ABSTRACT
In this article, we describe the development of a comprehensive measure of breast and cervical cancer literacy for immigrant populations. To our knowledge, this is the first attempt to use a health literacy framework in this endeavor. Using qualitative strategies, we (a) developed an understanding of the experiences of Mexican and Filipina immigrant women with low health literacy through individual interviews, (b) conducted focus groups to obtain feedback from experts and participants to determine the adequacy of items included in the measure, and (c) refined the set of items to create an empirically based measure. The final measure included 129 items that assess beliefs, attitudes, knowledge, emotions, and contextual factors related to breast and cervical cancer. Processes for adapting the measure for use with other immigrant groups are discussed.
Subject(s)
Breast Neoplasms/ethnology , Early Detection of Cancer , Emigrants and Immigrants/education , Health Literacy , Uterine Cervical Neoplasms/ethnology , Adult , Aged , Aged, 80 and over , Asian People , Breast Neoplasms/diagnosis , Emotions , Female , Focus Groups , Health Knowledge, Attitudes, Practice , Humans , Middle Aged , Patient Acceptance of Health Care , Philippines/ethnology , Qualitative Research , United States/epidemiology , Uterine Cervical Neoplasms/diagnosisABSTRACT
As health care reform promises to change the landscape of health care delivery, its potential impact on women's health looms large. Whereas health and mental health systems have historically been fragmented, the Affordable Care Act (ACA) mandates integrated health care as the strategy for reform. Current systems fragment women's health not only in their primary care, mental health, obstetrical, and gynecological needs, but also in their roles as the primary caregivers for parents, spouses, and children. Changes in reimbursement, and in restructuring financing and care coordination systems through accountable care organizations and medical homes, will potentially improve women's health care.
Subject(s)
Mental Disorders/therapy , Patient Protection and Affordable Care Act/legislation & jurisprudence , Patient-Centered Care/organization & administration , Women's Health/legislation & jurisprudence , Caregivers , Health Services Accessibility/legislation & jurisprudence , Humans , Information Systems , Insurance, Health/legislation & jurisprudence , Patient-Centered Care/legislation & jurisprudence , Reproductive Health Services/legislation & jurisprudence , Spouse Abuse/therapy , United States , Women, Working/legislation & jurisprudenceABSTRACT
BACKGROUND: Despite the high risk of depression among Vietnamese refugees, there has been insufficient attention to the psychometric properties of the most utilized scale, the Vietnamese Depression Scale (VDS: Kinzie et al., 1982). AIM: The primary aim of the study is to empirically derive the factorial structure of the VDS to support its use as a culturally responsive depression screening tool in community samples of Vietnamese adults. METHOD: The factorial structure, reliability, and associations of the VDS factors with recognized socio-demographic correlates were examined using data collected from interviews with a non-probability community sample of 180 Vietnamese refugee adults in the Houston area. RESULTS: The empirically derived factorial structure of the VDS approximated the theorized conceptualization of depression introduced by the scale's originators. Three factors (depressed affect, somatic symptoms, and cultural-specific symptoms) accounted for 65% of the variance. As hypothesized, the VDS factors correlated with age and acculturation variables. CONCLUSION: Overall results suggest that the conceptualization of depression among this sample of Vietnamese refugees has both universal and culturally specific features. Implications for providing culturally responsive mental health services are offered.
