Mobile Video Interpretation to Optimize Communication Across Language Barriers

Summary

Patients and families with limited English proficiency (LEP) and/or who use a language other than English for medical care (LOE) experience substantial barriers to communication in the healthcare setting, leading to medical care that is less safe, less efficient, less effective, and inequitable. Professional interpreter use has repeatedly been shown to improve outcomes and reduce disparities, yet it remains widely underused. This study will test two discrete, scalable implementation strategies for improving professional interpreter use in primary care, while collecting detailed information about mechanisms of action and costs that will be applicable to many sites of care and contribute meaningfully to the goal of reducing communication-based disparities. The investigators hypothesize that improving provider knowledge, confidence, and interpreter access will change behavior under real-world conditions.

Conditions

• Limited English Proficiency

Interventions

BEHAVIORAL

Web based educational modules

This strategy will consist of 6 web-based modules, clinic-specific interpreter access information, and 4 booster modules, all delivered via the internet. The online modules will cover 6 topics: 1) the importance and fundamentals of good communication; 2) the importance of professional interpreter use and disparities for LEP populations; 3) how to use an interpreter effectively; 4) what to do when the encounter is not going well; and 5) special challenges and 6) solutions related to remote interpreter use. Modules will be interactive, with tailoring to the learner, and each will be \<15 minutes long. All modules will be available at once, but assigned providers will be prompted to view a new one each week. Every month for months 3-6 after randomization, a booster module will be released. The brief (\<10 min) boosters will review crucial points from initial modules and feature video vignettes. Providers will be reminded to view these weekly until they are complete.

BEHAVIORAL

mobile video interpreting (mVI) access

This strategy will involve giving assigned providers access to mobile video interpreting (mVI) on a personal device, installation and support as needed, a tip sheet, and an extra charger, optional shock-resistant case, disposable antimicrobial sleeves, and a positioning stand to support use of their personal device for clinical care. mVI-assigned providers can opt for a study-issued smartphone in lieu of using their own. Access to mVI is achieved by downloading the application from the relevant location (e.g., Apple App Store), then entering an access code that links to a billing account. The study staff would then demonstrate use and answer questions. Technical support will be offered in-person following randomization; we will then email mVI-assigned providers weekly for the first month, then monthly, to offer additional support. A tip-sheet will be sent via email during the first week of the study that will include mVI instructions and best-practices.

Sponsors & Collaborators

• Seattle Children's Hospital

  lead OTHER

Study Design

Allocation

RANDOMIZED

Purpose

HEALTH_SERVICES_RESEARCH

Masking

SINGLE

Model

PARALLEL

Eligibility

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2022-10-24

Primary Completion

2025-09-02

Completion

2026-08-31

Countries

• United States

Study Locations