BC省社会工作学院 participation is led by Donahue and DiFelice Professor Kirsten Davison, 左, 以及罗西奥·卡尔沃副教授. (李Pellegrini)
The COVID-19 pandemic in the United States laid bare the health-related systematic disparities faced by some racial and ethnic groups, 尤其是拉丁裔人口. 正如许多电子游戏正规平台人员和倡导者所指出的那样, Latinxs have consistently borne the brunt of COVID’s impact: They are more likely to become infected with the virus, 更有可能住院, 更有可能死于COVID.
While the numbers are even higher for Latinxs with mental illnesses such as depression, 焦虑, 和成瘾, their vaccination rates—for COVID as well as influenza—lag behind other groups. But a project to be launched in coming months by the 电子游戏软件 School of 社会工作 and Harvard T.H. Chan School of Public Health aims to address this vaccine hesitancy by working with health care professionals at the community level.
BCSSW’s participation is led by Donahue and DiFelice Professor Kirsten Davison, 负责电子游戏正规平台的副院长, 以及罗西奥·卡尔沃副教授, 主管多样性的副院长, 股本, 和包容. Also working with the team are Connell School of Nursing Associate Professor Nadia Abuelezam and Assistant Professor Brittney van de Water; and Kimberly O’Brien, clinical social worker and research scientist at Boston Children’s Hospital and Harvard Medical School. Sebastien Haneuse, 生物静力学教授和专家, is coordinating the Chan School’s role and serves as principal investigator. 该项目获得了一项为期5年、价值2亿美元的资助.美国国立卫生电子游戏正规平台院拨款800万美元.
“ 而不是假设我们知道该做什么和怎么做, 我们正在回应社会的独特需求. 我们与EBNHC服务的人进行了交谈, 我们听到了他们的故事, and we also spoke with the staff at the center to get their perspectives because they are the ones who serve this community day in and day out.”
At the core of this study is a longstanding partnership between BCSSW’s nationally acclaimed Latinx Leadership Initiative directed by Calvo and the East Boston Neighborhood Health Center, 哪一种能容纳20多人,000 registered behavioral health patients with a mental health diagnosis, 其中超过70%是拉丁裔. EBNHC has served as a field practice placement site for LLI students since 2016 and LLI alumni have been part of its core BH staff. The project with EBNHC seeks to ameliorate the effect of structural racism and intersectional trauma on Latinxs with mental illness—particularly in their efforts to seek health care—by testing a BH intervention that is culturally and linguistically appropriate and, 希望如此, 会减少疫苗犹豫吗.
“而不是假设我们知道该做什么和怎么做,卡尔沃说, “我们正在回应社区的独特需求. 我们与EBNHC服务的人进行了交谈, 我们听到了他们的故事, and we also spoke with the staff at the center to get their perspectives because they are the ones who serve this community day in and day out.”
戴维森说:, “The frequency with which vaccination came up in these discussions, 包括病人和工作人员, 是惊人的. 关于疫苗犹豫, 中心的社工告诉我们的, 他们足够信任我们，才会提出这个问题. 但我们不想被视为“说服者”.”’ So, what we are trying to do here is to create a safe space for the patients to talk about vaccines in a way that is helpful and enlightening for them.”
The intervention to be utilized involves motivational interviewing (MI), 其中临床医生使用离散, accommodating language to discuss a patient’s vaccination status, 的观点, 和关切, 如:
“If it is OK, I’d like to shift our conversation to talk about vaccination.”
“I’m not here to try and make you get the COVID vaccine; I want to try my best to understand your situation and help you consider if you want to be vaccinated. 我可以帮你. 但这取决于你.”
“What would be the not-so-good things about getting the COVID vaccine? 你有什么好担心的? 什么是好的呢? 如果你没拿到，你觉得会发生什么?”
The clinician also uses MI to assess and enhance patients’ readiness to be vaccinated, asking him or her to rate from 0 to 100 percent how ready they are to get the vaccine and then discuss their response (“What would it take for you get a 100 percent rating?”). 取决于病人的反应, the clinician can provide information on walk-in or scheduled appointments, 提供疫苗信息, 服务, 或者以后的资源, 或者帮助病人向护士咨询医疗问题.
卡尔沃和戴维森强调, 然而, MI要想成功, clinicians must build a rapport and trust with Latinx patients, who often have negative health care-related experiences because of professionals’ lack of appreciation for cultural and language variations. Grasping the diversity within the Latinx population is vital to develop individualized therapeutic relationships, 他们说.
The MI intervention states the importance of identifying and respecting cultural values: “respeto”—how the patient would like to be addressed (Don? 先生? 小姐? 太太?); “personalismo”—whether the patient seeks to maintain harmonious relationships by not expressing disagreement directly; “confianza”—essentially the cross-cultural construct of trust.
流利的西班牙语, 并意识到其中的微妙之处, affords the best opportunity for a BH professional to connect with a Latinx patient, Davison and Calvo said: Common words used in Spanish to express emotional distress do not have equivalent meaning in English, and Latinx also use Spanish “dichos” (sayings) to describe feelings and symptoms embedded with cultural meaning.
“My grandmother had a dicho that translates to ‘Now peace and then glory,’” explained Calvo. “When you say that in Spanish instead of English, though, it has much more of an impact. 当然, there are certain words and phrases in English that don’t precisely translate into other languages. 这些看起来都是小事, but they’re very important to how a clinician can effectively communicate with a Latinx client.”
肖恩·史密斯|大学传播| 2022年10月