Tu Shin-Ping, Yip Mei-Po, Chun Alan, Choe John, Bastani Roshan, Taylor Vicky
Department of Medicine, University of Washington, Seattle, Washington, USA.
Med Care. 2008 Sep;46(9 Suppl 1):S51-61. doi: 10.1097/MLR.0b013e31817f0cde.
According to recent US census data, 52 million people reported speaking a language other than English at home, and almost 45% of this population reported limited English proficiency (LEP). Colorectal cancer (CRC) ranks among the top 3 most common cancers for several Asian ethnic groups, yet screening remains underutilized by Asian Americans.
This article describes the development of culturally and linguistically appropriate intervention materials for individuals with LEP. We discuss lessons learned from this research and implications for the translation of research into practice.
The Health Behavior Framework served as the conceptual model for this study, and qualitative findings guided the development of our intervention materials (a video and pamphlet). To recommend Western preventive behaviors, the research team bridged the gap between Western and Chinese values and beliefs by devoting particular attention to: (1) the target population's sociocultural values and health beliefs; and (2) unique linguistic features of the Chinese language.
Key lessons learned from this study include the importance of: (1) a conceptual framework to guide intervention development; (2) incorporating sociocultural values and health beliefs into the intervention; (3) addressing and capitalizing on complex linguistics issues; (4) using qualitative methodology in cross-cultural research; and (5) contributions from a multicultural and multilingual research team. Other lessons relate to the translation of research findings into practice. We surmise that lessons learned from this study may be pertinent to the promotion of CRC screening among other patient groups with LEP and applicable to additional cancer screening tests.
根据美国最近的人口普查数据，有5200万人表示在家中说英语以外的其他语言，并且该人群中近45%的人英语水平有限（LEP）。结直肠癌（CRC）在几个亚洲种族群体中是最常见的三种癌症之一，但亚裔美国人对结直肠癌筛查的利用率仍然较低。
本文描述了为英语水平有限的个体开发文化和语言适宜的干预材料的过程。我们讨论了从这项研究中吸取的经验教训以及将研究转化为实践的意义。
健康行为框架作为本研究的概念模型，定性研究结果指导了我们干预材料（视频和宣传册）的开发。为了推荐西方的预防行为，研究团队通过特别关注以下方面弥合了西方与中国价值观和信仰之间的差距：（1）目标人群的社会文化价值观和健康信仰；（2）汉语的独特语言特征。
从这项研究中吸取的关键经验教训包括：（1）一个指导干预开发的概念框架的重要性；（2）将社会文化价值观和健康信仰纳入干预；（3）解决和利用复杂的语言问题；（4）在跨文化研究中使用定性方法；（5）多元文化和多语言研究团队的贡献。其他经验教训与将研究结果转化为实践有关。我们推测，从这项研究中吸取的经验教训可能与在其他英语水平有限的患者群体中推广结直肠癌筛查相关，并且适用于其他癌症筛查测试。
