The Adolescent Health Care Broker-Adolescents Interpreting for Family Members and Themselves in Health Care.

Parents with limited English proficiency might rely on their adolescent children to interpret health information. We call this adolescent healthcare brokering. Using a mixed-methods, transformative research approach rooted in grounded theory, we sought to answer these questions: (a) "What is happening? What are people doing?" and (b) "What do these stories indicate? What might they suggest about social justice?" High school students from a community in which 53.4% speak another language at home were invited to participate in a survey and focus groups. Of 238 survey participants, 57.5% (n = 137) indicated they assisted with healthcare tasks. When doing so, 81.7% (n = 112) translated. Common tasks were reading prescriptions and talking to doctors. While some participants cited negative emotions associated with brokering, the net emotion was positive. Focus groups (n = 11) revealed that tasks varied broadly in complexity and type, emotional experiences were dichotomous, and access to interpreting services and other supports was inconsistent. This research adopts an advocacy lens and uses a mixed-methods, transformative research approach rooted in grounded theory to describe and call attention to a social justice phenomenon we call adolescent healthcare brokering. We define adolescent healthcare brokering as young people acting as linguistic interpreters in healthcare situations for themselves and for family members with limited English proficiency (LEP). In such situations, language acts as a barrier to health literacy and access to healthcare [17]. Despite this known barrier, there is a gap in the research regarding how to successfully address this situation (McKee, Paasche-Orlow, Journal of health communication 17(3):7-12, 2012).

Adolescent Healthcare Brokering: Prevalence, Experience, Impact, and Opportunities.

BACKGROUND: Limited health literacy disproportionately affects those with limited English proficiency (LEP). Parents with LEP might rely on their adolescent children to interpret health information. We call this adolescent healthcare brokering. This study uncovers the prevalence of brokering, kinds of tasks, emotional and academic impact, and desired support. METHODS: We invited 165 students from health classes (in a community in which 29.8% are foreign-born and 53.4% speak another language at home) to complete a survey. We used IBM SPSS to calculate descriptive statistics. RESULTS: Of the 159 who received parental consent and assented, 54.1% (N = 86) assist with healthcare tasks. When brokering, 80.2% (N = 69) translate. Most common tasks were talking to a doctor, reading prescriptions, and searching on the Internet. Participants were most confident reading prescriptions and talking to a doctor and least confident finding healthcare services. Among brokers, 29.1% (N = 24) missed school; 33.7% did not complete homework. They most wanted to learn about filling out insurance forms and talking to doctors. CONCLUSIONS: Despite assurances that children are not permitted to interpret, adolescents are acting as healthcare brokers. The impact can be academic and emotional. Findings indicate a need for further research and support for adolescents who want to learn about healthcare tasks.

Public health citation patterns: an analysis of the American Journal of Public Health, 2003-2005.

OBJECTIVES: The research sought to determine the publication types cited most often in public health as well as the most heavily cited journal titles. METHODS: From a pool of 33,449 citations in 934 articles published in the 2003-2005 issues of American Journal of Public Health, 2 random samples were drawn: one (n = 1,034) from the total set of citations and one (n = 1,016) from the citations to journal articles. For each sampled citation, investigators noted publication type, publication date, uniform resource locator (URL) citation (yes/no), and, for the journal article sample, journal titles. The cited journal titles were analyzed using Bradford zones. RESULTS: The majority of cited items from the overall sample of 1,034 items were journal articles (64.4%, n = 666), followed by government documents (n = 130), books (n = 122), and miscellaneous sources (n = 116). Publication date ranged from 1826-2005 (mean = 1995, mode = 2002). Most cited items were between 0 and 5 years old (50.3%, n = 512). In the sample of 1,016 journal article citations, a total of 387 journal titles were cited. DISCUSSION: Analysis of cited material types revealed results similar to citation analyses in specific public health disciplines, including use of materials from a wide range of disciplines, reliance on miscellaneous and government documents, and need for older publications.