Knowledge of heart disease risk among spanish speakers with diabetes: the role of interpreters in the medical encounter.

Abstract

OBJECTIVE: To investigate heart disease risk knowledge among Spanish speakers with diabetes. DESIGN: Single sample cross-sectional design. SETTING: A Spanish-language diabetes health fair in an inner-city community center in Connecticut. PARTICIPANTS: Ninety-four Spanish-speaking adults participated. They were predominantly from Puerto Rico, had less than high school education, and were economically disadvantaged. Most had type 2 diabetes (96%) for an average of 10 years. Most had health insurance and a primary care provider. A sizable minority relied on ad hoc interpreters (friends or family members) during clinic visits, but most would prefer to use a professional medical interpreter. MEASURES AND RESULTS: Knowledge of risk for heart disease was measured by a Spanish version of the Heart Disease Fact Questionnaire (HDFQ). Knowledge of heart disease was low (mean score 17.5 [out of 25], SD=5.0), and lack of knowledge was found for the risks of diabetes, high-fat foods, cholesterol, physical activity, hypertension, family history of heart disease, sex, and whether one is necessarily cognizant of having heart disease. Regression analyses showed that bank account status and use of ad hoc interpreters contributed significantly to the prediction of HDFQ scores. Having a bank account and not using family or friends as interpreters in visits with the primary care provider predicted higher HDFQ scores. CONCLUSION: Heart disease risk knowledge was low in Spanish speakers with diabetes. Providing professional medical interpretation instead of relying on ad hoc interpreters is recommended for this high-risk group.