Community and NYC Public Healthcare System Partnership to Promote Equitable Access to Language Services and Optimal Preventive Health Services Use Among Individuals With Limited English Proficiency
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 入组人数
- 17,500
- 试验地点
- 3
- 主要终点
- Percentage of appropriate interpreter use
研究概览
简要总结
This is a community-based study that will engage community and health care stakeholders to develop, implement, and evaluate a Health Literacy (HL)-informed, culturally- and linguistically- sensitive approach to improving language access services for patients with limited English proficiency (LEP) to promote health equity and reduce disparities in preventive health services use and health outcomes in New York City (NYC). This study will have a total of 4 phases that include a preparatory work phase (Non-Human Subjects Research), a pre-implementation phase, an implementation phase, and a post-implementation phase.
Findings from the preparatory work and pre-implementation phase and discussions with key partners will inform the co-design of intervention strategies and endpoints for the later phases (implementation and post-implementation phase).
详细描述
The preparatory work phase (Non-Human Subjects Research) will collect information on policies and procedures related to language access (LA) services use. Educational and patient-facing materials will also be reviewed. This information will be collected pre- and post-implementation.
During the pre-implementation phase surveys and in-depth interviews with key stakeholders will be conducted to assess their views on barriers and facilitators to LA services and preventive services use and ideas about potential intervention strategies and resources to improve these services. Additionally, patients seen for ambulatory care preventive visit at one of the 4 study locations will be invited to complete an anonymous post-visit survey to assess their views on LA services use and provider-patient communication. Community members will also be invited to complete an anonymous survey to assess knowledge of LA rights and satisfaction with LA services. NYC Health & Hospitals (H+H) EHR reports will also be generated to collect visit-level information.
The implementation phase will include the development of culturally and linguistically appropriate and HL informed strategies and materials/toolkit for community members, patients, and health care providers and staff. Findings from the preparatory work and pre-implementation phase and discussions with key partners will inform the co-design of intervention strategies.
During the post-implementation phase surveys and in-depth interviews will be conducted with key stakeholders to assess their views on barriers and facilitators to LA services and preventive services use and ideas about future potential intervention strategies and resources to improve these services. We will also examine perceived appropriateness, acceptability, feasibility, and sustainability of the intervention. We will assess use and adoption of the intervention toolkit. Additionally, patients seen for ambulatory care preventive visit at one of the 4 study locations will be invited to complete an anonymous post-visit survey to assess views on LA services use and provider-patient communication. Community members will be invited to complete an anonymous survey to assess knowledge of LA rights and satisfaction with LA services. H+H EHR reports will also be generated to collect visit-level information.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Retrospective
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •(pre- and post- implementation phase):
- •Post-visit survey (Patients/Caregivers):
- •Patient seen for ambulatory care preventive visit at one of the study locations OR caregiver of a pediatric patient seen for ambulatory preventive visit at one of the study locations.
- •18 years of age and older
- •Willingness and ability to participate
- •H+H EHR Reports:
- •Patient seen for ambulatory care preventive visit at one of the study locations
- •Community survey (Community members):
- •Individual that attends community based organizations (CBO) events or uses CBOs' services
- •18 years of age and older
- •Willingness and ability to participate
- •Key Stakeholder interviews:
- •Patients/Caregivers/Community Members Inclusion Criteria: In order to be eligible to participate, an individual must meet all of the following criteria:
- •Prefers to speak in Bengali, French, Spanish, Mandarin, or Polish
- •18 years of age or older
- •Patient seen for ambulatory care preventive visit at one of the 4 study locations, caregiver of a pediatric patient seen for ambulatory care preventive visit at one of the 4 study locations OR a community member referred by a CBO
- •Willingness and ability to participate
- •NYC H+H Leadership/Providers/Staff Inclusion Criteria:
- •Work at one of the 4 NYC H+H study locations that does language access related work or communicates with patients that prefer to speak a language other than English regularly.
- •Leadership (e.g., chief medical officer, Department Director, etc.), provider (Physician, Nurse, Resident), or staff (Interpreter, language access coordinator, clerical staff) at the NYC H+H location
- •18 years of age or older
- •Willingness and ability to participate
- •CBO Leadership/Staff Inclusion Criteria:
- •CBO leadership (Director/Coordinator) or staff (Case manager, Patient navigator, etc.)
- •18 years of age or older
- •Willingness and ability to participate
排除标准
- •(pre- and post- implementation phase):
- •CBO Leadership/Staff Exclusion Criteria:
- •Does not have a working phone number
- •Uncorrected hearing impairment
- •Post-visit survey (Patients/Caregivers):
- •Enrolled to key stakeholder interviews
- •Does not have a working phone number
- •H+H EHR Reports (Patients):
- •No exclusion criteria
- •Community survey (Community members):
- •Does not have a regular doctor in the US.
- •Key Stakeholder interviews:
- •Patients/Caregivers/Community Members Exclusion Criteria:
- •Speaks English very well (non-LEP)
- •Does not have a working phone number
- •Uncorrected hearing impairment
- •NYC H+H Leadership/Providers/Staff Exclusion Criteria:
- •Does not have a working phone number
- •Uncorrected hearing impairment
研究组 & 干预措施
H+H EHR reports of Patients (pre-implementation)
Community survey of Community members (pre-implementation)
Key stakeholder interviews of Patients/Caregivers/Community Members (pre-implementation)
Key stakeholder interviews of NYC H+H Leadership/Providers/Staff (pre-implementation)
Community survey of Community members (post-implementation)
干预措施: System level Language Access (LA) intervention (Other)
Key stakeholder interviews of Patients/Caregivers/Community Members (post-implementation)
干预措施: System level Language Access (LA) intervention (Other)
Key stakeholder interviews of NYC H+H Leadership/Providers/Staff (post-implementation)
干预措施: System level Language Access (LA) intervention (Other)
Key stakeholder interviews of CBO Leadership/Staff (post-implementation)
干预措施: System level Language Access (LA) intervention (Other)
Key stakeholder interviews of CBO Leadership/Staff (pre-implementation)
Post-visit survey of Patients/Caregivers (post-implementation)
干预措施: System level Language Access (LA) intervention (Other)
H+H EHR reports of Patients (post-implementation)
干预措施: System level Language Access (LA) intervention (Other)
Post-visit survey of Patients/Caregivers (pre-implementation)
结局指标
主要结局
Percentage of appropriate interpreter use
时间窗: up to Year 3
Percentage of appropriate interpreter use
时间窗: up to Year 2
次要结局
- Percentage of patients up to date with preventive screenings and vaccinations(up to Year 3)
- Percentage of patients with knowledge of federal rights related to LA services(up to Year 3)
- Percentage using untrained interpreters(up to Year 3)
- Percentage using recommended HL-informed verbal counseling practices (e.g., teach-back)(up to Year 3)
- Percentage of patients with satisfaction with LA services preventive health services utilization(up to Year 3)
- Percentage of patients up to date with preventive screenings and vaccinations(up to Year 2)
- Percentage of patients with knowledge of federal rights related to LA services(up to Year 2)
- Percentage using untrained interpreters(up to Year 2)
- Percentage using recommended HL-informed verbal counseling practices (e.g., teach-back)(up to Year 2)
- Percentage of patients with satisfaction with LA services preventive health services utilization(up to Year 2)