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
Overview
- Phase
- Not Applicable
- Intervention
- H+H EHR reports of Patients (pre-implementation)
- Conditions
- Appropriate Use of Language Across Services
- Sponsor
- NYU Langone Health
- Enrollment
- 17500
- Locations
- 3
- Primary Endpoint
- Percentage of appropriate interpreter use
- Status
- Recruiting
- Last Updated
- 3 months ago
Overview
Brief Summary
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).
Detailed Description
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.
Investigators
Eligibility Criteria
Inclusion Criteria
- •(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
Exclusion Criteria
- •(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):
Arms & Interventions
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)
Intervention: System level Language Access (LA) intervention
Key stakeholder interviews of Patients/Caregivers/Community Members (post-implementation)
Intervention: System level Language Access (LA) intervention
Key stakeholder interviews of NYC H+H Leadership/Providers/Staff (post-implementation)
Intervention: System level Language Access (LA) intervention
Key stakeholder interviews of CBO Leadership/Staff (post-implementation)
Intervention: System level Language Access (LA) intervention
Key stakeholder interviews of CBO Leadership/Staff (pre-implementation)
Post-visit survey of Patients/Caregivers (post-implementation)
Intervention: System level Language Access (LA) intervention
H+H EHR reports of Patients (post-implementation)
Intervention: System level Language Access (LA) intervention
Post-visit survey of Patients/Caregivers (pre-implementation)
Outcomes
Primary Outcomes
Percentage of appropriate interpreter use
Time Frame: up to Year 3
Percentage of appropriate interpreter use
Time Frame: up to Year 2
Secondary Outcomes
- 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)