Improving Satisfaction and Appointment Attendance Through Navigation for Spanish-Speaking Families

Flower, Kori B.; Wurzelmann, Samuel; Rojas, Claudia; Heredia, Kristina Morris; Peereboom, Myriam; Sylvester, Francisco; Agostinelli, Kellei; Ritter, Victor; Fine, Jason P.; Steiner, Michael

doi:10.1353/hpu.2020.0062

Cited by 6 publications

(8 citation statements)

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“…By addressing intersecting barriers to care, patient navigation that was designed in response to these caregiver interviews was associated with improved appointment attendance and satisfaction. 11 Spanish-speaking caregivers in this study often found written communications in Spanish helpful, including after-visit summaries (AVS). Since AVS became an expectation tied to meaningful use of electronic health records, 25 they have become ubiquitous, yet relatively little has been published about patient perspectives on their usefulness.…”

Section: Article In Pressmentioning

confidence: 81%

Section: Discussionmentioning

confidence: 99%

“…Since these interviews, our monthly monitoring of patient portal activation has revealed a widening disparity between Spanish and English-speaking caregivers, suggesting persistence of the barriers described by caregivers in this study. As a result of the interest caregivers described in patient portals and HIT, we are building on the existing bilingual patient navigation program 11 to evaluate whether patient portal access can be facilitated by navigators (ClinicalTrials.gov Identifier: NCT04410380).…”

Section: Discussionmentioning

confidence: 99%

“…23 We used the barriers identified by caregivers to design a bilingual patient navigation intervention to improve communication. 11 For example, caregivers described "getting by" through using limited English proficiency skills 24 in initial communication, such as appointment scheduling. Since misunderstanding during these communications can delay care, patient navigation addresses points where caregivers described challenges, including check-in, nursing triage, and appointment scheduling.…”

Section: Article In Pressmentioning

confidence: 99%

“…The overarching purpose for obtaining caregiver perspectives was to guide the design and implementation of our patient navigation program for Spanish-speaking caregivers, which has been described previously. 11 A secondary aim of this study was to obtain information about experiences with health information technology (HIT) by families whose children require academic medical center care, with the goal of guiding optimal service provision.…”

Section: Introductionmentioning

confidence: 99%

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Spanish-Speaking Parents’ Experiences Accessing Academic Medical Center Care: Barriers, Facilitators and Technology Use

Flower

Wurzelmann

Tucker

et al. 2021

Academic Pediatrics

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Background and Objective Children of Spanish-speaking caregivers face multiple barriers to care in academic medical centers. This study identified barriers and facilitators of health care, and described use of health information technology in order to guide interventions and optimize services. Methods In-depth, audiotaped interviews were conducted with monolingual Spanish-speaking caregivers (N=28) of children receiving care in academic medical center clinics using a structured interview guide. Interviews were transcribed in Spanish, and key themes were identified using thematic analysis. Illustrative quotes for each theme were translated into English. Results Language-specific barriers included: arrival/registration occurring in English, lack of bilingual personnel, heavy reliance on interpreters, long wait times, and challenging phone communication. Non-language-specific barriers included: medical center size and complexity, distance to services, lack of convenient and coordinated appointments, missing work/school, and financial barriers including insurance coverage or lack of citizenship. Caregivers identified interpreters, bilingual physicians and staff, and written materials in Spanish as facilitators of care. Most caregivers had internet access and expressed interest in health information technology, including patient portals, to communicate about their children's health. Conclusions Caregivers of Spanish-speaking children encounter many language-specific barriers, which are compounded by non-language-specific barriers arising from complex health systems and social needs. Caregivers with limited resources described working hard to meet children's complex health care needs despite these barriers. Most caregivers had internet access and interest in patient portals. Academic medical centers may need multifaceted interventions that improve the availability of bilingual staff and interpreters and also address caregivers' social and informational needs.

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Section: Article In Pressmentioning

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%