Areas of Interest

Culture and Health
Cross-Culture Care
Healthcare Delivery

Communicative Competence; Support Network; Medical Decision-Making

Patient Communicative Competence in Gynecological Oncology. Sponsored by the University of Oklahoma-Health Sciences Center/Oklahoma Tobacco Settlement Endowment Trust. Role: Principal Investigator. Period: 01/01/2012-06/30/2012. $60,335. [Completed]

This longitudinal study represents a pioneering work by examining health literacy in temporal and interpersonal contexts. We define communicative competence as the collaborative and evolving ability to acquire and use health information to achieve optimal health outcomes, which is a form of enacted health literacy. Communicative competence: (a) can empower participants to address their priorities and concerns, (b) is established through individuals’ communication, negotiation, and execution of their needs and goals, and (c) is evolving and situated in individuals’ illness experiences. The specific aim of the study is to identify changes in communicative competence over the course of an illness event. We are particularly interested in how communicative competence may evolve (a) during the emergent, dynamic interactions within a single medical encounter (e.g., sequential development of a medical discourse), and (b) over time across multiple medical encounters (e.g., changes of communicative strategies across multiple medical encounters). In addition, we are interested to examine providers’ and interpreters’ role in influencing the changes of patients’ communicative competence. Our study can provide insights into how communicative competence is not an individual property but rather an emergent characteristic of certain kinds of interaction, an area identified as critical in advancing current research.

The study includes both qualitative and quantitative research designs and incorporates a variety of data. The study represents a pioneering work by juxtaposing actual practice with the participants’ perceptions and evaluation of the quality of provider-patient communication (e.g., interviews). We will track 40 patients (i.e., 20-Spanish-speaking and 20 English-speaking patients) over an 6-month period, collecting a total of 160 video-recorded medical encounters. The total number of the medical encounters of the proposed study (n=160) is comparable to (in fact, slightly more than) other studies with similar research design for monolingual medical encounters. We will also conduct interviews with providers and patients. The longitudinal design also provides insight into how providers, patients, and interpreters can develop effective strategies to coordinate care over time. The quantity and quality of the data is unprecedented in research on bilingual health care.

Bilingual Health Communication, Interpreter-Mediated Interactions, Cross-Cultural Care

Providers' Views of the Roles of Medical Interpreters. Grant (#1R03MH76205-01-A1) funded by National Institute of Mental Health of the National Institutes of Health. Role: Principal Investigator. Period: 09/01/2006-08/31/2009. $146,417.[Completed]

The importance of medical interpreters to improve the health literacy of patients with limited English proficiency (LEP; e.g., through effective communication with health care providers) has been widely recognized; however their roles and functions are less understood and more widely debated. Although there are a few studies that have examined how interpreters understand their roles in health care settings, no studies have examined health care providers' expectations for the roles of interpreters and the quality of bilingual health communication. The objective of the study is to generate a new communication theory that highlights providers' communicative goals during a medical encounter and educates interpreters to respond to the providers' needs more effectively. The specific aims of this study are (a) to assess providers' experiences with, perceptions of, attitudes about, expectations for medical interpreters and (b) to explore differences in these dimensions across different medical specialties. The proposed study is a two-year project, involving both qualitative and quantitative methods. In year one, focus groups will be conducted with health care providers who have worked with medical interpreters to explore their views of interpreter-mediated interactions. In year two, based on the themes and categories developed from the focus group interviews, the PI will develop a questionnaire to survey health care providers about their attitudes about medical interpreters. The use of focus groups in year one to develop and test questionnaires in year two will increase the reliability and validity of the instrument. The specific research questions are: (a) What are providers' experiences with and attitudes about the communicative strategies used by interpreters?; (b) What are the criteria used by providers to evaluate the success of bilingual health communication?; (c) What are providers' expectations for interpreters' roles and performances?; and (d) Do providers in different specialties vary in their perceptions, attitudes, and expectations? Answering these questions will allow the PI to develop a program of research that includes further developing bilingual health communication theory and designing training programs to increase health literacy of patients with LEP.

Bilingual Health Communication, Interpreter-Mediated Interactions, Cross-Cultural Care

Illness as a Coordinated Family Activity: Use of Traditional Chinese Medicine by Elderly Chinese in the United States. Oklahoma Clinical and Translational Sciences Institute (OCTSI) Scholar Program funded by the Clinical and Translational Science Award Planning Grant (NIH-NCRR-1 P20 RR023477-01P) and the College of Medicine at the University of Oklahoma-Health Sciences Center. Role: Faculty mentor to OCTIS scholar: Haiying Kong. Period: 06/01/2009-07/31/2009.[Completed]