Staton Michele, Cramer Jennifer, Walker Robert, Snell-Rood Claire, Kheibari Athena
University of Kentucky, College of Medicine, Department of Behavioral Science, 141 Medical Behavioral Science Building, Lexington, KY 40536.
University of Kentucky, College of Arts & Sciences, Department of Linguistics, 1415 Patterson Office Tower, Lexington, KY 40506-0027.
Rural Ment Health. 2019 Oct;43(4):138-149. doi: 10.1037/rmh0000117. Epub 2019 Sep 16.
A focus on the use of shared language to enhance congruence in interventionist-client dialogue is missing from traditional research on evidence-based practices and rural behavioral health. This study incorporates qualitative interactional sociolinguistics, which includes discourse analysis (typically written or audio recordings of face-to-face encounters with 11 clients and a study interventionist), to describe those speech patterns in a broad sense (dialect), as well as more specific use of communicative strategies to increase parity in the interaction between a rural interventionist delivering an evidence-based practice in the context of a research study with rural women opioid users in a non-therapeutic context. Study findings indicated that in the context of delivering the intervention, use of a shared language, language pattern congruence, and communication styles can greatly augment the intent of the approach with vulnerable populations. In addition, other communicative strategies connected with traditional Appalachian values - such as religion, home, and family - were also important. This study makes an important contribution to behavioral health research and practice by understanding critical factors that may influence evidence-based practice delivery, particularly in real-world settings with vulnerable populations. These findings have important implications for the utilization of creative approaches to understand critical components of the clinical interaction as indicators of fidelity.
传统的循证实践和农村行为健康研究中，缺乏对使用共享语言以增强干预者与服务对象对话一致性的关注。本研究纳入了定性互动社会语言学，其中包括话语分析（通常是与11名服务对象和一名研究干预者面对面交流的书面记录或录音），从广义上描述那些言语模式（方言），以及在非治疗背景下，农村干预者在对农村女性阿片类药物使用者进行研究的过程中，采用循证实践时使用更具体的沟通策略以提高互动平等性的情况。研究结果表明，在实施干预的背景下，使用共享语言、语言模式一致性和沟通方式能够极大地增强该方法对弱势群体的适用性。此外，与传统阿巴拉契亚价值观相关的其他沟通策略——如宗教、家庭和亲情——也很重要。本研究通过了解可能影响循证实践实施的关键因素，特别是在弱势群体的现实环境中，为行为健康研究和实践做出了重要贡献。这些发现对于采用创新方法理解临床互动的关键组成部分作为保真度指标具有重要意义。
