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Effect of language immersion on communication with Latino patients.

BACKGROUND: In the US, the fastest growing segment of the general pediatric population is Latino children. Language barriers may impede optimal care for these patients. Programs are needed to enhance communication effectiveness with Latino patients. We examined the effect of language immersion training for pediatric faculty on their communication with Latino patients. METHODS: Five general pediatric faculty physicians were sent to Guatemala for a two-week language immersion course and then had monthly one-hour Spanish language meetings for one year. Before and after immersion, six, and twelve months later, their Spanish skills were assessed. Before and after faculty training, Latino parents of pediatric patients were surveyed to assess their trust in and communication with the attending pediatricians. Spanish survey instruments were pilot tested and revised (trust scale alpha = 0.79; communication scale alpha = 0.80). RESULTS: Language proficiency increased for all the faculty participants, from a baseline score of 28% to a post-intervention score of 55%, p < 0.001. This increase in proficiency was sustained six and twelve months after the intervention. General linear modeling with repeated measures was used to examine associations between physician, parent, and clinic variables and the doctor-patient communication and patient trust scores. Even though baseline communication and trust scores were high, both improved after the intervention, p < 0.01. CONCLUSION: A two-week faculty language-training program can improve physician' language skills, communication, and trust between non-Latino doctor and Latino patient. Other measures of cultural competence should be measured and cost-benefit analyses conducted to assess the impact of immersion versus classroom experience.

Adult↗

Training of trainers in the Caribbean Basin Water Management Project.

This article discusses the Caribbean Basin Water Management Project, a joint venture of 10 Caribbean countries, the Canadian International Development Agency (CIDA), the Government of the Netherlands, and PAHO. In 1977 an assessment of the project revealed that though training activities were carried out, most of them were designed for engineers and technicians-a small percentage of all employees-who did not pass on their knowledge to their coworkers. The training of trainers program was initiated to encourage improved communication among staff members. The fundamental precept of this program is that training should be a basic component of management activities. The article outlines the criteria for selecting participants for the training workshops, stressing that the prospective candidates should be in supervisory positions where training is part of their job. Instructors should also be carefully selected, and, as in the case of the participants, should have a long-term commitment to the water utility. At the end of the workshop series, the trainees should be able to make a task analysis, write and evaluate performance objectives, demonstrate communication techniques, use training aids, develop and implement an instructional sequence, and apply evaluation mechanisms. The article summarizes the benefits of the program, such as increased productivity of the supervisors, better communication between supervisors and the staff, and improved attitudes on the part of the staff toward their work.

International Cooperation↗

Adopt an MRA--an education program for clinicians.

The 'Adopt an MRA' program aims to facilitate communication between clinicians and Medical Record Administrators (MRAs) regarding medical record documentation, coding, DRG assignment and general casemix issues, within the realms of a 650 bed Sydney Teaching Hospital. This paper aims to provide the reader with some insight into the background, processes and outcomes of the program.

Australia↗

[The prevalence of communication problems in neglected children under three years of age].

OBJECTIVE: Estimate the prevalence of communication problems in children under three taken into care by Youth Centres in Quebec for negligence. Prevalence is calculated for the pragmatic aspect, receptive and expressive language, according to age and sex. METHOD: This is a cross-sectional study. A representative sample of 84 children was drawn consecutively from the lists of new children registered at the Youth Centres. RESULTS: 46.4% of the children present a problem in at least one area of communication. The prevalence and seriousness of the problems increase significantly with age. Boys are significantly more affected than girls. CONCLUSION: Negligence constitutes a threat to the development of communication. According to the data reported in this study, there is substantial justification for early intervention, promotion and prevention programs with regard to communication problems among neglected children.

Child Abuse↗

Sexuality and sex education at home and school.

This article reviews numerous studies of parent-adolescent communication about sexuality and 30 studies of sexuality and HIV education programs. Although parent-adolescent communication about sexuality has increased during the last few decades, both the occurrence and the quality of this communication could still be greatly improved. There does not exist a clear simple relationship between greater parent-adolescent communication and less adolescent risk-taking behavior, but both adults and youth believe it is important anyway. Sexuality and HIV education programs do not increase any measure of sexual activity, but some of them with ten common characteristics do reduce sexual risk-taking, either by delaying or reducing sexual behavior or increasing condom use. Thus, these programs can be an effective component in a larger initiative to reduce HIV, other STDs, and unplanned pregnancy in adolescence.

Adolescent↗

The benefits of library liaison programs for small libraries: an overview.

Library liaison programs are commonly used and provide a successful framework for communication in academic libraries. Liaison programs, whereby librarians are formally designated as the primary contact between the library and one or more departmental or administrative units, are proven to improve the transfer of information between the library and users, to improve the quality of collections and services, and to enhance the library's image. Previously published literature on liaison programs is primarily devoted to large-scale liaison programs in academic settings, the market where this model is commonly employed. Small hospital and other smaller libraries are nearly absent in the literature, reflecting the low level of liaison use in the smaller library setting. This article invites hospital and other smaller libraries to explore the liaison model by presenting common liaison goals and activities that are not only pertinent to, but also scalable, adaptable, and adoptable by smaller and larger libraries alike.

Academic Medical Centers↗

Preparing health care organizations for successful case management programs.

This article reports the results of a study of four hospital-based providers in varying stages of implementing case management programs. Three of the providers had most of the necessary elements in place to ensure success, such as a mix of reimbursement sources, an effective and integrated information management system, a full range of clinical services, and continuous quality improvement programs. The authors make several suggestions for key activities that must be pursued by any health care organization seeking to implement a case management program in an era of managed care, tightening reimbursement, and consumer demand for quality care. These include the need to (a) organize essential case management functions under a centralized structure; (b) set realistic, quantifiable targets, and (c) design a communications plan for the program.

Case Management↗

Cardiovascular health among African-Americans: a review of the health status, risk reduction, and intervention strategies.

BACKGROUND: This article reviews the literature of African-American risk and identifies the disparity in cardiovascular health status, particularly hypertension, hypercholesterolemia, and cigarette smoking, and mortality rates between African-Americans and whites. METHODS: Data on African-Americans' knowledge and attitudes toward preventing hypertension and heart disease are summarized and compared to that of whites. RESULTS: Program implementation details such as communication channels, activities, and health outcomes in cardiovascular risk reduction programs in African-American communities are summarized. DISCUSSION: Promising approaches to program planning and implementation for cardiovascular risk reduction among African-Americans are recommended.

Adult↗

Modeling: a method for program development.

Successful program development is crucial for nursing. The methodology of modeling systematically integrates program development strategies recommended in the nursing literature. In addition to guiding program planning and design, the series of diagrams which modeling generates can be used to guide program implementation, evaluation, refinement, and reformulation. The diagramming also facilitates communication with others about the program.

Health Services Needs and Demand↗

Smoking behaviour of Czech adolescents: results of the Global Youth Tobacco Survey in the Czech Republic, 2002.

The Czech Republic Global Youth Tobacco Survey (GYTS) is a school-based survey of students in grades 7-9, conducted in 2002. A two-stage cluster sample design was used to produce representative data for all of the Czech Republic. On a large sample of students (N=4,149) from 7-9th grade it reveals that smoking among children has been continually growing. According to the results of this study, over 34% of the respondents smoke. Results of the study help us to understand social and attitudinal factors that affect adolescent smoking habits. Social factors include particularly the convenient availability of cigarettes and the lack of the legal regulation of the retail of cigarettes: over one half of all smokers under 15 years of age regularly purchase cigarettes in regular retail outlets; 72% of them reported never having been restricted in their purchases because of their age. Advertising and media coverage appears to be another important factor that affects smoking in this age group. Over 80% of children under 15 years of age reported that they have been exposed to the tobacco advertising. The study also allows an interesting analysis of the exposure to the environmental tobacco smoke. Compared to non-smokers, this exposure has been significantly higher in the case of smokers--both in their homes and at other locations (58% vs. 25%, and 90% vs. 57% respectively). The analysis of the data also revealed a strong misconception about the health risks related to passive smoking among smokers. The study provides three key findings for health promotion: (1) it is necessary to exert a continuous pressure on the political representation to strictly enforce the regulations of tobacco distribution and availability to minors; (2) school health education as well as community oriented prevention programs need to explicitly communicate non-smoking as a standard; and (3) it is important to increase the attractiveness and availability of smoking cessation programs.

Adolescent↗

Intergenerational talk and communication with older people.

A program of research conducted within an anti-agism paradigm demonstrates that young people process and respond to the speech of older people in stereotypical ways. Such conclusions result from studies using a variety of research methods. Experimental studies demonstrate that older-sounding speech triggers age schematic responses and that young people tend to use agist strategies of information seeking and compliance gaining from older people, while interactive studies explore how stereotypes and age identities are co-produced by young and old people in conversation. We use lifespan and intercultural perspectives to argue that the communicative patterns we observe in our studies are in some senses and contexts counterproductive in both the long and short term, in that they can reproduce negative attitudes toward aging as well as inhibit successful aging.

Adult↗

An experimental assessment of facilitated communication.

This report presents a quantitative study of facilitated communication. Participants were 12 people living at an institutional autism program and 9 people who provided them with facilitated communication support. These subjects were the 12 most competent producers of facilitated communication in the program. They were shown pictures of familiar objects and asked to type the names of the objects under three conditions: (a) assisted typing with facilitators unaware of the content of the stimulus picture, (b) unassisted typing, and (c) a condition in which the participants and facilitators were each shown pictures at the same time. In this last condition the paired pictures were either the same or different, and the participant's typing was facilitated to label or describe the picture. These participants were unable to succeed in the tasks without facilitator assistance. On trials when the facilitators and participants had different pictures, the only "correct" labels were for pictures shown to the facilitators and not shown to the participants. This finding demonstrates that the facilitators were unknowingly determining what was typed.

Adolescent↗

Operationalizing strategic marketing.

The strategic marketing process, like any administrative practice, is far simpler to conceptualize than operationalize within an organization. It is for this reason that this chapter focused on providing practical techniques and strategies for implementing the strategic marketing process. First and foremost, the marketing effort needs to be marketed to the various publics of the organization. This chapter advocated the need to organize the marketing analysis into organizational, competitive, and market phases, and it provided examples of possible designs of the phases. The importance and techniques for exhausting secondary data sources and conducting efficient primary data collection methods were explained and illustrated. Strategies for determining marketing opportunities and threats, as well as segmenting markets, were detailed. The chapter provided techniques for developing marketing strategies, including considering the five patterns of coverage available; determining competitor's position and the marketing mix; examining the stage of the product life cycle; and employing a consumer decision model. The importance of developing explicit objectives, goals, and detailed action plans was emphasized. Finally, helpful hints for operationalizing the communication variable and evaluating marketing programs were provided.

Advertising↗

Developing communication competency in the context of cancer: a critical interpretive analysis of provider training programs.

We conducted a critical interpretive analysis of 47 studies from the Cochrane Review of the communications training literature to capture the empirical indicators used to judge provider communication competency and to describe how the indicators were characterized in the context of a cancer care system. Of the 47 studies reviewed, few showed any resemblance to recommendations from two international consensus conferences of experts in the communication research field. Some of the challenges in moving forward with cancer-related communication skills involve deciding what we want people to learn, providing learning across various experiences, identifying learning models, and finding alternate ways of motivating people to learn. Once core competencies are clearly articulated, we can determine the best approaches for developing cancer-specific training programs.

Communication↗