Developing an audio-based communication tool for NICU discharge of Latino families with limited English proficiency |
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| Institution: | 1. Johns Hopkins School of Medicine, Department of Pediatrics, 1800 Orleans St., Baltimore, MD 21287, United States;2. Johns Hopkins Berman Institute of Bioethics, 1809 Ashland Ave, Baltimore, MD 21205, United States;3. Johns Hopkins Bloomberg School of Public Health, 615N Wolfe St., Baltimore, MD 21205, United States;1. Division of Pharmacy, School of Allied Health, The University of Western Australia, Perth, Australia;2. Pharmacy Department, Perth Children’s Hospital, Perth, Australia;3. Department of Anaesthesia and Pain Management, Perth Children’s Hospital, Perth, Australia;4. Perioperative Medicine, Telethon Kids Institute, Perth Australia;5. Division of Emergency Medicine, Anaesthesia and Pain Medicine, The University of Western Australia, Perth, Australia;6. Pharmacy Department, Sir Charles Gairdner Hospital, Nedlands, Australia;1. Department of Family Medicine and Siaal Research Center for Family Practice and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheba, Israel and Clalit Health Services, Southern District, Beer-Sheba, Israel;2. Department of Counseling and Human Development, University of Haifa, Haifa, Israel;1. College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA;2. Department of Sociology, University of Nebraska-Lincoln, Lincoln, NE, USA;3. Department of Sociology and Anthropology, Southern Oregon University, Ashland, OR, USA;1. Center for Adaptive Rationality, Max Planck Institute for Human Development, Berlin, Germany;2. Institute for Medical Sociology & Rehabilitation Science, Charité – University Hospital Berlin, Berlin, Germany;3. Drug Commission of the German Medical Association, Berlin, Germany;4. Center for Anesthesiology and Intensive Care Medicine, Charité – Universitätsmedizin Berlin, Germany;1. Department of Nursing Science, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia;2. Department of Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur Malaysia;1. Division of General Internal Medicine, Zuckerberg San Francisco General Hospital, University of California San Francisco, San Francisco, CA, USA;2. Center for Vulnerable Populations, University of California San Francisco, San Francisco, CA, USA;3. Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA |
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| Abstract: | ObjectiveResearch shows NICU Latino parents with limited English proficiency (LEP) feel less comfortable asking questions and participating in medical decision-making, which may negatively affect transition to community healthcare. Question prompt lists (QPL), suggested questions sometimes drawn from families and providers, can improve family-centered communication. We explored clinician and parent perceptions to inform development of and pilot a NICU discharge QPL.MethodsFocus groups with NICU and primary care providers explored perceived educational needs of Latino parents LEP and barriers to effective transition to community healthcare. Semi-structured interviews with Latino parents LEP explored perceptions of knowledge gaps and recommendations to improve the transition process. A Spanish audio QPL for parents and an English written version for providers were developed and pilot tested for acceptability.ResultsProvider focus groups (n = 27) and parent interviews (n = 19) identified themes: decreased parent activation, knowledge gaps, limited-use interpreters, unfamiliarity with healthcare system, and social isolation as barriers to smooth NICU-to-home transition. Providers (n = 11) and parents (n = 10) favored QPL introduction early in NICU admission, finding it useful to improve communication and transition processes for families.ConclusionOur QPL may address challenges faced by Latino parents LEP when transitioning home.Practice implicationsQPLs may improve Latino NICU infants’ healthcare outcomes. |
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| Keywords: | NICU Latino NICU parent NICU Latino parent NICU discharge LEP limited English proficiency QPL Question Prompt List communication |
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