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This article demonstrates how digital information and communication technologies (ICTs) (Zoom/WhatsApp) unexpectedly and counterintuitively proved to be valuable tools for community-engaged health research when, in the context of the COVID-19 pandemic, they were integrated into a research study testing a peer support group intervention with female immigrants from Mexico. Because of pandemic restrictions, we changed the study protocol to hold meetings remotely via Zoom rather than in person as originally planned. Because we recognized that this would lack some opportunities for participants to interact and develop relationships, we created a WhatsApp chat for each group. Despite challenges for participants to use ICTs and participant-stated preference for in-person meetings, the results demonstrated that participants overwhelmingly endorsed these technologies as promoting access, participation, engagement, and satisfaction. Zoom/WhatsApp created a valuable environment both as a method for conducting research with this population, but also as part of the intervention for immigrant women to support and learn from each other. ICT adaptations have now permanently changed the way we conduct community-engaged health research.
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We are a group of 11 women in Albuquerque, New Mexico. Nine of us are immigrants from Mexico. One of us is from an immigrant household. One of us is neither. We have been working collaboratively on a research study called Tertulias (Spanish for "a social gathering"), which is an innovative women's peer support group approach we created to reduce social isolation, depression, and stress among women immigrants from Mexico, and to increase their resilience and sense of empowerment. In the process of implementing the Tertulias study, we are revealing the profound power of peer support, friendship, and small, quotidian kindnesses. But we are also exposing the immensity and scope of trauma, fear, loneliness, depression, and self-blame that exist in the Mexican immigrant community because of domestic violence. Our experience with domestic violence and with the consciousness-raising and support we found in Tertulias has made us want to be involved in a positive manner to do something about this issue in our community. We want our experience to mean something-to be used to make a difference. We are opening our hearts and sharing our stories and ideas. We wanted to be included as co-authors of this article because we want our stories to be received and heard by other women. We want to plant seeds to help other women find their inner strength to be able to escape from their chains. We have to return for others. It is a commitment-to understand how we were able to do it and share that with others. Through our experience participating in Tertulias, we learned that we could overcome what felt overwhelming and impenetrable. We could leave the violence and rediscover and recreate ourselves and our lives.
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Violencia Doméstica , Emigrantes e Inmigrantes , Femenino , Humanos , Empleo , MéxicoRESUMEN
Study designs involving randomization can be difficult to communicate to participants, especially those with low literacy. The literature on strategies to explain research concepts is limited, especially for non-English speakers. We measured the effectiveness of a culturally and contextually situated multimedia approach to recruit a cohort of 60 female Mexican immigrants (FMI) to a randomized control trial (RCT) to reduce social isolation and depression. This strategy was designed to explain the concept of randomization, explain what participating in the research study entailed, and ensure informed consent. Potential participants viewed a presentation explaining the study and a video including animation with voice-over explaining the concept of randomization. We administered a pre/post survey. Respondents (N = 59) reported an increase in their understanding of randomization, intention to enroll, and attitude towards participating in research. We conclude that a culturally and contextually situated multimedia approach is an effective model when recruiting underrepresented populations with low literacy for RCTs.
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Consentimiento Informado , Multimedia , Femenino , Humanos , Hispánicos o Latinos , Intención , Encuestas y Cuestionarios , Ensayos Clínicos Controlados Aleatorios como Asunto , Competencia Cultural , Selección de Paciente , Emigrantes e Inmigrantes , México/etnología , New MexicoRESUMEN
This study aimed to test the 2 × 2 model of dispositional perfectionism in an Ecuadorian sample of 1562 students aged between 12 and 17 years (M = 14.83 years, standard deviation = 1.86 years). The Child and Adolescent Perfectionism Scale and the brief 21-item version of the Depression Anxiety Stress Scales were used. Cluster analysis revealed four profiles: Pure Self-Oriented Perfectionism, Pure Socially Prescribed Perfectionism, Mixed Perfectionism, and Non-perfectionism. Mixed Perfectionism and Non-perfectionism obtained, respectively, the highest and lowest scores in anxiety, depression, and stress. The results are discussed in light of cultural differences in the interpretation and consequences of perfectionism.
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Ansiedad/epidemiología , Depresión/epidemiología , Perfeccionismo , Estrés Psicológico/epidemiología , Adolescente , Niño , Ecuador/epidemiología , Femenino , Humanos , Masculino , Estudiantes/psicologíaRESUMEN
Our philosophical framework for research with low-income Latino patients with diabetes prioritizes hiring research staff who share the culture and language of the population of study. Inclusive research design requires an active role by patient stakeholders with training opportunities in a collaborative learning environment to allow patient stakeholder data collectors (PSDCs) to build on existing strengths and expertise. To develop this manuscript, our team reflected on our collective experiences in implementing research-specific trainings for PSDCs. Although our population of study is known to be difficult to recruit and retain, our PSDCs have successfully enrolled participants on schedule, and attrition is low. Although language, institutional requirements, and funding restrictions presented training challenges, we overcame these by using a flexible approach and by incorporating the data collectors' expertise in refining our protocols. We propose that our success in recruiting and retaining participants is a reflection of our engaged research strategy and framework and demonstrates that engagement promotes better science. However, our experience also demonstrates research institutions need to make policy and infrastructural improvements to reduce barriers and make engaged approaches more feasible.
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BACKGROUND AND OBJECTIVES: Neither the health care system nor the training of medical residents focus sufficiently on social determinants of health. Community health workers (CHWs) are a growing presence in health care settings. Culturally and linguistically competent, typically they are from underserved communities and spend more time addressing social determinants of health than others on the health care team. However, CHWs are an infrequent presence in resident clinical training environments. The University of New Mexico Family Medicine Residency placed family medicine residents at a community clinic in Albuquerque managed by CHWs, recognizing that CHWs' collaboration with residents would enhance resident competency in multiple domains. Residents gained skills from CHWs in inter-professional teamwork, cultural proficiency in patient care, effective communication, provision of cost-conscious care, and advocating for both individual and community health. Our model recognizes the value of CHW skills and knowledge and creates a powerful rationale for greater recognition of CHW expertise and integration of CHWs as members of the care team.
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Agentes Comunitarios de Salud , Medicina Familiar y Comunitaria/educación , Internado y Residencia/métodos , Determinantes Sociales de la Salud , Comunicación , Conducta Cooperativa , Competencia Cultural , Accesibilidad a los Servicios de Salud , Humanos , Relaciones Interprofesionales , Modelos Educacionales , Grupo de Atención al PacienteRESUMEN
BACKGROUND: Previous work has established a surprisingly high prevalence of acanthosis nigricans (AN) and its association with increased risk of type 2 diabetes in a Southwestern practice-based research network (PBRN). Our objective was to establish whether this high prevalence of AN would be present in other areas. METHODS: We examined the prevalence of type 2 diabetes and its risk factors and the prevalence of AN among patients aged 7 to 65 years who had been seen by one of 86 participating clinicians in a national PBRN consortium during a 1-week data collection period. In a subsample of nondiabetic matched pairs who had or did not have AN, we compared fasting glucose, insulin, and lipid levels. RESULTS: AN was present in 19.4% of 1730 patients from among all age ranges studied. AN was most prevalent among persons with more risk factors for diabetes. Patients with AN were twice as likely as those without AN to have type 2 diabetes (35.4% vs 17.6%; P < .001). In multivariable analysis, the prevalence ratio for diabetes was 2.1 (95% CI, 1.3-3.5) among non-Hispanic whites with AN and 1.4 (95% CI, 1.1-1.7) among minority patients with AN. In a subsample of 11 matched pairs, those with AN had higher levels of insulin and insulin resistance. CONCLUSIONS: We found high rates of AN among patients in primary care practices across the country. Patients with AN likely have multiple diabetes risk factors and are more likely to have diabetes.
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Acantosis Nigricans/epidemiología , Diabetes Mellitus Tipo 2/epidemiología , Atención Primaria de Salud/organización & administración , Adolescente , Adulto , Anciano , Investigación Biomédica , Niño , Comorbilidad , Estudios Transversales , Diabetes Mellitus Tipo 2/prevención & control , Práctica Clínica Basada en la Evidencia , Femenino , Humanos , Masculino , Persona de Mediana Edad , Análisis Multivariante , Prevalencia , Atención Primaria de Salud/métodos , Factores de Riesgo , Sudoeste de Estados Unidos/epidemiología , Adulto JovenRESUMEN
Se analizan los factores de riesgo presentes en infecciones de heridas operatorias en cesárea de urgencia en un hospital público docente asistencial de Santiago. Se diseñó un estudio de casos y controles prospectivos que incluyó 90 casos y 171 controles. Los resultados obtenidos fueron analizados según tipo de incisión, presencia de obesidad, número de tactos vaginales, número de horas de rotura ovular, tipo de cirujano, uso de irrigación del tejido celular subcutáneo y hora del día en que se realizó la intervención. Los resultados obtenidos indican que no hay diferencia entre los tipos de incisión media infraumbilical o pfannenstiel, la presencia de obesidad o el tipo de cirujano. Existe mayor riesgo de infección de herida operatoria con más de 5 tactos vaginales en el trabajo de parto, más de 13 horas de trabajo de parto, uso de cierre del tejido celular subcutáneo y no irrigación de éste y cuando la intervención se realiza en la madrugada en nuestro hospital
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Humanos , Femenino , Adolescente , Adulto , Cesárea/estadística & datos numéricos , Infección de la Herida Quirúrgica/epidemiología , Urgencias Médicas/epidemiología , Estudios de Casos y Controles , Laparotomía/estadística & datos numéricos , Obesidad/complicaciones , Complicaciones Posoperatorias , Procedimientos Quirúrgicos Electivos/estadística & datos numéricos , Profilaxis Antibiótica , Factores de RiesgoRESUMEN
Se estudiaron 183 sujetos, divididos en tres grupos: (1) 61 sujetos dependientes de la cocaína, (2) 59 sujetos poliadictos (sujetos que utilizaban simultáneamente varias substancias psicoactivas), y (3) 63 sujetos de control , pareados por edad y nivel educacional. Todos los sujetos farmacodependientes cumplían los criterios de dependencia de acuerdo con el DSM-III-R (1987), pero presentaban un periodo de abstinencia de por lo menos treinta días. SE administró una batería de diagnóstico neuropsicológico, especialmente diseñada para esta investigación, que incluyó las siguientes secciones: (1) Una entrevista dirigida, (2) Escala de inteligencia Wechsler para Adultos (Wechsler, 1974), (3) Escala de memoria de Wechsler (Wechsler, 1945). (4) Prueba de denominación de Boston (Kaplan, Goodglass y Weintraub, 1983), (5) Prueba de rastreo, Formas A y B (Reitan y Wolfson, 1985), (6) Fluidez Verbal (Semántica y fonológica), (7) Figura compleja de Rey-Osterrieth, 1944) en tres condiciones (copia, reproducción inmediata, y reproducción diferida), y (8) Prueba de Clasificación de Tarjetas e Wisconsin (Berg, 1948, Heaton, 1981). Se observó un decremento significativo en las subpruebas de memoria a corto término y atención .los puntajes en las diferentes pruebas se correlacionaron inversamente con el tiempo de consumo y/o la frecuencia de uso, surgiendo una relación directa entre el uso de cocaína y los defectos cognoscitivos. Los sujetos de los grupos experimentales y el grupo de control se diferenciaron significativamente en sus historias personales y familiares, apuntando a la existencia de factores predisponenetes a la farmacodependencia. En los sujetos experimentales con relación al grupo de controles normales se halló: (a) retardo en el desarrollo psicomotriz, asociado con problemas de hiperactividad, desviaciones, conducta, defectos atencionales, problemas de relaciones interpersonales, y en general, una historia inapropiada de desarrollo, (b) presencia de posibles...