Pilar Parra

Ethnicity, social status, and families' experiences of caring for a mentally ill family member

There is growing attention to the role of families as caregivers of family members with serious mental illness. This paper presents data from a multicultural sample of 90 family caregivers from diverse ethnic backgrounds. The paper examines families experiences with mental health services; their support networks and family burdens; and their conceptions of mental illness. The paper both provides one of the first comparative studies of family caregivers from different ethnic groups and suggests an agenda for future research in this area.

Midwives in the Mexican health system

The health care system in Mexico was built upon a western model in which curative rather than preventive medicine is emphasized. However, the incorporation of indigenous midwives into maternal and child care and family planning programs by several public health agencies is an exception to the governmental health policies. An analysis of midwife preferences among rural women indicates that primarily poor illiterate women with children, living in remote areas with difficult access, rely on midwives. The continued reliance on midwives by this sector of the population makes the government programs most important. These programs are a unique case in which the incorporation of traditional practitioners in the modern health system has occurred. However, in order to implement programs that have the capability to offer rural women the benefits of both health systems, the incorporation of the traditional midwives requires not only the upgrading of their skills in modern antiseptic techniques, but the recognition of the contributions of traditional health practices, and the research of elements and practices to foster its understanding.

Cognitive Interviewing to Enhance Comprehension and Accuracy of Responses to a Spanish-Language Nutrition Program Evaluation Tool

OBJECTIVEnTo cognitively test a Spanish translation of a questionnaire evaluating parent and child food and activity behaviors and assess accuracy of understanding and ease of answering.nnnMETHODSnIterative rounds of cognitive interviewing, qualitative analysis, and revision were conducted with 19 low-income, native Spanish-speaking mothers of children aged 3-11 years, in 5 communities in New York. Key informant interviews were conducted with 2 Spanish-speaking nutrition educators experienced with the questionnaire.nnnRESULTSnBased on responses, improvements were made to (1) ensure clear and familiar wording, (2) clarify time frames for specifying the frequency of behaviors, and (3) express constructs not amenable to direct translation or for which meanings differed by country of origin. Cognitive interviewing results also informed improvements to the English language version.nnnCONCLUSIONS AND IMPLICATIONSnEven after translation by native speakers, in-depth cognitive interviewing is needed to ensure that questionnaires are understood as intended by low-literacy, immigrant populations and to facilitate collection of valid evaluation data.