Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Department of Medicine, Weill Cornell Medical College, New York, NY, USA.
Patient Educ Couns. 2022 Feb;105(2):398-406. doi: 10.1016/j.pec.2021.05.040. Epub 2021 Jun 2.
Many breast cancer patients are vulnerable to poor nutritional status and may benefit from nutrition education, but existing materials are not generally tailored to the needs of low-literacy immigrant and minority patients.
With nutritionist guidance, we developed a nutrition presentation for breast cancer patients. English- (n = 29) and Spanish-speaking (n = 19) patients were recruited from 5 safety-net hospitals, an academic cancer center, and a Latina cancer support organization. Materials were tested using multiple rounds of cognitive interviewing (with an adapted USDA interview guide), followed by study team reviews and modifications, until saturation.
Seven rounds of interviews per language were needed. Approximately 25% of interviewees had less than a high school education. Changes included adapting to regional lexicons and resolving vague/confusing phrasing. Specific food examples needed cultural tailoring. Text color coding (red/bad, green/good) was requested. Labeled images enhanced participants' understanding of concepts. Spanish speakers expressed a desire to understand nutrition labeling, and this was emphasized in the Spanish slides.
Cognitive interviews were an important tool for creating a nutrition curriculum tailored to the needs of low-literacy, mostly immigrant patients.
Cultural and linguistic factors should be considered for nutritional education materials in diverse patient populations.
许多乳腺癌患者容易出现营养状况不良的情况，可能需要接受营养教育，但现有的材料通常无法满足低识字移民和少数族裔患者的需求。
在营养师的指导下，我们为乳腺癌患者开发了一份营养讲座材料。我们从 5 家社区医疗中心、一家学术癌症中心和一家拉丁裔癌症支持组织招募了英语（n=29）和西班牙语（n=19）患者。我们使用多轮认知访谈（使用经过改编的美国农业部访谈指南）对材料进行了测试，然后由研究团队进行审查和修改，直到达到饱和。
每种语言需要进行 7 轮访谈。大约 25%的受访者受教育程度低于高中。修改内容包括适应区域性词汇和解决模糊/混淆的措辞。特定的食物示例需要进行文化调整。文本颜色编码（红色/不良，绿色/良好）受到了参与者的欢迎。带标签的图像增强了参与者对概念的理解。西班牙语受访者表示希望了解营养标签，因此西班牙语幻灯片中对此进行了强调。
认知访谈是为低识字、主要为移民患者量身定制营养课程的重要工具。
在为不同患者群体提供营养教育材料时，应考虑文化和语言因素。
