿着it.This建议描述了一个创新的教育干预护士执业学生称为综合语言学习慢性护理（IL2L）的设计和评价。它追求L2和沟通技能的综合发展，这将促进讲西班牙语的护士执业者和LEP西班牙裔糖尿病患者之间的富有成效的互动。将采用混合方法研究设计来检查干预措施的初步疗效和可接受性。在患者层面，我们将采用随机对照试验来确定IL 2 L对未控制糖尿病患者的身体健康、心理健康和自我效能的影响。在学生层面，我们将采用Roter互动分析系统来衡量干预前后西班牙语互动技能的收益。在计划层面，我们将使用语言课程评估方法来评估在一个领先的护理学院的护士执业培训计划的干预措施的可接受性。

DESCRIPTION (provided by applicant): Integrated Second Language Learning for Chronic Care: An Intervention to Improve Nursing Care for Hispanics with Diabetes ABSTRACT Language barriers in healthcare are recognized as a leading determinant of health disparities among Hispanics in the United States.1 Limited English proficiency (LEP) has also been linked to the soaring diabetes epidemic among Hispanics. For Hispanics, the prevalence of type 2 diabetes mellitus (DM2) is 1.5 times that of non- Hispanic whites.3 Hispanic patients who do not speak English at home are at greater risk of foregoing diabetes care and they are significantly less likely than non-Hispanics to adopt a special diet for diabetes control, to exercise regularly, and to receive a yearly eye examination.6, 3 Recent research suggests that language concordance (LC) between patients and primary care providers is an effective precondition that improves outcomes in the treatment of LEP patients with diabetes. Interventions to increase the number of LC nurse practitioners consist of educational programs that develop second language (L2) abilities for health care professionals. A review of extant literature on L2 training for health professionals revealed that the preponderance of programs and materials are directed at basic levels of proficiency and confined to limited types of clinical interactions. The view of he present research team is that these programs and materials are substantially geared towards acute care and reflect a mismatch between an LEP patient population with chronic illnesses and a health professional workforce trained in L2 for acute care functions. This mismatch, we contend, exacerbates the difficulties faced by LEP patients with diabetes in achieving successful self- management and the physical and emotional wellness that goes along with it. This proposal describes the design and evaluation of an innovative educational intervention for nurse practitioner students called Integrated Language Learning for Chronic Care (IL2L). It pursues an integrated development of L2 and communication skills that will facilitate productive interactions between Spanish-speaking nurse practitioners and LEP Hispanic patients with diabetes. A mixed-method study design will be used to examine the preliminary efficacy and acceptability of the intervention. At the patient level, we will employ an RCT to determine the impact IL2L on the physical health, mental health, and self-efficacy of patients with uncontrolled diabetes. At the student level, we will employ the Roter Interaction Analysis System to measure gains in Spanish language interaction skills pre and post intervention. At the program level, we will use language program evaluation methodologies to assess the acceptability of the intervention within a nurse practitioner training program in a leading College of Nursing.