Cognitive Testing of PAIN Report It-Spanish in Monolingual Hispanic Adults.

BACKGROUND: A Spanish language computerized tool would facilitate cancer pain assessment and management for the underserved population of native Spanish speakers who do not speak or lack command of the English language. OBJECTIVE: Our aim was to identify Spanish-speaking adults' understanding and interpretation of the PAIN Report It-Spanish items and instructions as well as translation and technical issues. METHODS: In a cross-sectional study, 20 mostly monolingual Spanish-speaking adults engaged in 1.5- to 2-hour, audio-recorded cognitive interviews as they completed the multidimensional PAIN Report It-Spanish. Three bilingual researchers conducted content data analysis. RESULTS: Sixteen women and 4 men generally understood the translated text, but some had interpretation issues regarding the 0 to 10 number scale and understanding of the pain quality descriptors. Many participants found the program easy to complete, even when they had problems in some areas. Most participants welcomed the opportunity to report pain in their native language and appreciated research to help Hispanics with the management of their pain. CONCLUSION: PAIN Report It-Spanish is a valid tool to assess pain in a Spanish-speaking population. Improved orientation to the pain reporting tasks and alternate translations for several problematic/confusing Spanish words require additional study, especially among underrepresented black Hispanics and males. IMPLICATION FOR PRACTICE: Findings indicate that Spanish-speaking adults (1) easily use a body outline to report their pain location, (2) may use a 0 to 10 scale differently than other individuals, and (3) may have a limited repertoire of pain quality and pattern descriptors.

Reproductive Health CHOICES for Young Adults with Sickle Cell Disease or Trait: Randomized Controlled Trial Outcomes over Two Years.

Interventions to assist reproductive health decision-making in populations affected by sickle cell disease (SCD) or trait (SCT) lack proven efficacy over time. Our aim was to compare effects of CHOICES, a Web-based multimedia education program on implementing informed reproductive plans, and usual care education (e-Book) on reproductive knowledge, intention, and behavior over 24 months. We randomized 234 participants with SCD (n = 138) or SCT (n = 96) (age 18-35 years, 35 % male, 94 % African American) to CHOICES and e-Book groups. Participants completed a sickle cell-specific reproductive measure before and four times after the intervention (6, 12, 18 and 24 months). Compared to the e-Book group the CHOICES group had significantly more improvement in knowledge over time (p = .004) but not intention (p = .18) or behavior (p = .69). At baseline, 114 (48.7 %) participants reported having partners who would not put the couple at risk for their children inheriting SCD. Of the 116 (49.6 %) at-risk participants, a higher poroportion of those who were in the CHOICES group chose partners that reduced their risk by the last visit than the e-Book group (p = .04). Study findings provide important insights for designing a national trial of the CHOICES intervention focusing on subjects whose partner status puts them at risk for having a child with SCD.

Evaluation of the SCKnowIQ tool and reproductive CHOICES intervention among young adults with sickle cell disease or sickle cell trait.

The study purpose was to evaluate a computer-based questionnaire (SCKnowIQ) and CHOICES educational intervention using cognitive interviewing with childbearing-aged people with sickle cell disease (SCD) or trait (SCT). Ten control group participants completed the SCKnowIQ twice. Ten intervention group participants completed the SCKnowIQ before and after the CHOICES intervention. Most participants found the questionnaire items appropriate and responded to items as the investigators intended. Participants' responses indicated that the information on SCD and SCT and reproductive options was understandable, balanced, important, and new to some. Internal consistency and test-retest reliability were adequate (.47 to .87) for 4 of the 6 scales, with significant within-group changes in knowledge scores for the intervention group but not for the control group. Findings show evidence for potential efficacy of the intervention, but proof of efficacy requires a larger randomized study.