For many people, it can be difficult to recognize the signs of acute coronary syndrome, commonly known as a heart attack. Few studies have focused on how people understand heart attack symptoms, and even fewer focus specifically on Spanish-speaking communities in the U.S. This is where nurse researchers come in: they gather data to better understand the needs of communities, then create recommendations for improving nursing practice and patient outcomes.
MCN faculty members Dr. John Blakeman and Dr. Susana Calderon are doing just that. The two first met at Millikin University, where Blakeman was a student in Calderon’s health assessment lab. Blakeman’s research focuses on cardiovascular disease and symptom science, while Calderon’s work focuses on oral health in underserved populations. By chance, they both landed as faculty at MCN. “Now, we have a strong cardiac research team,” says Calderon. They wondered: “Do Spanish-speaking individuals in Bloomington-Normal know the signs of a heart attack? And do they know what to do if they experience symptoms?”
“Within Hispanic and/or Latinx communities, there isn’t a lot of information about heart attack symptoms,” said Calderon. One 2006 paper found that there’s even less information in communities of people who speak solely Spanish. Though there are public health campaigns to spread awareness, they aren’t always accessible to everyone. Calderon insists, “We can’t ignore this segment of the population.”
To address this disparity, Blakeman and Calderon are working with the Community Health Care Clinic (CHCC) in Normal, which serves a primarily Spanish-speaking population, with most patients identifying as Hispanic, Latino, Latina, or Latinx. They are measuring the extent to which CHCC patients recognize the signs of a heart attack, as well as whether they know what to do if they experience symptoms.
From statistics to translation, this research requires a diverse set of skills. Because of this, the project has been a team effort in collaboration with MCN, the CHCC, and others on campus including MCN faculty Dr. Marilyn Prasun, Dr. Myoung Jin Kim, Dr. Susie Watkins, and Ph.D. student Kate Peterson; nursing students (including, as of the writing of this article, Ashley Belsan and Mary Horcher, both of whom are part of the CAUSE program and are fluent in Spanish); and Dr. Montserrat Mir from the Department of Languages, Literatures, and Cultures, who collaborated with nursing faculty on this project.
MCN has an existing partnership with CHCC through the CAUSE program, which is directed by Watkins. “We are continuing to build that partnership by being intentional about our research methods,” says Blakeman. One component that was important to the team was making sure that all materials were available in both English and Spanish.
There were other barriers to consider beyond translation, too. “When you do research with Spanish-speaking folks, first-generation folks, or new immigrants, a major barrier can be complex issues of immigration, relocation, and education level,” says Calderon. It was important to protect the safety of participants and to also let them self-identify. For example: “Some participants use the term Latinx, but some don’t. They can choose Latina, Latino, Latinx, or Hispanic.”
The path to a good partnership is paved by ethical research. “We have to think about how our research can benefit them,” says Calderon. “Research is not always done ethically. When people hear ‘research,’ they walk away. Because I am from this population, I know that this especially happens for minorities due to the history of being harmed by research. That’s why, as researchers, we always want to make sure we are giving back to these communities.”
“This is new ground,” says Blakeman. It’s a small study, so nurses can’t generalize it for all populations. But for Bloomington-Normal and communities like it across the country, the information is valuable. “Looking at the data, we will be able to focus on areas in which we can improve in terms of education, messaging, programming, and ways we can connect with this population. It’s not just an educational intervention; it’s a multilayered, intentional process to help people change behavior.” Ultimately, it will help places such as the CHCC improve their patient care and best strategize how to address health disparities within the populations they serve.
The study helps build relationships between MCN and the patient population, too. Calderon hopes that patients who shared their contact information might be willing to participate in future studies, such as those related to her work on improving oral health.
Finally, the study sets the groundwork for future research in acute coronary syndrome. With more funding, it could serve as a rationale for future research in the field and be replicated on a larger scale.
“The future is there. The need is there. The interest is there,” says Calderon. “What it needs is funding.”
Blakeman and Calderon would like to thank their collaborators and funding agencies for their support during this research initiative. They would also like to thank the College, Dean Judy Neubrander, Dr. Mary Dyck, Dr. Montserrat Mir, and the Department of Language, Literatures, and Cultures. This research was made possible thanks to an Illinois State University research grant.