Evaluating the Linguistic Appropriateness and Cultural Sensitivity of a Self-Report System for Spanish-Speaking Patients with Cancer

Abstract

Spanish speakers in the United States encounter numerous communication barriers during cancer treatment. Communication-focused interventions may help Spanish speakers communicate better with healthcare providers and manage symptoms and quality of life issues (SQOL). For this study, we developed a Spanish version of the electronic self-report assessment for cancer (ESRA-C), a web-based program that helps people with cancer report, track, and manage cancer-related SQOL. Four methods were used to evaluate the Spanish version. Focus groups and cognitive interviews were conducted with 51 Spanish-speaking individuals to elicit feedback. Readability was assessed using the Fry readability formula. The cultural sensitivity assessment tool was applied by three bilingual, bicultural reviewers. Revisions were made to personalize the introduction using a patient story and photos and to simplify language. Focus group participants endorsed changes to the program in a second round of focus groups. Cultural sensitivity of the program was scored unacceptable (falsex¯=3.0) for audiovisual material and acceptable (falsex¯=3.0) for written material. Fry reading levels ranged from 4th to 10th grade. Findings from this study provide several next steps to refine ESRA-C for Spanish speakers with cancer.

Prostate Cancer Information Available in Health-Care Provider Offices: An Analysis of Content, Readability, and Cultural Sensitivity

“…Cultural sensitivity was assessed using the Cultural Sensitivity Assessment Tool (CSAT), which was originally developed to assess cultural sensitivity of printed cancer materials for AAs ( Guidry & Walker, 1999 ), and has since been used to evaluate cancer educational materials for diverse racial/ethnic groups ( Friedman & Hoffman-Goetz, 2006a ; Friedman & Kao, 2008 ; Thomson & Hoffman-Goetz, 2007 ; Tofthagen et al, 2014 ). Three categories of CSAT—format (3 items), written message (11 items), and visual message (16 items)—were assessed using a 4-point Likert scale (4 = strongly agree ; 3 = agree ; 2 = disagree ; 1 = strongly disagree ).…”

Overcoming Disparities in Cancer: A Need for Meaningful Reform for Hispanic and Latino Cancer Survivors

“…Non-English speaking HLs may experience challenges engaging with healthcare professionals due to the language barrier as many providers are English monolingual 88 . Despite efforts to use medical interpreters, patient navigators or promotoras, these challenges persist and may lead to an inadequate patient understanding of illness and a barrier to engaging further with healthcare providers 89,90 .…”

“…With a better understanding of their disease, treatment algorithms, and prognoses, HL can then make informed decisions about their care and feel empowered to guide their own treatment, helping to overcome the large disparities often present. The benefits afforded by pairing a patient with a member of their ethnic background may be partially due to alleviating language barriers, but studies have shown that additional cultural factors help to improve patient comfort as well [88]. Hispanics and Latinos identify more with health care providers of similar cultures, family beliefs, and religions because of a bond formed through shared experiences [140].…”