Language

I listened to "Where's my Babel Fish" yesterday and have been thinking a bit about language in general. First off I think it's great that we were given a list of slang and profane words and phrases to help us understand a little bit better what is going on. In addition, I have been thinking a lot about language from doing the translation work for my consent and assent forms. There are so many words that are just not common in Spanish. For instance some of the exercises and equipment that I will be using just are not common words in Spanish- at least not for a common person. I think I could say the same thing for English sometimes. If I start talking about lateral flexion of the I.S. joint, most people are not going to understand what I'm talking about. This is also something that I have seen when I work in the physical therapy clinic. The PT will explain certain structures of the body or procedures using words that I just learned in my anatomy class last semester. So, I am sure that the patient does not quite understand what he is talking about. This is just not too helpful for that person. This is something that I will need to be careful of when I am in the field. Common words for me may be uncommon to the people I will be living with. Even Spanish words that I have learned in class may actually be rarely used in rural Mexico and there will be other words that the people use for what I want to say. I imagine I will have frequent headaches while I am there trying to understand what is going on. So while this difficulty and problem is inevitable, I hope that it will not hinder me too much in my field study experience. In fact, I am excited to figure out how the people living in the rural areas outside of Irapuato speak and communicate differently than I have imagined here. It will be neat to learn some of the appropriate words and phrases that are unique only to Mexico and even only to Irapuato and the Ranchos.
In addition, it is not only language that differs between cultures, but as Liann described, there are concepts and ideas that vary greatly. Some ideas in American English just do not exist in India. I anticipate that there will be some similar difficulties that I find in Mexico. I am especially interested to find out the differences in their understanding of health and physical activity and then see how these differences in ideas bring about differences in behavior. At the end of Liann's discussion she mentions that she wishes she had emphasized the qualitative data more because it helps interpret the significance of the quantitative data so much more. This is something that I have been thinking about. I hope that three months in Irapuato is sufficient time to shed some light on the cultural reasons for physical differences between Mexico and other areas of the world.

insights from class

I really appreciated the things that we talked about in class today. The problems that might arise while I'm in the field are inevitable but I just have this feeling that I cannot possible guess what they will be. Or at least there will for sure be some things that come up that I never would have been able to prepare for. So I liked the thought that Ashley gave about the importance of being flexible. I have a project pretty well planned out and it almost seems like the way it is set up - especially the fact that it needs to match other projects that will be done in other countries in order to be effective- it seems that there is not a lot of room for changes to the project. This thought makes me a little stressed. But at the same time, I am coming to realize that this is not necessarily true. No project is perfect, with perfect methods that match completely from every side. If the project was too rigid, in fact, it would become less valid. I have to account for the differences in site and culture that come from being in Mexico. I have to adapt my project to fit to Mexico. If I am too rigid, there may be something that I miss entirely. --- Even if this means that my project ends up being useless after I'm done- or even completely failing- I am excited about the learning experience of being in Mexico and attempting to do something that I've never done before, with people that I've never met, in a place that I've never been, speaking a language in a way that I never have before. Just being able to do that in itself makes the experience a success.
Still I imagine that I will have moments of panic and worry as I try to figure out how to make sure that my project fits in with the culture. Or I'm even sure that I'll have difficulties in many of the areas that I listed on my paper today. How to prepare for them- be flexible- roll with the punches, as Ashley said. This is similar to what I said in my earlier post about just being patient. So maybe that makes this a reiteration. Really though, I think patience and flexibility are different and so it is good to be ready to have both skills when I get out into the field.

Understanding language and culture better in my study

I have a few thoughts concerning what we talked about it class today. For one thing I am grateful that Spanish does not seem to be quite such a complicated language as Tamil- however, I'm sure that it comes with it's complications. I was thinking about my own Spanish and while I am not fluent in it by any means- I can get by here. However, I'm sure that there is lingo that I can't learn here and I will only hear when I get there. I was thinking aboput that article that we skimmed over in class- where different groups of people had different language that they used and the researcher, without knowing what those words or phrases meant could get really lost. Already I know that there will be times that I get lost just because it is in Spanish- but I'm sure that there will be other times when someone uses a word that I've never heard before that no one uses anywhere else. I know that this happened to me quite a bit on my mission and sometimes it could be quite frustrating. I think what helped me the most was when I wasn't shy about asking for clarification- I had to be careful because sometimes people weren't patient with me- but for the most part if I didn't try to pretend like I understood but I respectfully told them that I didn't understand- things went a lot better. In addition, I had to be patient with myself. that is pretty key.
I was also thinking about some of the suggestions that I was given from my journal entries on how I am going to cope with misunderstandings that occur. Right now I don't really have a great answer. I think one thing that is important is again- patience. I need to be patient with myself and with the people that I'm with. I have to make sure that I don't get mad or offended- I don't feel like I'm the type to do this anyway. I also have to not get frustrated to the point that I don't want to continue or work through it. Taking it with the attitude of "this is a learning experience" rather than a "this isn't what I thought it would be" attitude can make a big difference when in the middle of turbulence.
I have one more thought- I have had issues with whether to do a questionnaire or not. I talked to Amy- she likes the questionnaires and didn't think that they took up too much time. I do think that they can be a good way to take into account more of the cultural aspects of physical activity and health in Mexico. However, looking at the questionnaire- I can see that it is probably not the best anyway. So regardless of whether I use the questionnaire or not for the study, I think that it is important to make observations and take notes regarding physical activity in Mexico in order to draw my own conclusions as to why they might have the posture or body composition that they do. I'm not sure how it will fit into my project- or even if it will- but I feel that the information that I gather could help us modify or tailor the project a little better to whatever locations we might go to mext. It could also bring up ideas or questions that we hadn't really thought of before.
So I'm not sure exactly how I will do this, but it is something that I am going to think about a bit in order to make sure that my project is looking at as many aspects as possible and not just those physical aspects contained within the study.

My biggest hang-up for the moment

Okay so I have been working really hard on getting my IRB protocol worked out. So far it is looking pretty good, but I have a kink in my methods. The whole purpose of doing this project is to relate type of physical activity to degree of musculo-skeletal fitness. Amy collected data about physical fitness through a Previous Day Physical Activity Recall, PDPAR. She was also planning to use pedometers but she said that didn't work out. (I sent her an email asking her why and hope to get some better insight.) Dr. Johnson said that the questionnaires took too long and so I should just use a pedometer. But I don't want to get to Mexico and find out that I have the same difficulty with the pedometers that Amy did and therefore have no way of generating data about physical activity type.
I have been thinking about a method that I found in my research called SOFIT in which I observe the physical activities and score them based on a system developed my scientific researchers in physical education. But this method is used to evaluate physical education lessons more than it is used to see what kinds of activities children engage in on their own. I will look over this and see if I can adapt it to my study. The problem is that I need it to be comparable to the data collected in other studies. These studies will be using an accelerometer, which is by far the best method to measure activity level- it just won't work in Mexico because they are too expensive to distribute to the kids. But I need to be able to compare the two studies.
My other idea is to modify the questionnaire so that it does not take too much time to fill out. I'm not sure if this ill generate reliable data either.
This brings me to another thought- this is the whole point of cultural immersion. If all I do is go to Mexico and measure how long they can stay in a plank position etc. and I don't take note of any of the cultural influences of physical fitness and health, then I feel that I will really lose a lot of the knowledge and understanding that I could gain from them. I'm sure that I will observe and take notes of a lot of these things but I feel that it should be emphasized somehow within my project.

Methods and IRB

Honestly I have been so busy I am not sure what I have been learning. We've been going over the IRB protocols and it has been good to see the different projects that everyone is doing. It has also really helped me to see where the most important parts of the protocol are and what I need to emphasize as I am writing mine. I have several sections of my protocol that I need to work on- specifically the risks section, the literature review, and the methods section. The risks and the methods are probably the most important parts of the protocol. I have to do a lot of work with the methods because I am changing them from what Dr. Johnson is doing in Hungary. He is using an accelerometer and that is just not a realistic or a good idea for me in Mexico- they are $300 each. So I will just be using a pedometer. One of my concerns is that Amy said that she ended up having to ditch the pedometers and she just used a questionnaire. Dr. Johnson said that the questionnaires took too long to fill out. So... I'm not quite sure what will be the best way to measure physical activity but I need to figure it out soon. Needless to say, I am a little bit stressed out about this stuff. :)

New Insights

Okay so this is going to be an exciting post because I have some new insights that I can share. First, I was thinking about that thing that Amy said about making the assessments more functional. Well I can't really change the tests because then it wouldn't match the other studies making the idea kind of obsolete. However, I was thinking that while I am in Mexico for the first little while, I will try to observe different activities that the people do (either the kids or the adults) that are similar to or use the same movements as the the things that I will be testing. Then when I test the kids I can compare it to that activity and they can maybe see the value in me doing the tests instead of telling me that I'm torturing them, like Amy said the kids in Ghana told her. I don't know about you but I think this is a good idea. So for instance, for the hurdle step, maybe there is a fence that the kids have to climb over everyday and I could say that with this test we can see how good they are at climbing over a fence without wobbling over or using support. I just have to figure out how to say wobbling in Spanish.
Another piece of advice that Amy mentioned was understanding the culture to know how to influence them to let me do this study. It sounds somewhat manipulative but Amy is so sweet I don't think she manipulated them at all. She just used it to her advantage. She said the the Ghanaian people are somewhat proud of their physical strength so when she would present them the project they were eager to demonstrate how they were, "of course" stronger than the fat Americans. That was kind of her hypothesis so it wasn't a terrible assumption on their part. Anyway, she said that made it easier for her. So she would emphasize that it was a comparative study regarding strength and the Ghanaians were very eager to help her. So, when I'm in Mexico I will be looking for indications of which part of the study the Mexican people will relate to and when I present the study I'll be sure to explain that part- and I wouldn't leave out other things of course. I wish I could think of some things now that I could prepare for. All I can really think of is that I just feel like all Latinos, Mexicans included, are so nice and so they will probably be willing to help me. This come from my interaction with them here in the States- but they might just be nice here because I am a little white girl who is willing to speak my cute Spanish with them. Anyway, this will be something that I think about.
In addition, in the IRB protocol whatnot that we had today I was told to try and think of more risks that might be involved in the study- just to be thorough. One risk I will emphasize earlier is the risk of working with children. I also thought of the risk of competition among the children. What will some children think if they don't get picked for the study or if their parents don't allow it? Also, there may be competition within the kids that get picked. I don't want to have any of the other subjects present while I am assessing another child. I wouldn't want that child to be embarrassed. There also may be some more obese children that feel uncomfortable doing these exercises because they get made fun of or for other reasons. And there is also my gender- some kids may be shy doing this in front of a girl. So I may need to think of a way to get someone to help me with that- maybe a teacher or someone. In any case, I need to minimize these risks and try to think of any others that I can include in the protocol just to be thorough.
So these are my new insights and I think they are pretty good. They have at least gotten me thinking a little bit about how I can better prepare for the culture of Mexico.
Voila!

Finally got to talk to Amy

I was finally able to talk to Amy today. She brought up a lot of really great points for me to think about while I do the study in Mexico. I will highlight a few things. She mentioned that there were a lot of cultural differences that she didn't think of before getting there. - Kind of like we've been learning in class- :) For instance the Ghanaian perception of exercise is a lot different than the American idea. We think its no big deal to go for a run- or we even want to because we know that will help us stay fit. The Ghanaians don't need to exercise to stay fit. The things that they do everyday keep them fit. They walk everywhere and they do a lot of physical labor. So to go for a run is like torturing yourself. In addition, they don't have physical education in the schools there so they are not used to being told how to exercise or stay fit and they definitely are not used to fitness assessments.When Amy would test the kids, she would have them do side bridges etc for as long as they could and they would think it was so pointless- how can that determine if you are strong or you can work hard etc? For them it was like she was torturing them. So she said it would have been better to have them perform some sort of functional task determined by their culture- like carry a load on their heads- which they do all the time and measure that some how. I'm not sure what kinds of functional tests I could give the kids in Mexico- maybe something to do with a soccer ball. I'll have to think about that.
When I spoke to my Mexican friend for the Methods 1 interview- she said that they do have PE in Mexico and they have fitness testing in the lower levels. So I can anticipate that the kids are somewhat used to it but I am sure there will be some differences from the United States and the kids/all the people will have a difficult time understanding why I am making them do what I am will make them do. I'm not sure what these differences will be. I think I will talk to another Mexican that I know about this.
Amy also told me how she did her recruiting and I think it sounds genius and so simple that I wish I had thought of it before. She went through the teacher and sent letters home to the parents for them to sign giving kids permission to participate in the study. One thing she said she wished she'd had was to be able to meet the parents. The area she was in was fairly large and so she couldn't go meet all the parents there. But my area will be small and so it will be much easier for me to meet the parents and discuss the project with them and just in general build rapport. Also, this way I can make sure that they understand what the study is for because she said that she felt that a lot of people signed the form without really knowing what it was - especially since it wasn't in their native language.
There were several other insights that I got from Amy- mostly concerning timing and how to conduct the project. So it was a really good meeting. One sort of take home message that she said was- try to anticipate all the cultural differences that will affect your project but realize that you can't actually anticipate them all.

I have so many questions that I need answered.

Okay so starting the IRB proposal seemed like it was going to be a headache. And it kind of was but I was able to get a few things finished up. I still have a lot of holes though. I am a little frustrated because I haven't had success getting with my mentors about the project. I have just been emailing them questions but I think going to their offices will be much more effective. They have a lot of the answers that I need especially concerning the methods that we will use for the project. For now in my proposal I have made up a lot of the procedures according to what I think it will be like, but that might just change. But I'm just trying to think through the process and write it out as logically as possible. There are some places though where I know that I do not understand exactly how it will be so before wasting a lot time, I want to ask them directly.
I have been able to get a hold of Amy. We plan to have a meeting in Salt Lake this Saturday to discuss the project. I have a lot of questions to ask her as well. These questions have more to do with conducting the study in a different culture than they are about the methods. For instance, What went easier than she expected- if anything did. What was a lot harder than she anticipated? How did she find participants? How did she explain the project to the participants and the parents? How was she received? How did she handle any negative feelings that she may have encountered? What was most affective in working with the children? Was she able to effectively instruct them on the exercises? How did the pedometers work out? Did she lose any? (I want to know because my mentors want to give the kids accelerometers this time and they are a lot more expensive.) What advice can she give me for this type of a project? What would she think would differ in Mexico from her project in Ghana?
These are just a few of the questions that I have had in my mind and while I have a few ideas about the responses, it is always better to hear it from someone who has first hand experience. So in conclusion, I have a lot of questions that I need to ask a lot of people before I can move forward with my project.