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Biomedical subjects

Deborah E Bender

Publications and source records attributed to Deborah E Bender.

6 recordsLinked to original sources
PubMed2006

Perceived insufficient milk as a barrier to optimal infant feeding: examples from Bolivia.

In its recently adopted Global Strategy on Infant and Young Child Feeding, the World Health Assembly called for urgent action in addressing the barriers to optimal feeding practices. This paper examines mothers' concerns about milk insufficiency as a major contributor to suboptimal infant feeding decisions, using survey data from peri-urban areas of two Bolivian cities. Mothers in the lowland modernizing city of Santa Cruz were more likely than mothers in the highland traditional city of Cochabamba to express concern about insufficient milk, and also less likely to feed their infants according to international recommendations. Furthermore, perceived milk insufficiency was particularly common among mothers of infants younger than 6 months of age -- an age at which infants are particularly vulnerable to the adverse effects of breast-feeding cessation and complementary feeding initiation. The paper concludes with policy, programme and research recommendations to address the critical problem of perceived insufficient breast milk.

Adult↗
PubMed2006

Development of an easy-to-use Spanish Health Literacy test.

OBJECTIVE: The study was intended to develop and validate a health literacy test, termed the Short Assessment of Health Literacy for Spanish-speaking Adults (SAHLSA), for the Spanish-speaking population. STUDY DESIGN: The design of SAHLSA was based on the Rapid Estimate of Adult Literacy in Medicine (REALM), known as the most easily administered tool for assessing health literacy in English. In addition to the word recognition test in REALM, SAHLSA incorporates a comprehension test using multiple-choice questions designed by an expert panel. DATA COLLECTION: Validation of SAHLSA involved testing and comparing the tool with other health literacy instruments in a sample of 201 Spanish-speaking and 202 English-speaking subjects recruited from the Ambulatory Care Center at UNC Health Care. PRINCIPAL FINDINGS: With only the word recognition test, REALM could not differentiate the level of health literacy in Spanish. The SAHLSA significantly improved the differentiation. Item response theory analysis was performed to calibrate the SAHLSA and reduce the instrument to 50 items. The resulting instrument, SAHLSA-50, was correlated with the Test of Functional Health Literacy in Adults, another health literacy instrument, at r=0.65. The SAHLSA-50 score was significantly and positively associated with the physical health status of Spanish-speaking subjects (p<.05), holding constant age and years of education. The instrument displayed good internal reliability (Cronbach's alpha=0.92) and test-retest reliability (Pearson's r=0.86). CONCLUSIONS: The new instrument, SAHLSA-50, has good reliability and validity. It could be used in the clinical or community setting to screen for low health literacy among Spanish speakers.

Adolescent↗
PubMed2005

The Americans With Disabilities Act: explaining legislative intent through experiential learning.

Imparting the requirements of healthcare workforce legislation to students is only one aspect of preparing undergraduate healthcare management students to be effective managers. On first review, the Americans with Disabilities Act (ADA) appears quite straightforward. The Act applies to any employer with 15 or more employees and covers a full range of employment practices. What the law does not address are the skills in empathy and decision-making that are needed for effective implementation of the law. In this article, the authors describe an experiential learning model that was designed to teach healthcare management majors, (soon-to-be healthcare managers), not only the provisions of the ADA law but also skills in empathy and critical decision-making. Reflections from student participants are included. These reflections are examples of changes in students' empathy occurring as a result of participation in the ADA Experience. The authors also present actual case requests for "reasonable accommodation" made by persons employed in a healthcare setting.

Architectural Accessibility↗
PubMed2004

Improving access for Latino immigrants: evaluation of language training adapted to the needs of health professionals.

The number of Latinos in North Carolina grew by almost 400% between 1990 and 2000. The rapid change in demographics in this state and other southeastern states has caught healthcare providers unprepared. Lack of ability to communicate with Latino patients may result in errors in diagnosis or reduced compliance with recommended treatments. The Culturally and Linguistically Appropriate Services (CLAS) Standards, published in 2001, mandate culturally and linguistically appropriate services for persons with limited English proficiency. This paper describes an innovative strategy to promote Spanish and culture-learning skills of healthcare providers and presents results of the evaluation conducted to determine its impact on access to quality care. The evaluation used a 360 degrees case study design, at 1-year follow-up. Use of Spanish language health-related materials is key to the training's success. The authors make recommendations for replication of the integrated language and culture-training model in other new settlement areas, especially those in the southeast of the United States.

Communication Barriers↗