Health and Racial Disparities: Importance of Accurate and Reliable Ethnicity, Race, and Language Data.

Introduction: Accurate demographic data are essential to identify and monitor differences, trends, and changes in diabetes-related conditions between Hispanics and non-Hispanic Blacks (NHBs). It also provides pertinent information to reduce health and racial disparities among English- and Spanish-speakers. Method: The study's design was a quantitative cross-sectional one. Electronic medical record (EMR) and survey data of the same sample were compared. Descriptive statistics were computed for ethnicity, preferred language, and physiological data. Frequency and percentages were calculated for each continuous and categorical variable. Chi-square was calculated to compare physiological variables by ethnicity and language. Results: During a 5-month period (September 2021-February 2022), 106 individuals from New York City with diabetes took part in this study. Among Hispanics, most from the EMR identified as Other (82.4%), whereas from the survey, most identified as White (57.1%). More Hispanics (19%) and Spanish speakers (18%) had high triglyceride levels compared to NHBs (2%) and English speakers (3%). Conclusion: Ensuring that demographic data are accurate can better inform programs. Because Hispanics and Spanish speakers had the highest triglyceride levels, diabetes programs need to include information on cardiovascular disease and must be available in Spanish, to further reduce risk factors, improve health outcomes, and promote health equity among these populations.

National Institutes of Health R-series Grants portfolio of racism and healthcare, 2017-2022.

BACKGROUND: Any form of racism in healthcare is an unacceptable barrier to receiving equitable and quality care, further contributing to health disparities among populations. For these reasons, it is critical to have a better understanding on the amount of research and scientific advances of funded projects aimed at racism in healthcare. An examination of the distribution of R-series funded research by the National Institutes of Health (NIH) on racism in healthcare during a 5-year fiscal year (FY) period (2017-2022) was conducted by the study team. METHODS: This cross-sectional study used publicly available data from the NIH RePORTER (Research Portfolio Online Reporting Tools: Expenditures and Results) for research project grants awarded on racism and healthcare during the FYs of 2017 to 2022. The number of R-series NIH funded projects on racism in healthcare were examined, including the abstract and public health relevance statement, number of publications, spending category, fiscal start and end dates, total amount of funding each year, funding agency/center(s), and type of funding opportunity announcements. Descriptive statistics were performed on the data by the research team. RESULTS: There were a total of 93 R-series grants funded during the FYs of 2017 to 2022. Most of the grants were R01s (77.4%); focused primarily on racism at the system-wide level (68.8%), and on patients (64.5%); the largest racial and ethnic minority group reported were African/American/Black (20.4%); and close to 40% did not report race or ethnicity. None of the grants focused in internalized racism, which is at the individual -level. From the FYs of 2017 to 2022, 0.07% of all NIH research funding was awarded to racism in healthcare. CONCLUSION: The findings of this study showed the need for continued funding and of the need of more research on racism in healthcare, that potentially can reduce health disparities and inequities.

What Are the English to Spanish Translation Methods Used on Written Health-Related Information?

Objective: This systematic review was conducted to examine methods and tools used to translate written health-related information from English to Spanish. Methods: The design of this study was a systematic review. This review search was of all published articles up to July 2022. Three databases were used: CINAHL Plus, MEDLINE, and PubMed. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis flowchart was used in the systematic review. Results: A total of 17 articles were used in the analysis. Six (35.3%) of the articles used a machine and human translation method, and eight (47%) used Google Translate as the machine translation tool. The screening, full-text review, and data extraction were done using the Covidence software. Discussions: As translating health-related information accurately is crucial, using metrics or standardizing one is urgently needed. Nursing implications: This review highlights that in addition to a lack of standardized metrics, there currently is no criterion on the qualifications or credentials required by individuals who translate written information from English to Spanish, allowing anyone to do so. This is concerning because it is critical that Spanish speakers and those with limited English proficiency receive linguistically accurate and appropriate resources that allow them to improve their health literacy and promote health.

COVID-19 survey among NYC non-Hispanic Black and Hispanic/Latino adults with diabetes.

OBJECTIVES: To better understand the knowledge, practice, importance, awareness, usefulness, and confidence of non-Hispanic Black and English- and Spanish-speaking Hispanic/Latino adults with diabetes. DESIGN: A descriptive cross-sectional survey study design was used and descriptive statistics was conducted. SAMPLE: Non-Hispanic Black and Hispanic/Latino adults with diabetes were recruited from three New York City public hospitals. MEASUREMENTS: A one-time survey was delivered via email, text message or over the phone. RESULTS: Of the 96 participants, 47.9% were Hispanic/Latino and 52.1% were non-Hispanic Black individuals; 43.8% of the surveys were completed in Spanish and 56.3% in English; 41.7% were female and 58.3% male; 77.1% preferred to complete the survey via the telephone, 14.6% through email, and 8.3% via text message. Chi-square findings showed, 90.6% knew mask wearing prevented COVID-19; 96.9% knew that covering the nose and mouth during mask wearing is needed, 93.8% wore a mask, and 92.8% felt it important or very important to wear a mask to prevent the spread of COVID-19. For social distancing, 88.5% knew it prevented the spread of COVID-19, 93.8% practiced it, and 95.8% felt it important or very important. CONCLUSION: In having a better understanding of the knowledge and practices of COVID-19 among non-Hispanic Black and Hispanic populations with diabetes, the development of culturally and linguistically tailored community-based mitigation strategies can be developed that are aimed at improving the preparedness of these groups for the next emerging infectious disease, such as COVID-19.

Literature Review on Diabetes Internet-based Spanish-Language Information.

BACKGROUND: Diabetes is a growing epidemic that is affecting Hispanics in high rates. INTRODUCTION: Although Hispanics use the internet for health-related informational and educational purposes, there is a lack of information available in the Spanish-language. METHODS: A review was conducted to examine the literature on internet-based, Spanish-language, diabetes focused information. One search was conducted using three different databases (i.e. CINAHL, MEDLINE, and PubMed). The search used the keywords diabetes, internet, and Spanish, and was based on published articles from January 1, 2005 to June 30, 2016. RESULTS: Of the 46 articles reviewed, one was a duplicate, and 41 were eliminated. These findings show a lack of data and research on Spanish-language, internet-based diabetes informational and educational sites. CONCLUSION: Qualitative and quantitative studies are needed to develop and examine Spanish-language diabetes internet sites and the health-related impact they have on Hispanics who prefer Spanishlanguage sites.

Health effectiveness of community health workers as a diabetes self-management intervention.

OBJECTIVE: To evaluate the health effectiveness of community health workers among three groups (intervention, attentional control and control groups) of Hispanic adults with uncontrolled (HbA1c >8%) type 2 diabetes mellitus. METHODS: This was a randomized clinical trial involving 180 English- and Spanish-speaking Hispanic individuals with uncontrolled type 2 diabetes mellitus, 40-74 years of age, who received diabetes care at an outpatient, public, urban hospital. Repeated-measures analysis of variance was used to evaluate the effect of time and group on the primary outcome measure and secondary outcomes. Group differences in the percentage of participants achieving at least 1% reduction in HbA1c levels were assessed using chi-square tests. RESULTS: Patients' ages ranged from 44 to 74 years, 40% were male, 97% preferred Spanish and seven Spanish-speaking countries were identified as country of origin. Relative to the control and attentional control groups, the intervention group showed greater HbA1c reduction from baseline to 12 months and was the group with the highest percentage of participants showing 1% or more HbA1c reduction. CONCLUSION: Integration of community health workers improved disease control for patients with type 2 diabetes mellitus during the intervention phase. Peer-driven/interactive ways to sustain diabetes control need to be explored.

Validating an electronic health literacy scale in an older hispanic population.

AIM: To examine the validity of the Spanish version of an instrument used to measure electronic health literacy (eHEALS) with an older Hispanic population from a number of Spanish-language countries living in New York City in the United States (US). BACKGROUND: Although the Internet is available globally, complex skills are needed to use this source of valuable health-related information effectively. Electronic health literacy is a multifactorial concept that includes health literacy but also requires technology skills. DESIGN: Cross-sectional. METHOD: Recruitment occurred at a Senior Organization located in a largely Hispanic neighbourhood in New York City (N = 100). Participants completed eHEALS and selected items from the Health Information National Trends Survey (HINTS) which assesses how adults use different communication channels, including the Internet, to obtain vital health information. Data from the US HINTS sample (N = 162) were matched to the Senior Organization sample on age range and Hispanic ethnicity. The average Senior Organization participant was 68 years old, female, born in one of six different Spanish-language countries, and completed high school while the average HINTS participant was 67 years old, female and had high school or less education. RESULTS: Although there was no relationship with the two HINTS subscales and electronic health literacy, there were significant relationships between electronic health literacy and health status and confidence in self-care. CONCLUSIONS: Inadequate electronic health literacy is a barrier to positive health outcomes. The Spanish version of eHEALS could be used as a screening instrument to identify gaps and tailored interventions could be developed to increase consumer confidence in using the Internet for reliable health-related information. RELEVANCE TO CLINICAL PRACTICE: Knowledge in self-management is related to positive health outcomes; all persons irrespective of their electronic health literacy should be able to use all sources of health information to enhance their self-care.

Electronic health literacy of older Hispanics with diabetes.

Although the internet increases the availability of diabetes-related health information, health care consumers need to have different skills in order to obtain, interpret and evaluate such information. The eHealth literacy scale (eHEALS) was originally developed to assess consumers' perceived skills at using information technology for health. The objective of this study was to explore the experiences of older Hispanics' with type 2 diabetes in using the internet for diabetes management. This study was conducted in the USA among a convenience sample of older Hispanics with type 2 diabetes (n = 20) who attended a senior center in East Harlem, New York City. All participants first completed eHEALS and a demographic, diabetes-related, and smart phone use form either in English or Spanish and then participated in a focus group. Descriptive statistics and a univariate exploratory analysis were conducted to determine differences in electronic health literacy based on age or gender. In addition, qualitative data from the focus groups were analyzed. No significant differences were found based on age (F = 0.76, p = 0.66), but a t-test found significant differences based on gender (t = -2.67, df = 18, p = 0.015). During the qualitative data analysis, five themes were identified from the focus group responses. Although the participants had access to the internet, they were not using the technology to access diabetes-related health information. Given the small sample size in this study, the Spanish version of the instrument needs to be used in a larger sample and further psychometric testing.

Mentoring Hispanic undergraduate and graduate research assistants: building research capacity in nursing.

BACKGROUND: This article discusses and describes the experiences of five Hispanic bilingual (English and Spanish) research assistants (RAs) who were undergraduate and graduate nursing students and who were part of a research team. METHOD: A capacity-building framework was used, which has six guiding principles: a whole-system approach; accommodating diversity; reducing barriers to participation; enabling collaboration; mentoring; and facilitating networking. In addition, mentorship and peer learning were essential components of building research capacity. RESULTS: Reflections of the five RAs highlighting how these principles were applied are described. The experiences of the five Hispanic RAs and the outcomes of the projects are also described. CONCLUSION: These experiences demonstrate the importance of involving undergraduate and graduate nursing students in research, which can build research capacity and increase the number of Hispanic nurses in the workforce.