CLHIN eNewsletter For March, 2013
CLHIN eNewsletter for October, 2013
CLHIN eNewsletter for September, 2013
Communicating With LEP Patients
The American Medical Association has released the 2nd edition of its Official Guide to Communicating with Limited-English-Proficient Patients [608 KB PDF]. It’s a very brief guide — only 11 pages of text in a foldover 8 1/2″ by 5 1/2″ booklet — but it’s packed full of very practical information covering questions like:
- What does the term “LEP” mean?
- How do I know if I have LEP patients in my practice?
- How do language barriers affect quality of care and patient safety?
- What is the relationship between language assistance and cultural competency?
- What current and emerging strategies exist that can help physicians care for LEP patients?
- How should physician offices handle telephone calls to and from LEP patients?
- What can your office do to improve access to services for LEP patients?
- How can physician offices finance language assistance services?
Besides its own practical information, the booklet also includes useful references to further information, including:
- The Cross-Cultural Health Care Program
- National Center for Cultural Competence [note: the URL in the booklet is incorrect; this is a correct link]
- National Health Law Program – see their Library of Resources on Cultural and Linguistic Access to Health Care
- The Addressing Language Access Toolkit by the California Academy of Family Physicians
- The Health Care Language Services Implementation Guide by the HHS Office of Minority Health
Table 1 of that booklet (p. 4) emphasizes that bilingual health-care practitioners provide an option with high interpreting quality and a high patient comfort level, that is appropriate for all healthcare settings. This September 2007 article from NurseZone describes the success of one such program at the University of California-Davis Medical Center that includes nurses who are fluent not only in English, but also in Spanish, Russian, or Hmong.
Día del Médico
Tomorrow is “el Día del Médico” in Mexico, which has been celebrated on 23 October annually since 1930. In recognizing the event, Notimex cites a recent international study called “The Global Doctor” in which market research firm Grupo Psyma AG surveyed 600 doctors in China, Germany, Japan, Spain, the United States and Mexico. The results of that study indicate that despite working conditions that are not always optimal, doctors in Mexico (both specialists and general practitioners) report a very high level of satisfaction with their work and with their personal lives — higher than in many of the other surveyed countries. The article notes that:
“One of the reasons that doctors feel satisfaction for their profession, despite adverse situations, is the high social recognition they have among the general population, the acceptance of their mission to help their neighbors, and their work in research and teaching… Mexican doctors are similar to their Chinese colleagues in terms of the social prestige of their profession, which is highly valued.”
¡Saludos a todos los médicos en su día!
Diabetes Research Funded
The Hispanic population of South Texas has been fighting a battle against two strong opponents…diabetes and obesity. But thanks to a $5 million grant from the National Institutes of Health’s National Center on Minority Health and Health Disparities, the fight to combat these two growing health problems will be fought even harder.
Researchers from the University of Texas School of Public Health’s Brownsville regional campus plan to establish the Center of Excellence on Diabetes in Americans of Mexican Descent. The aim of this center will be to develop prevention programs for diabetes and obesity in Mexican Americans. The additional funding will help to expand a region-wide media campaign on preventing obesity and improving health.
Figures from Cameron County prove the need for just such a program.
52% of county residents are obese
32 % of county residents are overweight
1 in 5 county residents has diabetes
23% of county residents have pre-diabetes
The goal of the researchers’ work is to find programs that will work in changing behavior and making Valley residents healthier.
Disparities in Adult Awareness of Heart Attack Warning Signs
The CDC’s Morbidity and Mortality Weekly Report for 2008-02-22 focused on a public health information issue potentially affecting hundreds of thousands of patients in the US each year. A new analysis of 2005 Behavioral Risk Factor Surveillance System (BRFSS) looked at data from 13 states and the District of Columbia, where the BRFSS included questions on the signs & symptoms of heart attack. The analysis found that overall, less than a third of all respondents were able to correctly identify the five warning signs of a heart attack, when given a list of closed-end (yes/no/don’t-know) questions. Those warning signs include:
- Pain and discomfort in the jaw, neck or back
- Feeling weak, lightheaded or faint
- Chest pain or discomfort
- Pain or discomfort in the arms or shoulder
- Shortness of breath
Even fewer respondents indicated that they would immediately call 9-1-1 if they suspected someone was having a heart attack. And although Texas was not one of the states studied, the analysis found notable disparities in awareness of heart-attack warning signs between Hispanic adults and non-Hispanic adults: only 14.3% of Hispanic adults knew the five warning signs and indicated they would call 9-1-1 in case of heart attack, compared with 16.2% among non-Hispanic blacks and 30.2% among non-Hispanic whites. Men also lagged significantly behind women overall (22.5% vs 30.8%) in awareness of the signs and correct steps to take.
Additional information on this study:
Dissatisfaction of Breast Cancer Decision-Making Among Latinas
The results of a study recently published in the journal Patient Education and Counseling shows dissatisfaction among Latinas, compared to other racial groups, in the decision-making process to have a mastectomy or lumpectomy.
The study consisted of a survey of over 2,000 women (Spanish-speaking Latinas, English-speaking Latinas, African Americans, and Caucasians) who had been diagnosed with early-stage breast cancer. The decision-making process itself was very similar in the percentages of women who, 1) let the surgeon play a mjaor role in treatment decision, 2) shared the process with the surgeon, or 3) based the surgery decision primarily on their own wishes. However, the results also showed a greater dissatisfaction with the decision-making process among the Spanish-speaking Latinas, and a greater feeling of regret about their decision.
Although reasons for the differences were not part of the study, one possible reason for the dissatisfaction may have been tied to one or more cultural issues, such as the need to have the family more involved in the decision-making process. According to Dr. Sarah T. Hawley of the University of Michigan in Ann Arbor and her colleagues, “These results…suggest that additional effort may be needed by clinicians to ensure that information is understandable and culturally appropriate and improve the decision making for all breast cancer patients.”
Effect of Acculturation on Drinking Along the Border
Acculturation to American society has often come with a price for immigrants, and that is the use of alcohol and the accompanying problems. This fact has been proven through research conducted primarily in metropolitan areas. But for the first time, research has focused on the use of alcohol on the Texas/Mexico border. Using information gathered during 2002-2003, among an almost even split of men and women, conclusions have been drawn on the effect of alcohol on the genders.
According to Raul Caetano, professor of epidemiology and regional dean (Dallas) at the University of Texas School of Public Health:
“There is a clear differential effect of acculturation by gender. While this was shown in previous research, the effects on the border seem to be more accentuated. Men drank less as they acculturated, and had a lower prevalence of alcohol-use disorders. Women drank more with acculturation, but this did not seem to lead to a higher rate of alcohol use disorders.”
The full report has been published in the February issue of Alcholism: Clinical & Experimental Research
El Paso to take part in diabetes study
With the rising number of diabetes cases along the Texas/Mexico border, it is important to know how to manage the disease in order to live a full, productive life. But, it is also important to do all that can be done to determine who might be at the greatest risk for developing diabetes. This is especially important in families where a family member has already been diagnosed.
It is with this goal in mind that El Paso has been chosen to take part in a seven-year study on diabetes funded by the National Institutes of Health. The study, which will involve approximately 840 El Paso residents, is aimed at detecting which relatives of people who already have Type 1 diabetes might develop the disease. El Paso was chosen due to the high number of people (approximately 85,000 ) with Type 1 and Type 2 diabetes.
The study will be conducted through the El Paso Diabetes Association , and will be done in conjunction with 18 clinical centers throughout the United States and other countries.