Hendrika Meischke

In the construction trades, recruiting and retaining tradeswomen is essential to advancing gender equity and economic mobility among women workers (Moir et al., 2011). As the industry continues to ...

Objective: Tradeswomen face psychosocial hazards, including harassment and discrimination, associated with adverse health. Mentorship has been recommended but not evaluated as a potential solution. Methods: In this randomized controlled trial, women apprentices across the US and Canada were matched with journey‑level tradeswomen trained to provide mentorship in communication, goal setting, and self‑advocacy. Mentees and controls were assessed at baseline, 6 months, and 12 months. Results: Of 267 women assessed for eligibility, 104 (40%) enrolled. Mixed‑effects regression showed no intervention effect on perceived stress, social support, or job satisfaction. Mentees had a 0.4‑point higher perceived stress score (95% CI: 0.09, 0.71) than controls, and the group‑time interaction was not significant. Conclusion: Larger studies with longer follow‑up are needed to clarify mentorship’s impact on tradeswomen’s well‑being and strengthen evidence for supportive interventions.

Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet #Preprint #PeerReviewMe: Warning: This is a unreviewed preprint. Readers are warned that the document has not been peer-reviewed by expert/patient reviewers or an academic editor, may contain misleading claims, and is likely to undergo changes before final publication, if accepted, or may have been rejected/withdrawn. Readers with interest and expertise are encouraged to sign up as peer-reviewer, if the paper is within an open peer-review period. Please cite this preprint only for review purposes or for grant applications and CVs (if you are the author). Background: Demanding working conditions and secondary exposure to trauma may contribute to a high burden of stress among 9-1-1 telecommunicators, decreasing their ability to work effectively and efficiently. Online mindfulness-based interventions (MBIs) can be effective in reducing stress in similar populations. However, low engagement may limit intervention effectiveness. Objective: To assess participant engagement in an online MBI designed for 9-1-1 telecommunicators. Specifically, we sought to describe: (1) participant characteristics associated with intervention engagement, (2) participant perspectives on engaging with the intervention, and, (3) perceived challenges and facilitators to engagement. Methods: We used qualitative and quantitative data from participant surveys (n=149) collected to assess the efficacy of the intervention. We conducted descriptive and bivariate analyses to identify associations between demographic, psychosocial, and workplace characteristics and engagement. We conducted a thematic analysis of qualitative survey responses to describe participant experiences with the MBI. Results: No individual participant characteristics were associated with level of engagement (low versus high number of lessons completed). Participant engagement did vary by call center (P<.001). We identified the following overarching qualitative themes: (1) participants perceived benefits of mindfulness practice; (2) participants perceived challenges to engaging with mindfulness and the intervention; and (3) intervention components facilitated engagement. Participants expressed positive beliefs in the perceived benefits of practicing mindfulness, including increased self-efficacy in coping with stressors and increased empathy with callers. The most commonly cited barriers were work-related, particularly not having time to do the intervention at work. Facilitators included shorter length meditation practices and the availability of multiple formats and types of intervention content. Conclusions: Our findings suggest that efforts to improve intervention engagement should focus on organizational-level factors rather than individual participant characteristics. Future research should explore the effect of mindfulness practice on the efficiency and effectiveness of 9-1-1 telecommunicators at work.

Background: In the United States, language barriers pose challenges to communication in emergency response and impact emergency care delivery and quality for individuals who are limited English proficient (LEP). There is a growing interest among Emergency Medical Services (EMS) personnel in using automated translation tools to improve communications with LEP individuals in the field. However, little is known about whether automated translation software can be used successfully in EMS settings to improve communication with LEP individuals. Objective: The objective of this work is to use scenario-based methods with EMS providers and nonnative English-speaking users who identified themselves as LEP (henceforth referred to as LEP participants) to evaluate the potential of two automated translation technologies in improving emergency communication. Methods: We developed mock emergency scenarios and enacted them in simulation sessions with EMS personnel and Spanish-speaking and Chinese-speaking (Mandarin) LEP participants using two automated language translation tools: an EMS domain-specific fixed-sentence translation tool (QuickSpeak) and a statistical machine translation tool (Google Translate). At the end of the sessions, we gathered feedback from both groups through a postsession questionnaire. EMS participants also completed the System Usability Scale (SUS). Results: We conducted a total of 5 group sessions (3 Chinese and 2 Spanish) with 12 Chinese-speaking LEP participants, 14 Spanish-speaking LEP participants, and 17 EMS personnel. Overall, communications between EMS and LEP participants remained limited, even with the use of the two translation tools. QuickSpeak had higher mean SUS scores than Google Translate (65.3 vs 48.4; P=.04). Although both tools were deemed less than satisfactory, LEP participants showed preference toward the domain-specific system with fixed questions (QuickSpeak) over the free-text translation tool (Google Translate) in terms of understanding the EMS personnel’s questions (Chinese 11/12, 92% vs 3/12, 25%; Spanish 12/14, 86% vs 4/14, 29%). While both EMS and LEP participants appreciated the flexibility of the free-text tool, multiple translation errors and difficulty responding to questions limited its usefulness. Conclusions: Technologies are emerging that have the potential to assist with language translation in emergency response; however, improvements in accuracy and usability are needed before these technologies can be used safely in the field.

BACKGROUND Demanding working conditions and secondary exposure to trauma may contribute to a high burden of stress among 9-1-1 telecommunicators, decreasing their ability to work effectively and efficiently. Web-based mindfulness-based interventions (MBIs) can be effective in reducing stress in similar populations. However, low engagement may limit the effectiveness of the intervention. OBJECTIVE The aim of this study was to assess participant engagement in a Web-based MBI designed for 9-1-1 telecommunicators. Specifically, we sought to describe the following: (1) participant characteristics associated with intervention engagement, (2) participant perspectives on engaging with the intervention, and (3) perceived challenges and facilitators to engaging. METHODS We used qualitative and quantitative data from participant surveys (n=149) that were collected to assess the efficacy of the intervention. We conducted descriptive and bivariate analyses to identify associations between demographic, psychosocial, and workplace characteristics and engagement. We conducted a thematic analysis of qualitative survey responses to describe participant experiences with the MBI. RESULTS We found that no individual participant characteristics were associated with the level of engagement (low vs high number of lessons completed). Participant engagement did vary by the call center (P<.001). We identified the following overarching qualitative themes: (1) the participants perceived benefits of mindfulness practice, (2) the participants perceived challenges to engage with mindfulness and the intervention, and (3) intervention components that facilitated engagement. The participants expressed positive beliefs in the perceived benefits of practicing mindfulness, including increased self-efficacy in coping with stressors and increased empathy with callers. The most commonly cited barriers were work-related, particularly not having time to participate in the intervention at work. Facilitators included shorter meditation practices and the availability of multiple formats and types of intervention content. CONCLUSIONS The findings of this study suggest that efforts to improve intervention engagement should focus on organizational-level factors rather than individual participant characteristics. Future research should explore the effect of mindfulness practice on the efficiency and effectiveness of 9-1-1 telecommunicators at work. CLINICALTRIAL ClinicalTrials.gov NCT02961621; https://clinicaltrials.gov/ct2/show/NCT02961621

BACKGROUND In the United States, language barriers pose challenges to communication in emergency response and impact emergency care delivery and quality for individuals who are limited English proficient (LEP). There is a growing interest among Emergency Medical Services (EMS) personnel in using automated translation tools to improve communications with LEP individuals in the field. However, little is known about whether automated translation software can be used successfully in EMS settings to improve communication with LEP individuals. OBJECTIVE The objective of this work is to use scenario-based methods with EMS providers and nonnative English-speaking users who identified themselves as LEP (henceforth referred to as LEP participants) to evaluate the potential of two automated translation technologies in improving emergency communication. METHODS We developed mock emergency scenarios and enacted them in simulation sessions with EMS personnel and Spanish-speaking and Chinese-speaking (Mandarin) LEP participants using two automated language translation tools: an EMS domain-specific fixed-sentence translation tool (QuickSpeak) and a statistical machine translation tool (Google Translate). At the end of the sessions, we gathered feedback from both groups through a postsession questionnaire. EMS participants also completed the System Usability Scale (SUS). RESULTS We conducted a total of 5 group sessions (3 Chinese and 2 Spanish) with 12 Chinese-speaking LEP participants, 14 Spanish-speaking LEP participants, and 17 EMS personnel. Overall, communications between EMS and LEP participants remained limited, even with the use of the two translation tools. QuickSpeak had higher mean SUS scores than Google Translate (65.3 vs 48.4; P=.04). Although both tools were deemed less than satisfactory, LEP participants showed preference toward the domain-specific system with fixed questions (QuickSpeak) over the free-text translation tool (Google Translate) in terms of understanding the EMS personnel’s questions (Chinese 11/12, 92% vs 3/12, 25%; Spanish 12/14, 86% vs 4/14, 29%). While both EMS and LEP participants appreciated the flexibility of the free-text tool, multiple translation errors and difficulty responding to questions limited its usefulness. CONCLUSIONS Technologies are emerging that have the potential to assist with language translation in emergency response; however, improvements in accuracy and usability are needed before these technologies can be used safely in the field.

Objective: To determine the consistency of responses to a standardized 2‐part “key” question (Key‐Q) about acute symptom onset in patients presenting with chest pain when measured using alternative questions (Qs) about symptom perception and decisions to seek treatment. Methods: A structured patient interview was performed at 3 university teaching hospitals and 1 community hospital. Convenience samples of adult patients presenting to these EDs with chest pain were asked specific questions related to their symptoms and recognition of illness. Information obtained included the 2‐part Key‐Q: “What are the symptoms that brought you here today?” and “When did those symptoms start?” The alternative Qs (in order of use) were as follows: Ql =“When did your very first symptom or sensation begin?”; Q2 =“When did your symptoms lead you to think something was wrong or that you were ill?”; Q3 =“When did your symptoms become serious enough for you to seek medical care?”; and Q4 =“When did you actually call 9‐1‐1/emergency medical services (EMS) or go to the hospital?” The documented ED arrival time, demographic variables, and whether the patient arrived by ambulance were obtained from the medical record. Patients also were queried regarding potential barriers to seeking medical care and their cardiac risk factors. Results: Of the 135 patients surveyed, 9 were unsure of the date and time of symptom onset. For the 126 patients with analyzable data, the mean (±SD) patient age was 62 ± 16 years, and 59% were male. The general sequence of events reported from acute symptom onset until hospital care was Q1/ Key‐Q ← Q2 ← Q3 ← Q4 ← ED arrival. The median differences and interquartile ranges (IQRs) in minutes between Q times and the Key‐Q response were: Q1 = 0 (0‐0); Q2 = 30 (0–210); Q3 = 140 (30–720); Q4 = 265 (90‐1,215); and ED arrival = 340 (120‐1,230). The interval from the Key‐Q response until calling 9‐1‐1/EMS or going to the hospital was shorter for those who used an ambulance and for those who did not consult a physician first. The interval from the Key‐Q response until considering symptoms to be serious was shorter for those with a family history of heart disease, but longer for non‐white patients. Conclusion: The Key‐Q elicited a response recalled near the time of first symptoms and generally before the patient had concluded something was “wrong or that he or she was ill.” Measurement of the out‐of‐hospital delay in chest pain patients using the Key‐Q appears promising.