卑诗省社会工作学院的参与由Donahue和学院教授Kirsten Davison领导, left, and Associate Professor Rocio Calvo. (Lee Pellegrini)
美国新冠肺炎疫情暴露了部分种族和族裔群体在健康方面的系统性差异, especially Latinx populations. As various researchers and advocates have noted, 拉丁裔一直首当其冲地受到新冠病毒的影响:他们更有可能感染这种病毒, more likely to be hospitalized, and more likely to die from COVID.
而患有抑郁症等精神疾病的拉丁裔人数甚至更高, anxiety, and addiction, 他们的COVID和流感疫苗接种率落后于其他群体. 不过，电子游戏软件社会工作学院和哈佛大学将在未来几个月推出一个项目.H. 陈公共卫生学院旨在通过与社区一级的卫生保健专业人员合作，解决这种疫苗犹豫问题.
BCSSW的参与由Donahue和分院教授Kirsten Davison领导, the school’s associate dean for research, and Associate Professor Rocio Calvo, assistant dean for diversity, equity, and inclusion. 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, 她是波士顿儿童医院和哈佛医学院的临床社会工作者和电子游戏正规平台科学家. Sebastien Haneuse, a professor and expert in biostatics, 协调禅宗的角色，并担任首席电子游戏正规平台员. The project has received a five-year, $2.8 million grant from the National Institutes of Health.
“ Rather than presuming we know what to do and how to do it, we are responding to the distinctive needs of the community. We spoke with people who are served by EBNHC, we heard their stories, 我们还与中心的工作人员进行了交谈，以了解他们的观点，因为他们是每天为这个社区服务的人.”
这项电子游戏正规平台的核心是由Calvo指导的BCSSW全国知名的拉丁裔领导倡议与东波士顿社区健康中心之间的长期合作伙伴关系, which serves more than 20,000名被诊断患有精神疾病的行为健康患者, more than 70 percent of them Latinx. 自2016年以来，EBNHC一直是LLI学生的实地实习地点，LLI校友一直是其核心工作人员的一部分. 与EBNHC合作的项目旨在改善结构性种族主义和交叉创伤对患有精神疾病的拉丁裔人的影响，特别是在他们寻求医疗保健的过程中，通过测试一种文化和语言上合适的BH干预措施, it is hoped, will reduce vaccine hesitancy.
“Rather than presuming we know what to do and how to do it,” said Calvo, “we are responding to the distinctive needs of the community. We spoke with people who are served by EBNHC, we heard their stories, 我们还与中心的工作人员进行了交谈，以了解他们的观点，因为他们是每天为这个社区服务的人.”
Davison said, “疫苗接种在这些讨论中出现的频率, both with patients and staff, was striking. On vaccine hesitancy, the center’s social workers told us, ‘They trust us enough to bring up the issue. But we don’t want to be seen as “persuaders.”’ So, 我们在这里要做的是为病人创造一个安全的空间，让他们以一种对他们有帮助和启发的方式谈论疫苗.”
要使用的干预包括动机性访谈(MI), in which the clinician uses discrete, 方便的语言讨论病人的疫苗接种状况, views, and concerns, such as:
“如果可以的话，我想把我们的话题转移到疫苗接种上.”
“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. I can help you with that. But that’s up to you.”
“接种COVID疫苗有什么不好的事情? What worries you about it? What would be the good things? What do you think would happen if you don’t get it?”
临床医生还使用MI来评估和提高患者接种疫苗的准备程度, 让他或她给自己接种疫苗的准备程度打分，从0到100%，然后讨论他们的反应(“你要怎么做才能得到100%的评分?”). Depending on a patient’s response, 临床医生可以提供预约或预约的信息, offer to give vaccine information, services, or resources at a later date, or help the patient consult a nurse for medical questions.
Calvo and Davison emphasized, however, that for the MI to be successful, 临床医生必须与拉丁裔患者建立融洽的关系和信任, 由于专业人员缺乏对文化和语言差异的理解，谁经常有与医疗保健相关的负面经历. 掌握拉丁裔人群的多样性对于发展个性化的治疗关系至关重要, they said.
精神障碍干预说明了识别和尊重文化价值观的重要性:“尊重”——病人希望被如何称呼(唐? Señor? Doña? Señora?); “personalismo”—whether the patient seeks to maintain harmonious relationships by not expressing disagreement directly; “confianza”—essentially the cross-cultural construct of trust.
A strong fluency in Spanish, and an awareness of its subtleties, 为BH专业人员提供了与拉丁病人联系的最佳机会, 戴维森和卡尔沃说:在西班牙语中用来表达情绪困扰的常用词汇在英语中没有相同的含义, 拉丁人也用西班牙语“dichos”(谚语)来描述带有文化含义的感觉和症状.
卡尔沃解释说:“我祖母有一个dicho，意思是‘时而和平，时而光荣’。. “不过，当你用西班牙语而不是英语说这句话时，它的影响要大得多. Of course, 英语中有些单词和短语并不能精确地翻译成其他语言. These may seem like little things, 但它们对于临床医生如何有效地与拉丁裔客户沟通非常重要.”
Sean Smith | University Communications | October 2022