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Members must participate in a process of collective learning within their domain.[1] Additionally, social structures must be created within the community to assist in knowledge creation and sharing. Knowledge must be shared and meaning negotiated within an appropriate context. Community members must learn through both instruction based learning and group discourse.

Dr. Foreman was incredulous about the heart attack, but the tests had been double checked. Dr. The domains of interest addressed in the survey questionnaire included: seeking prenatal care (barriers and facilitators, including women’s experience with the newly implemented Medicaid managed care eligibility process), receiving prenatal care (experience and perceptions), acculturation, social support, health behaviors during pregnancy (including substance use and abuse), border market purchasing practices, domestic violence,botanical slimming gel pills r, family planning practices and intentions, future health care intentions (for mother and infant), and crossing the border for health care services (present pregnancy and future intentions).The full details of the process used in the translation, linguistic adaptation, and assurance of cultural relevance, appropriateness, and psychometric properties of this tool are published elsewhere.35 Briefly, content validity of the instrument was confirmed by linking to the published literature and by receiving affirmation of the relevance of all survey items from a panel of perinatal experts. A certified translator crafted the English to Spanish form. Another individual who was also an expert in obstetrical terminology amended the Spanish form as necessary, and then backtranslated to the English language.