exploring health literary

Cultural & Language ResearchNESTOR & NATURAL

Cultural Horizons, Inc.

www.cultural-horizons.com

Nancy H. Lang

http://www.cultural-horizons.com/

www.cultural-horizons.com2

Health Literacy Intervention Points

Outcomes


Research

“Most of the tools currently available to measure health literacy primarily measure reading skills and do NOT include other critical skills.”

-IOM Report


Research

“Culture gives meaning to health communication. Health literacy must be understood and addressed in the context of culture and language”

-IOM Report


Objectives

•Explore health literacy needs at key points

•Understand general attitudes and treatment challenges

•Explore language and cultural implications

•Explore ideas for culturally sensitive Health Literacy tools/education programs

•Test journal ads with patients (allergic rhinitis)


Methodology

• Patients (focus groups)

– Hispanics of various nationalities– Caucasians (CIU only)

• Physicians (phone interviews)

– Latino and non-Latino providers

– At least 25% of providers’ patients had to be Latino


Research Tools

Naturalness – does the language sound natural?

Adequacy – is the literacy level adequate?

Translation – is the translation good?

Understanding – is the message understood?

Relevance – is the content relevant to needs and cultural preferences?

Action – will the message motivate them to take action?

Limitations – is the Spanish understood by just a particular nationality?

NATURALTM NESTORTM


Case Study

Nasacort original ad.pdf


Case Study


NESTORTM

Non-traditional medications and activities

Education needs for condition

Symptoms description

Treatment options (prescribed or auto-medicated)

Options to reach the patient that are culturally relevant

Recommendations to improve compliance, help with diagnosis, education, etc.

Nestor\Nes Tore\, n; [GR Nestor] Wisdom


Non-traditional medications and activities

Caucasians mentioned using the following home remedies:

– Oatmeal soaks– Baking soda– Witch-hazel– Epson salts– Vinegar– Aloe Vera– Paraffin coating

Latinos had the following products on their lists:

– Lime juice– Rubbing alcohol– Cornstarch– Chamomile soak– Arnica– Aloe Vera

NESTORTM


Education needs for specific condition

Content/Vehicles of patient education program:– Suggestions for content include:

• Information about the condition in lay terms

• A list of possible symptoms

• Treatment options and avoidance/prevention suggestions• Where to get help

• Do’s and don’ts of home/folk remediesDos: Aloe, cornstarch, chamomile might helpDon’ts: Alcohol, lime juice, arnica won’t help

– Create awareness of patients’ right to demand language assistance

NESTORTM


Symptoms descriptionNESTORTM

*hinchazonSwelling

*ampollasBlisters

*ardorBurning

*sarpullido (or *salpullido) and *erupcionRash

*ronchasHives

Picor*picazon*comezonItching

Puerto Rico

Cuba & S.A.

MexicoEnglish

*Spanish terms understood by all



Askilitos/hormigueo (sensation of bugs crawling on skin)

Itching (other terms)

*dolor de cabezaHeadache

*hinchazon de ojosSwelling of eyes

*piel seccaDry skin

Puerto Rico

Cuba & S.A.

MexicoEnglish





*rechazadoRejected

*deprimidoDepressed

*ansiedadAnxiety

*desesperadoDesperate

*irritable or *molestosoIrritable

Puerto Rico

Cuba & S.A.

MexicoEnglish


Treatment Expectations

Latinos are influenced by health experiences and behaviors developed in their home country. In the U.S., this influences their approach to:

– Product choice – some are loyal to established brands in their home country.

– Self-medication – either with OTCs, Rx (purchased in home country) or home remedies.

• Self medication with Rx products was not significant, but there were a few mentions of patients securing medications from their home countries.

– Expectations of how they are treated at the physician’s office.

NESTORTM


Options that are culturally relevant

According to patients, educational materials should:

– Be in Spanish and English– Be in everyday, “lay” language– Include visuals

Information might be made available:– On radio and TV– In newspapers and magazines– At doctors’ offices and clinics– At pharmacies (drugstores and grocery)– On medication boxes or inserts

NESTORTM


Recommendations

Physicians need to overcome the language barrier in order to reach their Latino patients:

– Explain the problem in a way patients understand

– Words used to describe symptoms can vary among Latinos

“Spanish does not equal Spanish does not equal Spanish.”

– There are few educational materials in Spanish• Visual aids, videos and a storybook format are

helpful for educating Latinos.

NESTORTM


Research Recommendations

• Develop an educational program that incorporates clinical and cultural/language issues that impact acceptance of care.

• Develop tools to enhance communication between the physician and the patient.– Empower patients to request an interpreter– Help in the diagnosis process– Promote compliance– Inform about the do’s and don’ts of home

or other remedies


“Knowing is not enough; we must apply, Willing is not enough, we must do.”

Goethe

Cultural & Language ResearchNESTOR & NATURAL

Cultural Horizons, Inc.www.cultural-horizons.com

Nancy H. [email protected]

http://www.cultural-horizons.com/

exploring health literary

Health & Medicine