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Comparing Remote Interpreter Modalities in the Pediatric Emergency Department

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ClinicalTrials.gov Identifier: NCT01986179
Recruitment Status : Completed
First Posted : November 18, 2013
Last Update Posted : May 20, 2015
Sponsor:
Information provided by (Responsible Party):
K. Casey Lion, Seattle Children's Hospital

Brief Summary:

Professional interpretation improves quality of care for patients with limited English proficiency (LEP). However, many health care settings lack access to professional interpreters, and even in locations with good access, logistical factors and perceived barriers have limited their widespread use. Remote methods of professional interpretation, including telephone and video, hold great promise for expanding access, but only limited data exist on the relative impacts of these modalities on patient care and provider uptake. Comparing how these modalities impact multiple aspects of health care quality, including family comprehension, provider communication, and consistency of provider interpreter use will inform dissemination of strategies for delivery of safe, efficient, and equitable care to LEP families.

Aim 1: To determine whether randomly assigned remote interpreter modality (telephone versus video) impacts parent-reported quality of communication and interpretation, diagnosis comprehension, and length of stay (LOS) among LEP Spanish-speaking families seen in a pediatric Emergency Department (ED).

Hypothesis 1: Parent-reported quality of communication and interpretation and parent diagnosis comprehension will be higher among families assigned to video interpretation compared to telephone interpretation.

Hypothesis 2: LOS will not differ between families assigned to video and telephone interpretation.

Aim 2: To determine whether assigned interpreter modality is associated with provider decision to communicate without professional interpretation.

Hypothesis 3: Parent-reported provider communication without professional interpretation (e.g. using the patient or a family member to interpret for some part of the visit) will be lower for families assigned to video interpretation compared to telephone interpretation.


Condition or disease Intervention/treatment Phase
Limited English Proficient Patients and Families Other: Telephone Interpretation Other: Video Interpretation Not Applicable

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 208 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary Purpose: Health Services Research
Official Title: Impact of Remote Interpreter Modality on Comprehension, Communication Quality, and Consistency of Interpreter Use in the Pediatric Emergency Department
Study Start Date : February 2014
Actual Primary Completion Date : August 2014
Actual Study Completion Date : August 2014

Arm Intervention/treatment
Active Comparator: Telephone Interpretation
These families will be assigned to use telephone interpretation throughout the ED visit.
Other: Telephone Interpretation
Professional interpretation provided over the phone by a national network of certified medical interpreters

Experimental: Video Interpretation
These families will be assigned to use video interpretation throughout the ED visit.
Other: Video Interpretation
Professional interpretation provided over video by a national network of certified medical interpreters




Primary Outcome Measures :
  1. Communication Quality [ Time Frame: Once, 1-7 days after the ED visit ]
    We will use the Consumer Assessment of Healthcare Providers and Systems (CAHPS) Child Visit Survey 2.0 communication composite, which includes 5 items.

  2. Interpretation Quality [ Time Frame: Once, 1-7 days after ED visit ]
    Interpretation quality will be measured with the Interpreter Satisfaction Survey (7 items).

  3. Diagnosis Comprehension [ Time Frame: Once, 1-7 days after ED visit ]
    Parents will be asked to name their child's diagnosis. Clinician-recorded diagnosis will be obtained from chart review for comparison. Responses will be classified as correct, incorrect, or vague/incomplete, using a method we have employed previously.

  4. Consistency of Interpreter Use [ Time Frame: Once, 1-7 days after ED visit ]
    Parents will be asked to report on the frequency with which providers used each of a list of potential communication methods (e.g. telephone interpreter, family or friend, spoke in English without an interpreter present). Response options are never, sometimes, frequently, or always.


Secondary Outcome Measures :
  1. Length of ED stay [ Time Frame: Once, after ED visit ]
    Time from arrival in Emergency Department to discharge home or admission to the hospital.



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Ages Eligible for Study:   up to 18 Years   (Child, Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Preferred language for medical care of Spanish
  • At least one primary caregiver requires interpretation
  • Presenting to Seattle Children's ED during recruiting hours

Exclusion Criteria:

  • Triage level 1 (life-threatening illness)
  • No parent or legal guardian present
  • Reason for visit is concern for abuse
  • reason for visit is primary behavioral or psychiatric complaint

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT01986179


Locations
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United States, Washington
Seattle Children's Hospital Emergency Department
Seattle, Washington, United States, 98105
Sponsors and Collaborators
Seattle Children's Hospital
Investigators
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Principal Investigator: K. Casey Lion, MD, MPH Seattle Children's Hospital
Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
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Responsible Party: K. Casey Lion, Assistant Professor of Pediatrics, Seattle Children's Hospital
ClinicalTrials.gov Identifier: NCT01986179    
Other Study ID Numbers: 14647
First Posted: November 18, 2013    Key Record Dates
Last Update Posted: May 20, 2015
Last Verified: May 2015
Additional relevant MeSH terms:
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Emergencies
Disease Attributes
Pathologic Processes