Faculty Bibliography

BACKGROUND: Research evaluating community health worker (CHW) programs inherently involves these natural community leaders in the research process, and often represents community-based participatory research (CBPR). Interpreting the results of CHW intervention studies and replicating their findings requires knowledge of how CHWs are selected and trained. METHODS: A summative content analysis was performed to evaluate the description of CHW selection and training in the existing literature. First-level coding focused on contextual information about CHW programs. Second-level coding identified themes related to the selection and training of CHWs. RESULTS: There was inconsistent reporting of selection and training processes for CHWs in the existing literature. Common selection criteria included personal qualities desired of CHWs. Training processes for CHWs were more frequently reported. Wide variation in the length and content of CHW training exists in the reviewed studies. A conceptual model is presented for the role development of CHWs based on the results of this review, which is intended to guide future reporting of CHW programs in the intervention literature. CONCLUSIONS: Consistent reporting of CHW selection and training will allow consumers of intervention research to better interpret study findings. A standard approach to reporting selection and training processes will also more effectively guide the design and implementation of future CHW programs. All community-based researchers must find a balance between describing the research process and reporting more traditional scientific content. The current conceptual model provides a guide for standard reporting in the CHW literature.

The nurse-to-population ratio (NPOP) is a standard indicator used to indicate a country's health care human resources capacity for responding to its disease burden. This study sought to explore if socioeconomic development indicators could predict the NPOP in a country. Mexico served as the case example for this exploratory study, with the final five variables selected based on findings from a qualitative study analyzing the development of nursing human resources in the country. Multiple linear regression showed that two variables proved significant predictors of the NPOP and the model itself explained 70% of the variance (r( 2) = .7; p = .0000). The findings have multiple implications for nursing human resources policy in Mexico and at a global level as governments attempt to build human capital to respond to population health needs.

OBJECTIVES: Cross-language qualitative research occurs when a language barrier is present between researchers and participants. The language barrier is frequently mediated through the use of a translator or interpreter. The purpose of this analysis of cross-language qualitative research was threefold: (1) review the methods literature addressing cross-language research; (2) synthesize the methodological recommendations from the literature into a list of criteria that could evaluate how researchers methodologically managed translators and interpreters in their qualitative studies; (3) test these criteria on published cross-language qualitative studies. DATA SOURCES: A group of 40 purposively selected cross-language qualitative studies found in nursing and health sciences journals. REVIEW METHODS: The synthesis of the cross-language methods literature produced 14 criteria to evaluate how qualitative researchers managed the language barrier between themselves and their study participants. To test the criteria, the researcher conducted a summative content analysis framed by discourse analysis techniques of the 40 cross-language studies. RESULTS: The evaluation showed that only 6 out of 40 studies met all the criteria recommended by the cross-language methods literature for the production of trustworthy results in cross-language qualitative studies. Multiple inconsistencies, reflecting disadvantageous methodological choices by cross-language researchers, appeared in the remaining 33 studies. To name a few, these included rendering the translator or interpreter as an invisible part of the research process, failure to pilot test interview questions in the participant's language, no description of translator or interpreter credentials, failure to acknowledge translation as a limitation of the study, and inappropriate methodological frameworks for cross-language research. CONCLUSIONS: The finding about researchers making the role of the translator or interpreter invisible during the research process supports studies completed by other authors examining this issue. The analysis demonstrated that the criteria produced by this study may provide useful guidelines for evaluating cross-language research and for novice cross-language researchers designing their first studies. Finally, the study also indicates that researchers attempting cross-language studies need to address the methodological issues surrounding language barriers between researchers and participants more systematically.