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

项目总结 每三名中老年女性中就有一人患有尿失禁，这是一种导致抑郁症的疾病， 社会孤立、功能衰退和丧失独立生活能力。虽然行为管理 诸如膀胱训练和盆底锻炼等策略在控制大小便失禁方面是有效的，许多 大小便失禁的女性从来没有接受过这些第一线行为技巧的适当培训。 此外，美国主流社会在从事行为失禁管理方面通常面临的障碍是 对于英语水平有限的少数民族女性来说，女性被大大放大了，她们很难找到 可以用英语以外的语言为大小便失禁提供教育或支持的保健提供者。 我们的研究解决了严重缺乏对一线行为管理的培训或支持的问题 英语水平有限的少数民族妇女大小便失禁。而不是依赖于稀缺 临床医生将大小便失禁的临床专业知识与流利的英语以外的语言结合在一起，我们 建议采用交互式的、基于网络的、面向患者的程序来管理行为失禁 (MyHealtheBtier)之前由我们研究团队的一名成员开发。专为智能手机设计，具有 图片、文字和有限的音频内容，该程序提供了一个潜在的可访问、可扩展的平台 为社区中不同类型的大小便失禁妇女提供与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医疗 为来自两个最大的少数族裔群体的妇女提供的方案，这些少数民族的英语熟练程度很高 美国：首选西班牙语的拉丁裔女性和美籍华裔女性 首选语言为中文。我们将招募来自这些背景的中年和老年女性 并获得他们对移动保健的内容和形式的反复的实质性反馈 程序。基于对初始语言一致的程序版本的试点测试以及来自当地的输入 关注拉美裔和华裔美国人健康的社区组织，我们将改进计划原型，以 为未来的后续研究铺平道路，这些研究可以评估联合治疗的可行性、可接受性和最终疗效 在这些人群中进行行为失禁管理的流动健康培训。 如果改编后的移动健康计划最终在更大规模的试验中被发现是有效的，它可以广泛应用 由医疗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女性中，以及适应额外语言和 未来的种族群体。因此，这项研究在减少大小便失禁的差异方面具有很大的潜力 对于那些在现有失禁护理系统中被边缘化的人口统计学上重要的群体。

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.