Search Results (41)

Background/Objectives: Hispanic caregivers report higher levels of burden and poorer mental health compared to non-Hispanic caregivers. While problem-solving interventions have shown promise in improving stroke caregiver and patient well-being, they have not been specifically tailored or tested with Hispanic stroke caregivers. This study aimed to evaluate the effectiveness of a telephone- and online-based problem-solving intervention that was culturally adapted for Spanish-speaking Hispanics on caregiver burden. Methods: A two-arm parallel randomized clinical trial (NCT03142841) with repeated measures was conducted with 210 Hispanic caregivers of veterans who had experienced a stroke within the past year. Participants were recruited from three VA medical centers. The intervention consisted of 8-telephone sessions using online materials conducted by a trained interventionist. Participants in the standard group received usual VA resources they would have received as part of routine care such as stroke-related information. Chi-square tests and regression analyses were used to assess outcomes at 9 and 21 weeks. Results: Most participants were female (88%), college-educated (49%), and spouses or partners of a veteran (46%). Caregivers in the intervention group showed significantly greater reductions in caregiver burden (p = 0.011; p < 0.001) compared to the standard care group. Conclusions: Similarly to others reporting positive findings with non-Hispanic caregivers, these findings suggest that the problem-solving intervention can potentially alleviate Hispanic Spanish-speaking stroke caregivers’ burden by improving coping skills, problem-solving, and social support. Further research is needed to address gaps in effective interventions and promote equitable care for this population. Full article

Background and Purpose: The Swallowing Quality of Life Questionnaire (SWAL-QoL) is recognized as the gold-standard instrument for assessing the impact of dysphagia on health-related quality of life (HRQoL). However, a validated Spanish version is currently unavailable. Therefore, the aim of this study was to evaluate the psychometric properties of the Spanish adaptation of the SWAL-QoL (SSWAL-QoL) in fibromyalgia patients. Materials and Methods: A cross-sectional study was completed. Participants completed the SSWAL-QoL, the Spanish version of Hospital Anxiety and Depression Scale (HADS), the Spanish version of Short Form12 (SF12), the Spanish version of EQ-5D-3L, and the Spanish version of the Impact Fibromyalgia Questionnaire (FIQ). Construct validity, evaluated through Exploratory Factor Analysis and correlations with related measures, and reliability, estimated via internal consistency, were found to be adequate for the SSWAL-QoL. Results: The results indicated that the psychometric properties of the SSWAL-QoL are adequate and comparable to those of the original instrument. The result of Bartlett’s test of sphericity was 970.573 (df = 55, p < 0.001), and the value of the Kaiser–Meyer–Olkin (KMO) measure of sampling adequacy was 0.857. A total of two factors could be extracted. The reliability was high for the total subscales of the SSWAL-QoL. Differences were found between groups in all included outcomes. Conclusions: The SSWAL-QoL demonstrates satisfactory psychometric properties for its use in a Spanish-speaking population with fibromyalgia. As the first validation of this instrument in this specific population, it provides clinicians and researchers with a reliable and valid tool to assess the impact of dysphagia on HRQoL. Full article

This study examined child outcomes for five minimally verbal (or non-speaking) autistic preschoolers who participated in cascading coaching programs in which naturalistic developmental behavioral intervention (NDBI) techniques were taught to graduate student clinicians and Hispanic caregivers (three who primarily spoke English, and two who spoke Spanish). While prior studies reported on adult participant outcomes, this study analyzed child multimodal communication outcomes, using multiple baselines/probes single case experimental designs across contexts. Neurodiversity-affirming and culturally responsive principles were embedded within the intervention procedures. Following the introduction of a coached NDBI, all five children (three who received the intervention in English and two who received the intervention in Spanish) demonstrated increased use of (a) the total targeted communicative responses and (b) the targeted unprompted communicative responses, across both student clinician-led and caregiver-led play sessions. The Tau-U effect size measures revealed large-to-very large effects across all of the variables. Overall, higher rates of communication responses were observed during student clinician-led sessions than in caregiver-led sessions. Additionally, behavioral coding of the multimodal response forms (e.g., gestures, aided augmentative and alternative communication, signs, vocal words) using the Communication Matrix revealed that the children used a variety of response topographies during the intervention sessions beyond their preferred communication mode (e.g., signs for three participants). Four of the five children used symbolic communication forms consistently across both caregiver and student clinician-led sessions. Importantly, adults’ reinforcement of pre-symbolic or less advanced communication forms during the intervention did not inhibit the use of more advanced forms. Full article

Losing a loved one is a painful process that usually diminishes over time. Despite that, one out of ten bereaved adults are at risk of developing Prolonged Grief Disorder (PGD) Internet-delivered cognitive-behavioral therapies (iCBTs) can reach individuals in need of therapy and are both cost-effective and clinically effective. This study aimed to investigate the feasibility of an iCBT for Spanish-speaking individuals with PGD (GROw) compared to the same intervention delivered in a face-to-face videoconferencing format. As a secondary objective, the potential efficacy of GROw was explored. A total of 31 participants were randomized to the experimental group (N = 16) (GROw) and the active control group (N = 15) (videoconferencing treatment). There were four assessment points: baseline, after intervention, and 3- and 12-month follow-ups. Both GROw and videoconferencing treatments were well accepted in terms of preferences, expectations, satisfaction and evaluation about the usefulness of the intervention, and showed significant symptomatology reduction with large effect sizes in most of the outcomes. The dropout rate was 50% in the GROw and 33.33% in the videoconferencing group. GROw is a feasible, well-accepted iCBT for the treatment of PGD with promising results related to its potential efficacy. Full article

Didactic digital tools can commence, enhance, and strengthen reading fluency in children undergoing long-term hospitalization due to oncology conditions. However, resources specifically designed to support rapid naming and decoding in Spanish remain scarce. This study presents the design, development, and evaluation of a game prototype aimed at addressing this gap among Spanish-speaking preschoolers in hospital settings. Developed using Unity through a design-based research methodology, the game comprises three narratively linked levels targeting rapid naming, decoding, and fluency. A sequential exploratory mixed-methods design (QUAL-quan) guided the evaluation. Qualitative data were obtained from a focus group of hospital teachers (N = 6) and interviews with experts (N = 30) in relevant fields. Quantitative validation involved 274 experts assessing the game’s contextual, pedagogical, and technical quality. The prototype was also piloted with four end-users using standardised tests for rapid naming, decoding, and fluency in Spanish. Results indicated strong expert consensus regarding the game’s educational value, contextual fit, and usability. Preliminary findings suggest potential for fostering and supplementing early literacy skills in hospitalised children. Further research with larger clinical samples is recommended to validate these outcomes. Full article

Due to the challenges in evaluating chronic pain in dogs, owner-reported outcome measures have been developed, such as the Helsinki Chronic Pain Index (HCPI), originally written in Finnish and published in English, limiting its use among Spanish-speaking veterinarians and owners/caretakers. The goal of this study was to obtain an equivalent Spanish version of the HCPI. The translation process followed established guidelines. First, two native Spanish speakers independently translated the HCPI from English to Spanish. A veterinary professional and a third translator then compared the translations to create a unified version. Next, an independent linguist translated the reconciled Spanish version back into English. The research team, alongside one of the linguists, reviewed the translation to resolve any discrepancies. To conclude, a cognitive assessment was conducted with 62 dog owners from diverse demographics to evaluate clarity and understanding of the translated HCPI. This resulted in a linguistically validated Spanish version of the HCPI that is conceptually aligned with the original, as a first step to validate its use by Spanish-speaking veterinarians and researchers to manage chronic pain in dogs. The next step in the process is psychometric validation, which will ensure the tool’s reliability and applicability in both clinical and research settings. Full article

Background: Hospitalized patients’ expectations about their treatment play a key role in therapeutic adherence, satisfaction with care, and clinical outcomes. However, there is a lack of brief, psychometrically validated instruments in Spanish-speaking contexts that adequately assess this construct. Objective: The objective of this study is to culturally adapt and validate the Hospitalized Patients’ Expectations for Treatment Scale-Patient Version (HOPE-P) in a Peruvian population. Methods: A methodological, cross-sectional study was conducted with 277 hospitalized patients aged 18 to 85 years (M = 45.87; SD = 17.09). The adaptation process included translation, back-translation, expert review, and pilot testing. Confirmatory factor analysis (CFA) was performed to assess the factor structure, and reliability and validity indices were calculated. Results: The bifactorial model showed good fit (CFI = 0.97, TLI = 0.94, RMSEA = 0.06). One item with a low factor loading was removed to improve the model. Convergent and discriminant validity were confirmed through acceptable values of Average Variance Extracted (0.60 and 0.55) and inter-factor correlation (φ² = 0.23). Internal consistency was strong for both dimensions (α = 0.76–0.77; ω = 0.76–0.77). Conclusions: The Spanish version of the HOPE-P is a valid, reliable, and culturally appropriate instrument for evaluating treatment expectations in hospitalized Peruvian patients. Its implementation in clinical settings could enhance physician–patient communication, support shared decision-making, and contribute to better therapeutic outcomes, especially in high-demand healthcare environments. Full article

Background/Objectives: Preschool children from low-income, ethnically diverse communities face disproportionate rates of behavioral challenges and early expulsion from early care and education (ECE) programs. This study evaluated the efficacy, feasibility, and utility of Jump Start on the Go (JS Go), a bilingual, AI-enabled mobile application. JS Go is designed to deliver a 14-week early childhood mental health consultation model in under-resourced ECE settings. Methods: This mixed-methods study compared JS Go to the standard in-person Jump Start (JS) program. Participants included 28 teachers and 114 children from six centers (three JS Go, three JS). Quantitative measures assessed teacher classroom practices and child psychosocial outcomes at baseline and post-intervention. App usability and acceptability were only evaluated post-intervention. Seven semi-structured interviews were conducted post-intervention with JS Go directors/teachers to assess the app’s feasibility for implementing the four program pillars: safety, behavior support, self-care, and communication. Results: JS Go was more effective than JS in promoting teacher classroom practices related to behavior support and resiliency. Both programs were similar in improving children’s protective factors and reducing internalizing behaviors, with consistent effects across English and Spanish-speaking children. Teachers rated the JS Go app with high acceptability, though predicted future usage showed greater variability. Rapid qualitative analysis showed that participants found the app easy to use, frequently accessed its resources, and considered it helpful for reinforcing key strategies across the four program pillars. Conclusions: JS Go is a novel approach to providing mental health consultation. It represents a promising mobile adaptation of the established JS consultation model, with important implications for future practice and research. Full article

Background/Objectives: Oral anticoagulant therapy (OAT) has been prescribed for over seventy years to prevent thromboembolic complications associated with various conditions. The emergence of direct-acting oral anticoagulants (DOACs) has reduced the use of vitamin K antagonists (VKAs), but specific clinical scenarios still necessitate VKAs. Nurses play a crucial role in managing OAT, and their self-efficacy is essential for optimal patient outcomes. This study aims to validate and adapt the Nursing Self-Efficacy for Oral Anticoagulant Therapy Management (SE-OAM) questionnaire to Spanish (SE-OAM-SV) to assess nurses’ self-efficacy in managing OAT. Methods: A methodological design was employed to develop the validity and reliability of the SE-OAM-SV. The process included translation and back-translation, expert review, and a pilot study. Content validity was analyzed using the content validity index (CVI), modified kappa coefficient, and Aiken’s V. A descriptive cross-sectional study was conducted with 100 nurses across Spain to test the SE-OAM-SV and identify comprehension issues. Internal consistency was assessed via Cronbach’s alpha. Results: The translation process highlighted some items requiring clarification, which were resolved through expert consultation. The SE-OAM-SV demonstrated adequate content validity with a global CVI of 0.86. The pilot study revealed an average participant age of 41.3 years and 17.3 years of professional experience. The SE-OAM-SV showed high internal consistency with a Cronbach’s alpha of 0.96. The average score of participants on the SE-OAM-SV was 56.8 points, indicating room for improvement in all aspects of the scale. Conclusion: The SE-OAM-SV is a reliable and valid tool for measuring nurses’ self-efficacy in managing OAT in Spanish-speaking communities. This tool can facilitate the development of educational programs and public policies to enhance nurses’ self-efficacy and improve patient outcomes. The availability of the SE-OAM-SV supports larger-scale studies and validation in other Spanish-speaking countries. Full article

This paper presents the design and evaluation of e-SoundWay, a cross-platform serious game developed to improve English phonetic competence through a multimodal and narrative-driven approach. While the platform is specifically tailored to meet the needs of Spanish-speaking learners, it is adaptable for a wider range of English as a Foreign Language (EFL) users. e-SoundWay offers over 600 interactive multimedia minigames that target three core competencies: perception, production, and transcription. Learners progress along a gamified version of the Camino de Santiago, interacting with characters representing diverse English accents. A mixed-methods evaluation combining pre- and post-tests with a user experience questionnaire revealed statistically significant improvements across all domains, particularly in perception. Reduced post-test variability indicated more equitable learning outcomes. User satisfaction was high, with 64% of participants reporting satisfaction with their phonetic progress and 91% stating they would recommend the platform. These findings highlight the educational effectiveness, accessibility, and motivational value of e-SoundWay, reinforcing the role of serious games and multimodal technologies in delivering inclusive and engaging pronunciation instruction. Full article

In 2020, California banned the sale and agricultural use of chlorpyrifos, an organophosphate pesticide (OP) associated with neurotoxicity and other adverse health outcomes. We primarily assessed changes in chlorpyrifos associated with this policy and secondarily explored how other OP exposures changed. The participants were from California’s Central Valley, 18 years or older, and English- or Spanish-speaking. The surveys and urine samples were collected pre-ban (December 2020) and post-ban (February–April 2022). The urine samples were analyzed for a chlorpyrifos-specific metabolite (TCPy), six dialkyl phosphates (DEP, DMTP, DETP, DMDTP, DMP, DEDTP), and total DE and DM. The pre- and post-ban metabolite concentrations were compared via Wilcoxon signed-rank tests and natural log-transformed paired differences in linear mixed effects regression, adjusted for covariates. Forty-nine participants had repeated biomarker data. The mean age of the study population was 46.8 years (SD: 16), 61% female, 67% Spanish-speaking, 100% Hispanic/Latino(a), and 47% had less than a high school education. Six urinary metabolites (TCPy, DEP, DMP, DMTP, total DE and total DM) had sufficient variation for further analysis, while DMDTP, DEDTP, and DETP were undetected. The paired differences in adjusted models showed statistically significant increases in TCPy and DMP associated with the policy change (e.g., TCPy estimated ratio of geometric means: 4.53 (95% CI 2.66, 7.69)) Reductions in metabolites of chlorpyrifos exposure were not observed following California’s chlorpyrifos ban, suggesting ongoing exposure to chlorpyrifos from other sources. Full article

Objectives: Private sector engagement has been shown to improve tuberculosis diagnosis and treatment outcomes in Asia and Africa, but systematic reviews in 2015 and 2017 identified only two reports from Latin America. We conducted a systematic review to identify descriptions of private sector engagement interventions for tuberculosis in Latin America. Methods: We systematically searched for reports on private sector engagement for tuberculosis services in Spanish- and Portuguese-speaking countries of the Western Hemisphere. On 1 November 2024, we searched PubMed, Embase, LILACS, and SciELO, with terms related to tuberculosis, the private sector, and eligible countries. We double-reviewed abstracts and full-text articles and classified private sector engagement mechanisms according to an established framework. Results: We identified seven documents describing five distinct interventions for private sector engagement in 10 countries. The most common engagement mechanism was technical support to increase awareness, knowledge, or capacity in the private sector. Intervention goals included promoting collaboration, ensuring adherence to national guidelines, increasing referrals to the public sector, and reducing tuberculosis drug sales in private pharmacies. Three impact evaluations found evidence of improved referral to the public sector. Conclusions: We found few reports of private sector engagement interventions for tuberculosis in Latin America, suggesting missed opportunities for collaborations to expand and improve tuberculosis service delivery. A lack of impact assessments suggests a dearth of evidence on the best models for private sector engagement to advance tuberculosis elimination in the Latin American region. Full article

Objectives: The aims of this study were to compare pre- and post-operative word recognition scores (WRSs) for the adult Spanish-speaking population and to describe their cochlear implant (CI) performance trajectory. Methods: A retrospective chart review (n = 115) was completed for Spanish-speaking post-lingually deafened adults who underwent a traditional CI evaluation and subsequent surgery between 2018 and 2023. Pre- and post-CI (3, 6, 12-month) Spanish Bisyllable WRSs and CI datalogging (hours per day) were collected for 66 subjects who met inclusion. Patients were, on average, 61.4 years of age (SD = 14.9) at the time of their first CI, and all were Hispanic and White (100%). Results: The outcomes of the 66 subjects who met the inclusion criteria were analyzed. Spanish Bisyllable WRSs improved at all post-CI test intervals, though the mean change between intervals showed a decreasing trend over time, with a plateau in WRSs occurring by 6 months post-CI. Time was a significant predictor of increased post-CI WRSs at 6 months (p = 0.004) and 12 months (p < 0.001). Sex, the implanted ear, electrode type, CI manufacturer, and datalogging hours did not significantly predict Bisyllable WRSs. Conclusions: This study used the largest cohort dataset to date to describe pre-and post-CI WRSs for Spanish-speaking adults. The post-CI performance trajectory is similar in Spanish-speaking CI recipients compared to English-speaking cohorts. This study is fundamental in providing evidence-based outcomes for Spanish-speaking CI recipients and will assist clinicians with pre-CI counseling based on realistic expectations. Full article

The COVID-19 pandemic severely affected teaching and student outcomes throughout the world, yet the long-term impacts of the pandemic on teachers and students in Latin America and Spain remain largely underexamined. This study examined the experiences of 5416 teachers from 20 Spanish-speaking countries during and after the pandemic, with an emphasis on teachers’ health, teaching experiences, and school-based support; perceptions of their students’ experiences and struggles; and relationships with students, families, and colleagues. The study used an online survey design with recruitment primarily based on snowball sampling, with most variables being collected using Likert-style responses. Descriptive statistics as well as bivariate correlations between variables were calculated. The results suggested that teachers were mostly healthy and reported moderate fear of COVID-19, though there was much variability. While, on average, teachers did not believe the pandemic had had a negative impact on their relationships with parents, colleagues, and students, they believed that the pandemic had a meaningful negative impact on their students by increasing problems in five key domains: educational, behavioral, social, emotional, and familial. Teachers had received very little training regarding online teaching, although they were moderately satisfied with the resources they had received to teach online and the safety measures their schools had implemented. Schools should provide additional support to teachers, students, and families during times of prolonged stress such as pandemics to help mitigate their lasting effects on students’ academic and psychosocial functioning. Full article

Children born preterm are at an elevated risk of language delays compared to children born full-term. However, there is a dearth of research investigating language outcomes in premature children exposed to more than one language. There is also limited empirical evidence linking the quantity and quality of parent input and language outcomes in premature children and the strength of these relationships in bilingual contexts remains unknown. Therefore, the current study examined language skills, parent input, conversational turns, and their associations at 16 months to 36 months in monolingual and bilingual children born preterm. Nine English-speaking monolingual parent–child dyads, and nine Spanish–English bilingual parent–child dyads participated in parent–child interactions that occurred over time in play-based contexts. Results revealed that preterm monolingual and bilingual children exhibited similar language abilities at all time points assessed. While both monolingual and bilingual dyads engaged in a comparable number of conversational turns at 16 m, monolingual mothers produced more words than bilingual mothers during play. Significant associations were observed between children’s vocabulary skills and their ability to combine words within and across most time points. Notably, relationships between parental input, conversational turns, and language skills were limited to a significant association between conversational turns at 16 m and vocabulary skills at 24 m. Together, findings indicate that bilingual children born preterm acquire language on the same timeline as monolingual children born preterm. While it is crucial that the current work be replicated in larger samples of children born preterm, the current work is the first to compare relationships between children’s language outcomes and the quantity and quality of parental input in monolingual and bilingual contexts. Full article