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

慢性病护理综合第二语言学习：改善西班牙裔糖尿病患者初级护理的模式

基本信息

批准号：
8839601
负责人：
USHA MENON
金额：
$ 35.82万
依托单位：
OHIO STATE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2014
资助国家：
美国
起止时间：
2014-09-22 至 2019-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8839601
关键词：
Acute Adherence Adopted Affect Anxiety Care given by nurses Caring Chronic Care Chronic Disease Chronically Ill Clinical Communication Development Diabetes Mellitus Diabetic Retinopathy Diagnosis Diet Dimensions Discipline of Nursing Educational Curriculum Educational Intervention Emotional End stage renal failure Epidemic Evaluation Evaluation Methodology Exercise Eye Health Professional Healthcare Hispanics Home environment Individual Instruction Intervention Language Language Development Lead Linguistics Link Lipids Literature Measures Medical Errors Mental Depression Mental Health Methods Modeling Non-Insulin-Dependent Diabetes Mellitus Not Hispanic or Latino Nurse Practitioners Outcome Patients Perception Performance Personal Communication Population Prevalence Primary Health Care Program Evaluation Provider Quality of Care Randomized Reporting Research Research Design Risk Roter Screening for cancer Self Efficacy Self Management Students Systems Analysis Testing Time Training Training Programs Treatment Efficacy United States Weight cardiovascular disorder prevention chronic care model college design diabetes control diabetic falls health disparity high risk improved innovation patient oriented patient population physical conditioning post intervention preconditioning programs public health relevance response satisfaction skill acquisition skills success treatment planning

项目摘要

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.

描述（由申请人提供）：慢性护理的第二语言学习：用于改善医疗保健中糖尿病的抽象语言障碍的西班牙裔护理护理的干预措施被认为是美国西班牙裔健康差异的主要决定因素。1有限的英语能力（LEP）也已与Hispanics expanics epcanicection sepanice sepanics sepanics链接在一起。对于西班牙裔人来说，2型糖尿病（DM2）的患病率是非西班牙裔白人的1.5倍。3在家中不说英语的西班牙裔患者的预期糖尿病护理的风险更大，并且它们比非希斯氏疗法的可能性要少于糖尿病控制，锻炼特殊饮食，锻炼糖尿病的可能性要少得多。 6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）是一个有效的先决条件，可改善对LEP糖尿病患者治疗的预后。增加LC护士从业人员数量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。关于L2培训现有文献的评论对于卫生专业人员而言，大量的计划和材料针对基本水平，并仅限于有限类型的临床相互作用。目前的研究团队的观点是，这些计划和材料基本上旨在急性护理，并反映出患有慢性疾病的LEP患者人群与在L2接受过急性护理功能的卫生专业人员之间的不匹配。我们认为，这种不匹配加剧了LEP糖尿病患者在实现成功的自我管理以及随之而来的身体和情感健康方面所面临的困难。该建议描述了针对名为“慢性护理综合语言学习”的护士从业者学生（IL2L）的创新教育干预措施的设计和评估。它追求L2和沟通技巧的综合发展，这将促进讲西班牙语的护士从业者和LEP西班牙裔糖尿病患者之间的富有成效互动。混合方法研究设计将用于检查干预措施的初步疗效和可接受性。在患者一级，我们将采用RCT来确定IL2L对不受控制的糖尿病患者身体健康，心理健康和自我效能感的影响。在学生层面，我们将采用转子互动分析系统来测量西班牙语互动技能前后的干预措施。在计划级别上，我们将使用语言程序评估方法来评估在领先的护理学院护士从业者培训计划中干预措施的可接受性。