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Using eHealth to Expand Access to Behavioral Healthcare for non–English-Proficient Hispanic Patients

Significance and Potential Impact

Adoption of this research will expand access to evidence-based alternatives to medication for the management of chronic insomnia and may narrow existing racial and ethnic disparities in access to high quality behavioral health care for patients.

Access to behavioral healthcare is often a challenge but is even more difficult for non–English-proficient patients to find bilingual behavioral providers who understand how culture affects patients’ interactions with the healthcare system. While cognitive behavioral therapy for insomnia (CBT-I) is an evidence-based alternative to medication, access is limited because of the lack of qualified bilingual behavioral health providers.

Cultural adaptation is the systematic process of modifying and adapting the intervention by integrating cultural components that align with patients’ worldview. Beyond language adaptations, it includes “deep structure” cultural adaptations such as changing examples to make them culturally relevant and avoiding Spanish-language regionalisms.

Developing a cultural adaptation of an interactive digital program to deliver cognitive behavioral therapy for insomnia.

Dr. Carmela Alcantara, from Columbia University, is conducting research with non–English-proficient Hispanic patients with insomnia and behavioral health providers to develop a cultural adaptation of an existing digital CBT-I program. This intervention is an interactive program that can be delivered via tablet, smartphone, or computer that has been effective at reducing insomnia symptoms and co-occurring psychological symptoms.

Dr. Alcantara and her research team will conduct a randomized controlled trial with non–English-proficient Hispanic patients with chronic insomnia that compares the effectiveness of the culturally adapted digital version of CBT-I with enhanced usual care on reduction of insomnia symptoms.

Research Details